Ownership or Contr Ownership or Control Fliers

Attachment C-13
2012 Economic Census

Information; Professional, Scientific, and Technical Services; Management of
Companies and Enterprises; Administrative and Support and Waste Management
and Remediation Services; Educational Services; Health Care and Social
Assistance; Arts, Entertainment, and Recreation; and Other Services (Except Public
Administration) Sectors

Ownership and Control Fliers

STANDARD
A. Is your company owned or controlled by another domestic company
OR
does your company operate at more than one physical location?
Yes - Complete lines B and C and return this form with your completed 2012 Economic Census form.
No - Discard this form (NC-99510) and return your completed 2012 Economic Census form.
B. Ownership or control
1. Does another domestic company own more than 50 percent of the voting stock of your company or have the power
to control the management and policies of your company?
Yes - Enter the following information of the owning or controlling company
Name of owning or controlling company

Enter Employer Identification
Number (EIN) of owning or
controlling company (9 digits)

No - Go to line C

-

Home office address (Number and street)

City, town, village, etc.

State

ZIP Code

2. What percent of voting stock was held by the owning or controlling company? (Mark "X" only ONE box.)
Less than 50%

50%

More than 50%
2012
Number

C. Number of establishments operated at the end of 2012 under the EIN shown in the mailing address
or as corrected in 1 on the first page of the 2012 Economic Census form . . . . . . . . . . . . . .
If more than one establishment:
• Provide the physical location address and other information requested on the back of this form for each location.
• Provide the headquarters location first, followed by all other locations.
• Data for establishments operated during 2012, but not in operation at the end of the year, should be included with
the headquarters location.
• The sum of sales, shipments, receipts, or revenue for all locations should equal the amount reported in 5 of the
2012 Economic Census form.
• The sum of employment and payroll for all locations should equal the amounts reported in 7 of the 2012 Economic
Census form.
• For employees that worked at more than one location, report the employment and payroll data for the employees at
the ONE location where they spent most of their working time.

CONTINUE WITH LINE C ON PAGE 2

STANDARD
C. Number of establishments operated at the end of 2012 under the EIN shown in the mailing address or as corrected in
on the first page of the 2012 Economic Census form - Continued

1

BEFORE YOU BEGIN: If this EIN had more than 3 physical locations at the end of 2012, copy this page and provide the
requested data for all of your locations.
Name

2012
Estimates are acceptable
$ Bil.
Mil.
Thou.

Secondary name

Store or plant No. Sales, shipments, receipts, or
revenue . . . . . . . . . . . .
2012
Estimates are acceptable
Number

Physical location (Number and street)
Number of employees for pay
period including March 12 . . .

1 City, town, village, etc.

$ Bil.
State

Mil.

Thou.

First quarter payroll (JanuaryMarch 2012) . . . . . . . . . .

ZIP Code

-

Annual payroll . . . . . . . . .

Describe kind of business at this location

Name

2012
Estimates are acceptable
$ Bil.
Mil.
Thou.

Secondary name

Store or plant No. Sales, shipments, receipts, or
revenue . . . . . . . . . . . .
2012

Physical location (Number and street)

Estimates are acceptable
Number
Number of employees for pay
period including March 12 . . .

2 City, town, village, etc.

$ Bil.
State

Mil.

Thou.

First quarter payroll (JanuaryMarch 2012) . . . . . . . . . .

ZIP Code

-

Annual payroll . . . . . . . . .

Describe kind of business at this location

Name

2012
Estimates are acceptable
$ Bil.
Mil.
Thou.

Secondary name

Store or plant No. Sales, shipments, receipts, or
revenue . . . . . . . . . . . .
2012
Estimates are acceptable
Number

Physical location (Number and street)
Number of employees for pay
period including March 12 . . .

3 City, town, village, etc.

$ Bil.
State

First quarter payroll (JanuaryMarch 2012) . . . . . . . . . .

ZIP Code

Describe kind of business at this location

Annual payroll . . . . . . . . .

Mil.

Thou.

PS-54103, PS-54105, PS-54112
A. Is your company owned or controlled by another domestic company
OR
does your company operate at more than one physical location?
Yes - Complete lines B and C and return this form with your completed 2012 Economic Census form.
No - Discard this form (NC-99554) and return your completed 2012 Economic Census form.
B. Ownership or control
1. Does another domestic company own more than 50 percent of the voting stock of your company or have the power
to control the management and policies of your company?
Yes - Enter the following information of the owning or controlling company
Name of owning or controlling company

Enter Employer Identification
Number (EIN) of owning or
controlling company (9 digits)

No - Go to line C

-

Home office address (Number and street)

City, town, village, etc.

State

ZIP Code

2. What percent of voting stock was held by the owning or controlling company? (Mark "X" only ONE box.)
Less than 50%

50%

More than 50%
2012
Number

C. Number of establishments operated at the end of 2012 under the EIN shown in the mailing address or
as corrected in 1 on the first page of the 2012 Economic Census form . . . . . . . . . . . . . . .
If more than one establishment:
• Provide the physical location address and other information requested on the back of this form for each location.
• Provide the headquarters location first, followed by all other locations.
• Temporary branch or field offices should not be considered separate locations. Data for such sites should be included
with the controlling headquarters or branch location.
• Data for establishments operated during 2012, but not in operation at the end of the year, should be included with
the headquarters location.
• The sum of sales, shipments, receipts, or revenue for all locations should equal the amount reported in 5 of the
2012 Economic Census form.
• The sum of employment and payroll for all locations should equal the amounts reported in 7 of the 2012 Economic
Census form.
• For employees that worked at more than one location, report the employment and payroll data for the employees at
the ONE location where they spent most of their working time.

CONTINUE WITH LINE C ON PAGE 2

PS-54103, PS-54105, PS-54112
C. Number of establishments operated at the end of 2012 under the EIN shown in the mailing address or as corrected in
on the first page of the 2012 Economic Census form - Continued

1

BEFORE YOU BEGIN: If this EIN had more than 3 physical locations at the end of 2012, copy this page and provide the
requested data for all of your locations.
Name

2012
Estimates are acceptable
$ Bil.
Mil.
Thou.

Secondary name

Store or plant No. Sales, shipments, receipts, or
revenue . . . . . . . . . . . .
2012
Estimates are acceptable
Number

Physical location (Number and street)
Number of employees for pay
period including March 12 . . .

1 City, town, village, etc.

$ Bil.
State

Mil.

Thou.

First quarter payroll (JanuaryMarch 2012) . . . . . . . . . .

ZIP Code

-

Annual payroll . . . . . . . . .

Describe kind of business at this location

Name

2012
Estimates are acceptable
$ Bil.
Mil.
Thou.

Secondary name

Store or plant No. Sales, shipments, receipts, or
revenue . . . . . . . . . . . .
2012

Physical location (Number and street)

Estimates are acceptable
Number
Number of employees for pay
period including March 12 . . .

2 City, town, village, etc.

$ Bil.
State

Mil.

Thou.

First quarter payroll (JanuaryMarch 2012) . . . . . . . . . .

ZIP Code

-

Annual payroll . . . . . . . . .

Describe kind of business at this location

Name

2012
Estimates are acceptable
$ Bil.
Mil.
Thou.

Secondary name

Store or plant No. Sales, shipments, receipts, or
revenue . . . . . . . . . . . .
2012
Estimates are acceptable
Number

Physical location (Number and street)
Number of employees for pay
period including March 12 . . .

3 City, town, village, etc.

$ Bil.
State

First quarter payroll (JanuaryMarch 2012) . . . . . . . . . .

ZIP Code

Describe kind of business at this location

Annual payroll . . . . . . . . .

Mil.

Thou.

PS-54101
A. Is your company owned or controlled by another domestic company
OR
does your company operate at more than one physical location?
Yes - Complete lines B and C and return this form with your completed 2012 Economic Census form.
No - Discard this form (NC-99557) and return your completed 2012 Economic Census form.
B. Ownership or control
1. Does another domestic company own more than 50 percent of the voting stock of your company or have the power
to control the management and policies of your company?
Yes - Enter the following information of the owning or controlling company
Name of owning or controlling company

Enter Employer Identification
Number (EIN) of owning or
controlling company (9 digits)

No - Go to line C

-

Home office address (Number and street)

City, town, village, etc.

State

ZIP Code

2. What percent of voting stock was held by the owning or controlling company? (Mark "X" only ONE box.)
Less than 50%

50%

More than 50%
2012
Number

C. Number of establishments operated at the end of 2012 under the EIN shown in the mailing address or
as corrected in 1 on the first page of the 2012 Economic Census form . . . . . . . . . . . . . . .
If more than one establishment:
• Provide the physical location address and other information requested on the back of this form for each location.
• Provide the headquarters location first, followed by all other locations.
• Temporary or special purpose offices of law firms should not be considered separate establishments for the purpose
of this report. Data for such locations should be included with the controlling headquarters or branch location.
• Data for establishments operated during 2012, but not in operation at the end of the year, should be included with
the headquarters location.
• The sum of sales, shipments, receipts, or revenue for all locations should equal the amount reported in 5 of the
2012 Economic Census form.
• The sum of employment and payroll for all locations should equal the amounts reported in 7 of the 2012 Economic
Census form.
• For employees that worked at more than one location, report the employment and payroll data for the employees at
the ONE location where they spent most of their working time.
• Legal aid societies should report total revenue, including contributions, gifts, and grants, in the space provided for
sales, shipments, receipts, or revenue.

CONTINUE WITH LINE C ON PAGE 2

PS-54101
C. Number of establishments operated at the end of 2012 under the EIN shown in the mailing address or as corrected in
on the first page of the 2012 Economic Census form - Continued

1

BEFORE YOU BEGIN: If this EIN had more than 3 physical locations at the end of 2012, copy this page and provide the
requested data for all of your locations.
Name

2012
Estimates are acceptable
$ Bil.
Mil.
Thou.

Secondary name

Store or plant No. Sales, shipments, receipts, or
revenue . . . . . . . . . . . .
2012
Estimates are acceptable
Number

Physical location (Number and street)
Number of employees for pay
period including March 12 . . .

1 City, town, village, etc.

$ Bil.
State

Mil.

Thou.

First quarter payroll (JanuaryMarch 2012) . . . . . . . . . .

ZIP Code

-

Annual payroll . . . . . . . . .

Describe kind of business at this location

Name

2012
Estimates are acceptable
$ Bil.
Mil.
Thou.

Secondary name

Store or plant No. Sales, shipments, receipts, or
revenue . . . . . . . . . . . .
2012

Physical location (Number and street)

Estimates are acceptable
Number
Number of employees for pay
period including March 12 . . .

2 City, town, village, etc.

$ Bil.
State

Mil.

Thou.

First quarter payroll (JanuaryMarch 2012) . . . . . . . . . .

ZIP Code

-

Annual payroll . . . . . . . . .

Describe kind of business at this location

Name

2012
Estimates are acceptable
$ Bil.
Mil.
Thou.

Secondary name

Store or plant No. Sales, shipments, receipts, or
revenue . . . . . . . . . . . .
2012
Estimates are acceptable
Number

Physical location (Number and street)
Number of employees for pay
period including March 12 . . .

3 City, town, village, etc.

$ Bil.
State

First quarter payroll (JanuaryMarch 2012) . . . . . . . . . .

ZIP Code

Describe kind of business at this location

Annual payroll . . . . . . . . .

Mil.

Thou.

HC-62104, HC-62105
A. Is your company owned or controlled by another domestic company
OR
does your company operate at more than one physical location?
Yes - Complete lines B and C and return this form with your completed 2012 Economic Census form.
No - Discard this form (NC-99562) and return your completed 2012 Economic Census form.
B. Ownership or control
1. Does another domestic company own more than 50 percent of the voting stock of your company or have the power
to control the management and policies of your company?
Yes - Enter the following information of the owning or controlling company
Name of owning or controlling company

Enter Employer Identification
Number (EIN) of owning or
controlling company (9 digits)

No - Go to line C

-

Home office address (Number and street)

City, town, village, etc.

State

ZIP Code

2. What percent of voting stock was held by the owning or controlling company? (Mark "X" only ONE box.)
Less than 50%

50%

More than 50%
2012
Number

C. Number of establishments operated at the end of 2012 under the EIN shown in the mailing address or
as corrected in 1 on the first page of the 2012 Economic Census form . . . . . . . . . . . . . . .
If more than one establishment:
• Provide the physical location address and other information requested on the back of this form for each location.
• Provide the headquarters location first, followed by all other locations.
• Offices which are not staffed on a full-time basis by at least one employee covered by this EIN should not be
considered separate establishments. Include data for these offices with data reported for the headquarters location.
Practitioners whose main practice is outside the hospital (clinic), but whose practice necessitates using hospital
facilities, should not consider the hospital (clinic) as a separate location (e.g., a surgeon with a private practice
who utilizes hospital facilities). Practitioners who practice solely from hospitals or other medical facilities (e.g.,
anesthesiologists, physical therapists) should not consider these facilities as separate office locations.
• Data for establishments operated during 2012, but not in operation at the end of the year, should be included with
the headquarters location.
• The sum of sales, shipments, receipts, or revenue for all locations should equal the amount reported in 5 of the
2012 Economic Census form.
• The sum of employment and payroll for all locations should equal the amounts reported in 7 of the 2012 Economic
Census form.
• For employees that worked at more than one location, report the employment and payroll data for the employees at
the ONE location where they spent most of their working time.

CONTINUE WITH LINE C ON PAGE 2

HC-62104, HC-62105
C. Number of establishments operated at the end of 2012 under the EIN shown in the mailing address or as corrected in
on the first page of the 2012 Economic Census form - Continued

1

BEFORE YOU BEGIN: If this EIN had more than 3 physical locations at the end of 2012, copy this page and provide the
requested data for all of your locations.
Name

2012
Estimates are acceptable
$ Bil.
Mil.
Thou.

Secondary name

Store or plant No. Sales, shipments, receipts, or
revenue . . . . . . . . . . . .
2012
Estimates are acceptable
Number

Physical location (Number and street)
Number of employees for pay
period including March 12 . . .

1 City, town, village, etc.

$ Bil.
State

Mil.

Thou.

First quarter payroll (JanuaryMarch 2012) . . . . . . . . . .

ZIP Code

-

Annual payroll . . . . . . . . .

Describe kind of business at this location

Name

2012
Estimates are acceptable
$ Bil.
Mil.
Thou.

Secondary name

Store or plant No. Sales, shipments, receipts, or
revenue . . . . . . . . . . . .
2012

Physical location (Number and street)

Estimates are acceptable
Number
Number of employees for pay
period including March 12 . . .

2 City, town, village, etc.

$ Bil.
State

Mil.

Thou.

First quarter payroll (JanuaryMarch 2012) . . . . . . . . . .

ZIP Code

-

Annual payroll . . . . . . . . .

Describe kind of business at this location

Name

2012
Estimates are acceptable
$ Bil.
Mil.
Thou.

Secondary name

Store or plant No. Sales, shipments, receipts, or
revenue . . . . . . . . . . . .
2012
Estimates are acceptable
Number

Physical location (Number and street)
Number of employees for pay
period including March 12 . . .

3 City, town, village, etc.

$ Bil.
State

First quarter payroll (JanuaryMarch 2012) . . . . . . . . . .

ZIP Code

Describe kind of business at this location

Annual payroll . . . . . . . . .

Mil.

Thou.

PS-54102
A. Is your company owned or controlled by another domestic company
OR
does your company operate at more than one physical location?
Yes - Complete lines B and C and return this form with your completed 2012 Economic Census form.
No - Discard this form (NC-99563) and return your completed 2012 Economic Census form.
B. Ownership or control
1. Does another domestic company own more than 50 percent of the voting stock of your company or have the power
to control the management and policies of your company?
Yes - Enter the following information of the owning or controlling company
Name of owning or controlling company

Enter Employer Identification
Number (EIN) of owning or
controlling company (9 digits)

No - Go to line C

-

Home office address (Number and street)

City, town, village, etc.

State

ZIP Code

2. What percent of voting stock was held by the owning or controlling company? (Mark "X" only ONE box.)
Less than 50%

50%

More than 50%
2012
Number

C. Number of establishments operated at the end of 2012 under the EIN shown in the mailing address or
as corrected in 1 on the first page of the 2012 Economic Census form . . . . . . . . . . . . . . .
If more than one establishment:
• Provide the physical location address and other information requested on the back of this form for each location.
• Provide the headquarters location first, followed by all other locations.
• Temporary or special purpose offices of accounting, auditing, and bookkeeping services should not be considered
separate locations for the purpose of this report. Data for such locations should be included with the controlling
headquarters or branch location.
• Data for establishments operated during 2012, but not in operation at the end of the year, should be included with
the headquarters location.
• The sum of sales, shipments, receipts, or revenue for all locations should equal the amount reported in 5 of the
2012 Economic Census form.
• The sum of employment and payroll for all locations should equal the amounts reported in 7 of the 2012 Economic
Census form.
• For employees that worked at more than one location, report the employment and payroll data for the employees at
the ONE location where they spent most of their working time.

CONTINUE WITH LINE C ON PAGE 2

PS-54102
C. Number of establishments operated at the end of 2012 under the EIN shown in the mailing address or as corrected in
on the first page of the 2012 Economic Census form - Continued

1

BEFORE YOU BEGIN: If this EIN had more than 3 physical locations at the end of 2012, copy this page and provide the
requested data for all of your locations.
Name

2012
Estimates are acceptable
$ Bil.
Mil.
Thou.

Secondary name

Store or plant No. Sales, shipments, receipts, or
revenue . . . . . . . . . . . .
2012
Estimates are acceptable
Number

Physical location (Number and street)
Number of employees for pay
period including March 12 . . .

1 City, town, village, etc.

$ Bil.
State

Mil.

Thou.

First quarter payroll (JanuaryMarch 2012) . . . . . . . . . .

ZIP Code

-

Annual payroll . . . . . . . . .

Describe kind of business at this location

Name

2012
Estimates are acceptable
$ Bil.
Mil.
Thou.

Secondary name

Store or plant No. Sales, shipments, receipts, or
revenue . . . . . . . . . . . .
2012

Physical location (Number and street)

Estimates are acceptable
Number
Number of employees for pay
period including March 12 . . .

2 City, town, village, etc.

$ Bil.
State

Mil.

Thou.

First quarter payroll (JanuaryMarch 2012) . . . . . . . . . .

ZIP Code

-

Annual payroll . . . . . . . . .

Describe kind of business at this location

Name

2012
Estimates are acceptable
$ Bil.
Mil.
Thou.

Secondary name

Store or plant No. Sales, shipments, receipts, or
revenue . . . . . . . . . . . .
2012
Estimates are acceptable
Number

Physical location (Number and street)
Number of employees for pay
period including March 12 . . .

3 City, town, village, etc.

$ Bil.
State

First quarter payroll (JanuaryMarch 2012) . . . . . . . . . .

ZIP Code

Describe kind of business at this location

Annual payroll . . . . . . . . .

Mil.

Thou.

OS-81203
A. Is your company owned or controlled by another domestic company
OR
does your company operate at more than one physical location?
Yes - Complete lines B and C and return this form with your completed 2012 Economic Census form.
No - Discard this form (NC-99581) and return your completed 2012 Economic Census form.
B. Ownership or control
1. Does another domestic company own more than 50 percent of the voting stock of your company or have the power
to control the management and policies of your company?
Yes - Enter the following information of the owning or controlling company
Name of owning or controlling company

Enter Employer Identification
Number (EIN) of owning or
controlling company (9 digits)

No - Go to line C

-

Home office address (Number and street)

City, town, village, etc.

State

ZIP Code

2. What percent of voting stock was held by the owning or controlling company? (Mark "X" only ONE box.)
Less than 50%

50%

More than 50%
2012
Number

C. Number of establishments operated at the end of 2012 under the EIN shown in the mailing address or
as corrected in 1 on the first page of the 2012 Economic Census form . . . . . . . . . . . . . . .
If more than one establishment:
• Provide the physical location address and other information requested on the back of this form for each location.
• Provide the headquarters location first, followed by all other locations.
• Do not consider branch locations of laundries and drycleaners (including industrial, linen, and diaper supply) that are
only providing pick-up and distribution of finished work as separate establishments. Data for these locations should
be included with the plant in which the work is actually done.
• Data for establishments operated during 2012, but not in operation at the end of the year, should be included with
the headquarters location.
• The sum of sales, shipments, receipts, or revenue for all locations should equal the amount reported in 5 of the
2012 Economic Census form.
• The sum of employment and payroll for all locations should equal the amounts reported in 7 of the 2012 Economic
Census form.
• For employees that worked at more than one location, report the employment and payroll data for the employees at
the ONE location where they spent most of their working time.

CONTINUE WITH LINE C ON PAGE 2

OS-81203
C. Number of establishments operated at the end of 2012 under the EIN shown in the mailing address or as corrected in
on the first page of the 2012 Economic Census form - Continued

1

BEFORE YOU BEGIN: If this EIN had more than 3 physical locations at the end of 2012, copy this page and provide the
requested data for all of your locations.
Name

2012
Estimates are acceptable
$ Bil.
Mil.
Thou.

Secondary name

Store or plant No. Sales, shipments, receipts, or
revenue . . . . . . . . . . . .
2012
Estimates are acceptable
Number

Physical location (Number and street)
Number of employees for pay
period including March 12 . . .

1 City, town, village, etc.

$ Bil.
State

Mil.

Thou.

First quarter payroll (JanuaryMarch 2012) . . . . . . . . . .

ZIP Code

-

Annual payroll . . . . . . . . .

Describe kind of business at this location

Name

2012
Estimates are acceptable
$ Bil.
Mil.
Thou.

Secondary name

Store or plant No. Sales, shipments, receipts, or
revenue . . . . . . . . . . . .
2012

Physical location (Number and street)

Estimates are acceptable
Number
Number of employees for pay
period including March 12 . . .

2 City, town, village, etc.

$ Bil.
State

Mil.

Thou.

First quarter payroll (JanuaryMarch 2012) . . . . . . . . . .

ZIP Code

-

Annual payroll . . . . . . . . .

Describe kind of business at this location

Name

2012
Estimates are acceptable
$ Bil.
Mil.
Thou.

Secondary name

Store or plant No. Sales, shipments, receipts, or
revenue . . . . . . . . . . . .
2012
Estimates are acceptable
Number

Physical location (Number and street)
Number of employees for pay
period including March 12 . . .

3 City, town, village, etc.

$ Bil.
State

First quarter payroll (JanuaryMarch 2012) . . . . . . . . . .

ZIP Code

Describe kind of business at this location

Annual payroll . . . . . . . . .

Mil.

Thou.