Prototype Standard Prototype Standard Taxable Form

Attachment C-1
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

Prototype Standard Taxable Form

2012 ECONOMIC CENSUS

U.S. DEPARTMENT OF COMMERCE
Economics and Statistics Administration

U.S. CENSUS BUREAU

Legal Services

FORM

PS-54101

OMB No. 0607-0934: Approval Expires

(DRAFT)

(Please correct any errors in this mailing address.)

DUE DATE
FEBRUARY 12, 2013
Need help or have questions?
• Read the accompanying information sheet(s) before
answering the questions.
• Visit

PS-54101

census.gov/econhelp

• Call 1-800-233-6136, between 8:00 a.m. and 6:00 p.m.,
Eastern time, Monday through Friday.

Report Online - It's fast and secure!
Go to:
census.gov/econhelp

U.S. CENSUS BUREAU
1201 East 10th Street
Jeffersonville, IN 47134-0001

Mail your
completed
form to:

- OR -

YOUR RESPONSE IS REQUIRED BY LAW. Title 13, United States Code, requires businesses and other organizations
that receive this questionnaire to answer the questions and return the report to the U.S. Census Bureau. By the same
law, YOUR CENSUS REPORT IS CONFIDENTIAL. It may be seen only by persons sworn to uphold the confidentiality
of Census Bureau information and may be used only for statistical purposes. Further, copies retained in respondents'
files are immune from legal process.
• Use blue or black ballpoint pen.
• Do not use pencil or felt-tip pen.
• Do not put slashes through 0 or 7.

• Please center numbers in
their respective boxes.
• Place an "X" inside the box.

Examples:

The reporting unit for this form is an establishment. An establishment is generally a single physical location
where business is conducted or where services or industrial operations are performed. For further clarification, see
information sheet(s).
1

EMPLOYER IDENTIFICATION NUMBER
Is the Employer Identification Number (EIN) shown in the mailing address the same as the one used for this
establishment on its latest 2012 Internal Revenue Service Form 941, Employer's Quarterly Federal Tax Return?

54101019

0021

2

Yes - Go to

2

No - Enter current EIN (9 digits)

0022

-

0025

PHYSICAL LOCATION
A. Is this establishment's physical location the same as shown in the mailing address?
(P.O. Box and rural route addresses are not physical locations.)
0031

0032

Yes - Go to line B
No - Enter
physical
location

0035

Number and street

0036

City, town, village, etc.

0037

State

0038

ZIP Code

CONTINUE WITH
PENALTY FOR FAILURE TO REPORT

2

ON PAGE 2
CONTINUE ON PAGE 2

Form PS-54101
2

Page 2

(DRAFT)

PHYSICAL LOCATION - Continued
B. Is this establishment physically located inside the legal boundaries of the city, town, village, etc.?
(Mark "X" only ONE box.)
0041

Yes

No

0042

0043

No legal boundaries

0044

Do not know

0024

Do not know

C. In what type of municipality is this establishment physically located?
(Mark "X" only ONE box.)
0046

3

City, village,
or borough

Town or township

0047

0048

Other

OPERATIONAL STATUS
Which ONE of the following best describes this establishment's operational status at the end of 2012?
(Mark "X" only ONE box.)
0011

In operation

0013

Temporarily or seasonally inactive

0014

Ceased operation - Give date at right

0015

Sold or leased to another operator - Give date at right
AND enter name and address of new owner or operator
and Employer Identification Number (EIN) below
0060

Month

Day

Year

0018

Name of new owner or operator

0061

EIN (9 digits)

0062

Mailing address (Number and street, P.O. Box, etc.)

0063

City, town, village, etc.

0064

State

0065

ZIP Code

-

0016

4

Other - Specify

0815

Mark "X"
if None

MONTHS IN OPERATION

54101027

Number of months in operation during 2012 (If none, mark "X" and go to

HOW TO
REPORT
DOLLAR
FIGURES

5

30 .)

Mark "X"
if None

Dollar figures should be rounded to
thousands of dollars.
If a figure is $2,035,628.79:

Report

If a value is "0" (or less than $500.00):

Report

$ Bil.

0002

2012
Mil.

2

Thou.

0

3

6

EXAMPLE

SALES, SHIPMENTS, RECEIPTS, OR REVENUE
Operating receipts (Legal aid societies should report total revenue, including
contributions, gifts, and grants.) . . . . . . . . . . . . . . . . . . . . . .

6

. . . . . . . . . .

2012
Number

Mark "X"
if None $ Bil.

2012
Mil.

Thou.

Dol.

0100

Not Applicable.

CONTINUE ON PAGE 3

Form PS-54101

Page 3

(DRAFT)

If not shown, please enter your 11-digit Census File
Number (CFN) from the mailing address.
7

EMPLOYMENT AND PAYROLL
Include:
• Full- and part-time employees working at this establishment whose payroll was reported on Internal Revenue
Service Form 941, Employer's Quarterly Federal Tax Return, and filed under the Employer Identification Number
(EIN) shown in the mailing address or corrected in 1 .
Exclude:
• Temporary staffing obtained from a staffing service.
• Contractors, subcontractors, or independent contractors.
• Full- or part-time leased employees whose payroll was filed under an employee leasing company's EIN.
• Purchased or managed services, such as janitorial, guard, or landscape services.
• Professional or technical services purchased from another firm, such as software consulting, computer
programming, engineering, or accounting services.
2012
Number

Mark "X"
if None

For further clarification, see information sheet(s).
A. Number of employees for pay period including March 12 . . . . . . . . . . .
B. Payroll before deductions
(Exclude employer's cost for fringe benefits.)

0320

Mark "X"
if None

1. Annual payroll . . . . . . . . . . . . . . . . . . . . . . . .

0300

2. First quarter payroll (January-March, 2012)

0310

. . . . . . . . . .

$ Bil.

2012
Mil.

Thou.

8 – 18 Not Applicable.
19 KIND OF BUSINESS OR ACTIVITY
Which ONE of the following best describes this establishment's principal kind of business or activity in 2012?
If none of the provided selections seem appropriate, provide a specific description of the primary business activity.
Mark "X" only ONE box.
Offices of lawyers
0700

541 110 10 1

Law partnership or professional corporation/association, or individual lawyer or attorney
engaged in private practice

541 110 20 1

Legal aid societies and similar legal services

54101035

All other legal services
541 191 00 1

Title abstract or settlement offices

541 199 00 2

Notary public services

541 199 00 3

Paralegal services

541 199 00 1

Patent agent services

523 991 00 5

Trustee in bankruptcy

541 199 00 4

Process servers

Other kind of business or activity
773 000 00 1

Other kind of business or activity - Describe

0701

CONTINUE ON PAGE 4

Form PS-54101

Page 4

(DRAFT)

20 CLASS OF CUSTOMER
Estimate the percentage of receipts (reported in

5

2012

) by class of customer.

Whole percent
of receipts

1. Business firms and farms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

3108

2. Not-for-profit organizations (Include religious organizations) . . . . . . . . . . . . . . . . . . .

3107

3. Federal government . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

3105

4. State and local governments

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

3106

5. Individuals (Include receipts from individually owned businesses on line 1.) . . . . . . . . . . .

3100

6. TOTAL . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

%
%
%
%
%
1 0 0 %

21 SUPPORT SERVICES
Was this establishment primarily engaged in providing management, administrative, or support services to other
establishments of your enterprise (rather than for the general public or other business firms) in 2012?
0998

Yes

0999

No

HOW TO
REPORT
PERCENTS

2012
Report thousands of dollars OR whole percents.
Estimates are acceptable.
$ Bil.
Mil.
Thou.
Percent

Percents should be reported in
whole percents.

If figure is 38.76% of total sales: Report

3

9

22 DETAIL OF SALES, SHIPMENTS, RECEIPTS, OR REVENUE
(Report receipts by source either as a dollar figure or as a whole percent of total receipts (reported in 5 ). See HOW TO
REPORT DOLLAR FIGURES on page 2 and HOW TO REPORT PERCENTS above. Do not combine data for two or more
receipts lines.)
Line 1 - Report receipts from the practice of criminal law on the appropriate line(s). Include reimbursement of expenses
incurred for clients.
Line 2 - Report receipts from the practice of civil law on the appropriate line(s). Include reimbursement of expenses
incurred for clients.
Line 4a - Report receipts from researching public land records to gather information relating to real estate titles;
preparing documents necessary for the transfer of the title, financing, and settlement; conducting final real estate
settlements and closings; and filing legal and other documents relating to the sale of real estate.
Line 4b - Report receipts from document filing and search services. Report all document preparation on line 4c.
Line 5 - Report receipts from the serving of legal documents. Include all forms of writs, warrants, summons, citations,
libels, and orders used in judicial proceedings.
Line 11 - Report distributions from law partnerships to individual lawyers who are members of the partnership and
organized as professional service corporations/associations. Report fees for legal services provided directly to clients on
the appropriate detail lines under lines 1 and 2.

54101043

2012
Census
use

Description of sales, shipments, receipts, or revenue

Estimates are acceptable.
Report dollars OR percents.
$ Bil.

0723

0720

1.

Legal services, criminal law . . . . . . . . . . . . . . . . . . . . . . . . . . .

2.

Legal services, civil law
a. Real estate law

36370

b. Wills, estates, and trusts . . . . . . . . . . . . . . . . . . . . . . . . . . .

36380

22

Mil.

Thou.

Dol.

Percent
0722

36710

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

CONTINUE WITH

0721

ON PAGE 5
CONTINUE ON PAGE 5

Form PS-54101

Page 5

(DRAFT)

If not shown, please enter your 11-digit Census File
Number (CFN) from the mailing address.
22 DETAIL OF SALES, SHIPMENTS, RECEIPTS, OR REVENUE - Continued
2012
Census
use

Description of sales, shipments, receipts, or revenue

Estimates are acceptable.
Report dollars OR percents.
$ Bil.

0723

2.

0720

0721

Mil.

Thou.

Dol.

Percent
0722

Legal services, civil law - Continued
c. Family law

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

36390

d. Business and commercial law
(1)

Bankruptcy law

. . . . . . . . . . . . . . . . . . . . . . . . . . . . .

36401

(2)

Intellectual property law . . . . . . . . . . . . . . . . . . . . . . . .

36402

(3)

Taxation law . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

36403

(4)

Other business and commercial law, including antitrust,
incorporation, banking, securities, and insurance law - Describe

36404

(5)

Sum lines 2d(1) through 2d(4)

. . . . . . . . . . . . . . . . . .

36400

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

36410

f. Labor and employment law . . . . . . . . . . . . . . . . . . . . . . . . .

36420

e. Civil negligence

g. Other civil law
(1)

Environmental law

(2)

Public and international

(3)

Health care law

(4)
(5)
3.

. . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . .

36432

. . . . . . . . . . . . . . . . . . . . . . . . . . . . .

36433

Other civil law, including immigration/refugee, consumer, and
other non-criminal law . . . . . . . . . . . . . . . . . . . . . . . . .

36434

Sum lines 2g(1) through 2g(4)

36430

. . . . . . . . . . . . . . . . . .

Arbitration and mediation services

54101050

a. Arbitration and mediation services, international commercial

4.

36431

. . . .

36731

b. Arbitration and mediation services, excluding international
commercial . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

36732

c. Sum lines 3a and 3b . . . . . . . . . . . . . . . . . . . . . . . . . . . .

36730

Legal research and document services
a. Title, abstract, and settlement services

. . . . . . . . . . . . . . . . . .

36741

b. Patent, copyright, and other intellectual property document filing
. . . . . . . . . . . . . . . . . . . . . . . . . . . . .
and search services

36742

CONTINUE WITH

22

ON PAGE 6

CONTINUE ON PAGE 6

Form PS-54101

Page 6

(DRAFT)

22 DETAIL OF SALES, SHIPMENTS, RECEIPTS, OR REVENUE - Continued
2012
Description of sales, shipments, receipts, or revenue

Census
use

Estimates are acceptable.
Report dollars OR percents.
$ Bil.

0723

4.

0720

Mil.

Thou.

0721

Dol.

Percent
0722

Legal research and document services - Continued
c. Other document filing and search services . . . . . . . . . . . . . . . .

36743

d. Sum lines 4a through 4c

. . . . . . . . . . . . . . . . . . . . . . . . .

36740

5.

Process server services

. . . . . . . . . . . . . . . . . . . . . . . . . . . . .

36750

6.

Notarization and certification services . . . . . . . . . . . . . . . . . . . . .

36760

7.

Legal translation services

36770

8.

Appraisal services, except real estate

. . . . . . . . . . . . . . . . . . . . .

37970

9.

Seizure and execution services . . . . . . . . . . . . . . . . . . . . . . . . .

36790

10. Expert witness services

. . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . .

36800

11. Distributions from law partnerships to professional corporations/
associations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

36810

12. All other operating receipts - Describe if more than 10 percent of total
receipts

39721

13. TOTAL OPERATING RECEIPTS - Sum of lines should equal 5 if
reporting in dollars
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

1 0 0

39850

23 and 24 Not Applicable.
25 EXPORTED SERVICES
NOTE - An exported service is a product (e.g., service performed, license agreement) that is performed for, or sold
or transferred to, a customer or client (individual, government, business establishment, etc.) located outside the
United States (i.e., outside the 50 States, District of Columbia, U.S. Commonwealth Territories, or U.S. possessions).
Include products provided to unaffiliated and affiliated foreign firms (e.g., foreign parent firms, subsidiaries,
branches). Exclude products provided to domestic subsidiaries of foreign firms.

54101068

A. Did the receipts or revenue (reported in
0911

Yes - Go to line B

0912

No - Go to

5

) include any amounts for exported services?

26

B. Amount of receipts or revenue for exported services . . . . . . . . . . .

$ Bil.

2012
Mil.

Thou.

0914

CONTINUE ON PAGE 7

Form PS-54101

Page 7

(DRAFT)

If not shown, please enter your 11-digit Census File
Number (CFN) from the mailing address.
26 SPECIAL INQUIRIES
A. PERSONNEL BY OCCUPATION
Enter employment reported on IRS Form 941, Employer's Quarterly Federal Tax Return, by occupation. The
total should equal the number reported in 7 , line A.
Enter personnel who perform a variety of functions (secretaries, etc.) on the one line which best describes the
primary nature of their work.
Line 1 - Lawyers who are members of a professional service corporation should be included here. The
proprietor or partners not considered employees of the firm for federal tax purposes should be included in B,
PROPRIETORS AND PARTNERS OF UNINCORPORATED BUSINESSES.
Census
use

1. Associate lawyers (employees of firm)

. . . . . . . . . . . . . . . . . . . . . . . .

3231

2. Paraprofessionals (law clerks, legal assistants, investigators, etc.) . . . . . . . . . . . .

3232

3. Managers and other non-legal professional staff . . . . . . . . . . . . . . . . . . . .

3233

4. All other (stenographers, bookkeepers, etc.) . . . . . . . . . . . . . . . . . . . . . .

3234

5. TOTAL (Add lines 1 through 4. Total should equal

3200

7

, line A.) . . . . . . . . . . . . .

Number of
employees for pay
period including
March 12, 2012

B. PROPRIETORS AND PARTNERS OF UNINCORPORATED BUSINESSES
Unincorporated businesses should report each proprietor or partner not considered employees for federal
tax purposes at this location. For businesses operating at more than one location, report the proprietor or
partners at the location where they spend most of their working time.
2012
Mark "X" Number for the pay
if None
period including
March 12

Active proprietor or partners at this location . . . . . . . . . . . . . . . . . . . .

3260

C. EXPENSES OF LEGAL AID SOCIETIES
Total operating expenses, including payroll and fringe benefits, rent,
depreciation, business and property taxes, and other overhead.
(Exclude capital expenditures, funds invested, losses from the sale of assets,
interest paid, and bad debt.) . . . . . . . . . . . . . . . . . . . . . . . . .

2012
$ Bil.

Mil.

Thou.

Dol.

3520

D. FRANCHISE

54101076

Was this establishment operating under a trademark authorized by a franchisor in 2012?
(Mark "X" only ONE box.)
0237

Yes - franchisee owned establishment

0238

Yes - franchisor owned establishment

0239

No

27 – 29 Not Applicable.

CONTINUE ON PAGE 8

Form PS-54101

Page 8

(DRAFT)

REMARKS (Please use this space for any explanations that may be essential in understanding your reported data.)

$$CENSUS_REMARKS$$

30 CERTIFICATION - This report is substantially accurate and was prepared in accordance with the instructions.
Is the time period covered by this report a
calendar year?

54101084

Yes

Month

No - Enter time period covered

Telephone

-

Year

TO
Title

Number

-

Month

FROM

Name of person to contact regarding this report

Area code

Year

Extension

-

Area code

Fax

E-mail address

Number

Month

Day

Date
completed

Thank you for completing your 2012 ECONOMIC CENSUS form.
PLEASE PHOTOCOPY THIS FORM FOR YOUR RECORDS AND RETURN THE ORIGINAL.

Year