SA-42(AGBR) Annual Wholesale Trade Report (Agents, Brokers, Represen

Attachment 2
Page 26 of 33

OMB No. 0607-0195: Approval Expires 9/30/2014
U.S. DEPARTMENT OF COMMERCE
Economics and Statistics Administration

U.S. CENSUS BUREAU
FORM

SA-42(AGBR)

(DRAFT)

2011 ANNUAL WHOLESALE TRADE REPORT
AGENTS, BROKERS, REPRESENTATIVES, AND ELECTRONIC
MARKETS

DUE DATE

Need help or have questions?
Call 1-800-327-4389, option "3"
(8:30 a.m. - 4:30 p.m. ET, M-F)
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.
(Please correct any errors in name, address, and ZIP Code.)

Return via Internet:
census.gov/econhelp/awts

Return via Fax:
1-800-447-4613

To view survey results:
census.gov/wholesale

Username:
Password:
GENERAL INSTRUCTIONS
• This report should cover ALL wholesale distributor establishments in the United States reporting payroll
under the Employer Identification Number (EIN) as referenced in 1 on page 2.
• Include data for auxiliary facilities primarily engaged in supporting services to this EIN's establishment(s)
such as warehouses, garages, and central administrative offices.
• Any significant change in this EIN's operations should be noted in 7 on page 4.
• For establishments sold or acquired in 2011 or 2010, report data only for the period the establishments were
operated by this EIN.
• Estimates are acceptable if book figures are not available.
• Enter "0" where applicable.

42004010

SPECIAL INSTRUCTIONS

CONTINUE ON PAGE 2

Form SA-42(AGBR)
1

Attachment 2
Page 27 of 33
Page 2

(DRAFT)

AGENTS, BROKERS, REPRESENTATIVES, OR ELECTRONIC MARKETS
This report applies to firms that primarily arrange for the sale or purchase of goods owned by others, generally
on a fee or commission basis. Examples include:
• Auction companies
• Commission merchants
• Electronic markets (business to business)
• Import or export agents
• Manufacturers' agents

2

• Manufacturers' representatives
• Merchandise brokers
• Purchasing agents
• Selling agents

FEDERAL EMPLOYER IDENTIFICATION NUMBER (EIN)
Does this firm report payroll under EIN
Yes
EIN (9 digits)
No - Enter current 9-digit EIN AND date payroll was first
reported for this EIN . . . . . . . . . . . . . . . . . . . . . . . . .

Month

3

Day

Year

ORGANIZATIONAL CHANGE
A. Did this EIN experience any acquisitions, sales, mergers, and/or divestitures in 2011 or 2010?
Yes
No - Go to

4

on the next page

B. Which of the following organizational changes occurred in 2011 or 2010?
Check all that apply. If more than one organizational change occurred during the reporting period, explain in
page 4.
Month

Acquisition

Day

7

on

Year

Date of organizational change . . . . . . . . . . . . . . . .
Sale
AND
Merger
Enter detailed information below
Divestiture
Name of company

EIN (9 digits)

Address (Number and street, P.O. Box, etc.)

42004028

City, town, village, etc.

State

ZIP Code

-

CONTINUE ON PAGE 3

Form SA-42(AGBR)
4

Attachment 2
Page 28 of 33
Page 3

(DRAFT)

REPORTING PERIOD
What time period is covered by the data provided in this report?
2011
Beginning Date
Month Day
Year

Calendar year

2010
Beginning Date
Month Day
Year

Fiscal or partial year - Report beginning and ending
dates . . . . . . . . . . . . . . . . . . . . . . . .
Month

5

Ending Date
Day
Year

Month

Ending Date
Day
Year

SALES, RECEIPTS, OR REVENUE
INCLUDE
• All revenue from locations identified in 1
• Receipts from freight, installations, rentals,
maintenance, repairs, alterations, storage, and other
such services
• Excise taxes (such as those on gasoline, liquor, and
tobacco) that are levied on the manufacturer and
included in the cost of products purchased by this
firm

A. What were this EIN's commissions and
selling or listing fees earned in 2011
and 2010? . . . . . . . . . . . . . . .

$ Bil.

EXCLUDE
• Nonoperating receipts (such as interest income,
income from investments, and receipts from the
rental or sale of real estate)
• Taxes (sales, excise, and other) collected directly
from customers and paid directly to a local, state, or
federal tax agency
• Commissions or fees for goods that never entered
the United States
• Receipts from customers for carrying or other credit
changes
• Refunds and allowances for returned products
• The actual value of rebates and discounts granted
to the purchaser, even if granted as an increase in
trade-in allowance

Mil.

2011
Thou.

Dol.

$ Bil.

2010
Thou.

Mil.

Dol.

B. What were product sales of goods
that this EIN owned (took title to),
if any, or other operating revenue
earned in 2011 and 2010? . . . . . . .
C. What were the TOTAL commissions,
fees, sales, and operating revenue in
2011 and 2010? ( 5 A + 5 B = 5 C) . . . .

42004036

D. What was the gross selling value of the
goods this EIN earned commission or
fees for in Item 5 A in 2011 and 2010?
Gross selling value is the total value of
the goods sold
• Include any e-commerce sales conducted
for others
• Exclude commissions and fees reported
in 5 A . . . . . . . . . . . . . . . . .
2011
Percent

E. What was the AVERAGE commission rate earned in 2011 and 2010?
• 5 A divided by 5 D X 100
• Round to the nearest whole percent

. . . . . . . . . .

%

2010
Percent

%

Have questions? Call 1-800-327-4389 (option 3)

CONTINUE ON PAGE 4

Form SA-42(AGBR)
6

Attachment 2
Page 29 of 33
Page 4

(DRAFT)

OPERATING EXPENSES
INCLUDE
• Expenses arising from the normal course of
business, including payroll

What were the total operating
expenses for this EIN's agent, broker,
representative and electronic market
locations ONLY in 2011 and 2010? . . . .

EXCLUDE
• Bad debt/customer related loss
• Purchases of goods for resale or cost of goods sold
• Income taxes
• Taxes (sales, excise, and other) collected directly
from customers and paid directly to a local, State,
or Federal tax agency
• Interest expenses
• Impairment (reduction in value of long-lived assets
due to reappraisal)
• Capitalized expenses (except payroll and fringe
benefits)
• Transfers made within the company

$ Bil.

Mil.

Dol.

$ Bil.

Mil.

2010
Thou.

Dol.

7

REMARKS - Please use this space to explain any significant year-to-year changes, to clarify responses, or indicate where
data were estimated.

8

CONTACT INFORMATION
Name of person to contact regarding this report (Please print)

42004044

2011
Thou.

Area code
Telephone

Number

-

Title

Extension

Area code
Fax

Number

-

Website

THANK YOU
for completing your Annual Wholesale Trade Report.
We suggest you keep a copy for your records.
Public reporting burden for this collection of information is estimated to average 32 minutes per response, including the time for assembling data from existing
records and completing the form. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions
for reducing this burden, to: Paperwork Project 0607-0195, U.S. Census Bureau, 4600 Silver Hill Road, AMSD-3K138, Washington, DC 20233. You may e-mail
comments to [email protected]; use "Paperwork Project 0607-0195" as the subject. Respondents are not required to respond to any information collection
unless it displays a valid approval number from the Office of Management and Budget. This 8-digit number appears in the top right corner of this form.