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pdfU.S. DEPARTMENT OF COMMERCE
OMB No. 0607-0717: Approval Expires 5/31/2014
Economics and Statistics Administration
U.S. CENSUS BUREAU
MONTHLY RETAIL TRADE REPORT
FORM
SM-4512BE-A
(09-14-2012)
Due Date
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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. Under the same law,
information that you report
cannot be used for taxation,
regulation, or investigation and
are exempt from release under
the Freedom of Information Act.
Further, copies of your response
retained in your files are immune
from legal process.
(Please correct any errors in name, address, and ZIP Code.)
Return via Internet:
Return via Fax:
To view Survey Results:
econhelp.census.gov/mrts
1-800-447-4613
census.gov/retail
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GENERAL INSTRUCTIONS
• Any significant change in this firm's operations should be noted in 5
• For establishments sold or acquired during the month, report data only for the period the establishment was operated by this firm
• Estimates are acceptable if book figures are not available
• Enter "0" where applicable
INCLUDE
• Data for auxiliary facilities primarily engaged in supporting services
to this firm's establishment(s) such as warehouses, garages, central
administrative offices, and repair services
• Leased departments and concessions operated in other establishments
EXCLUDE
• Leased departments and concessions operated by other firms in this
firm's establishments
• Sales taxes and finance charges
• Data for establishments operated by other firms, such as franchises
44521011
ANNOUNCEMENTS AND SPECIAL INSTRUCTIONS
1
FEDERAL EMPLOYER IDENTIFICATION (EIN)
Has this firm acquired any new EINs for its retail operation(s) since last month?
Yes - List here and continue with
2
. Report additional EIN(s) in
5
EIN (9 digits)
. . . . . . . . . . .
No
2
NUMBER OF RETAIL ESTABLISHMENTS
Number
How many retail establishments did this firm operate? . . . . . . . . . . . . . . . . . . . . . . . . .
The remainder of this report refers to the establishments reported here.
CONTINUE ON PAGE 2
Form SM-4512BE-A
3
Page 2
(09-14-2012)
SALES, RECEIPTS, OR REVENUE
INCLUDE
EXCLUDE
• Cash and credit sales of merchandise whether or not payment was
received
• E-commerce sales if not submitted on a separate monthly retail report
• Wholesale sales and services revenue made by retail establishments
covered by this report
• Value of trade-ins taken as part payment for other merchandise
• Commissions from vending machine operators and from sales of
government lottery tickets
• Nonoperating receipts (such as interest income, income from
investments, and receipts from the rental or sale of real estate)
• Refunds and allowances for returned goods
• The actual value of rebates and discounts granted to the purchaser,
even if granted as an increase in trade-in allowance
A. What type of reporting period do this month's sales represent?
Calendar month reporting period - Go to
3
C
4-week reporting period
5-week reporting period
Ending Date
Month Day
B. If not a calendar month reporting period, what is the ending date for the period you are reporting sales?
Dollars
C. What were the total sales in
1. Main store sales . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2. Leased department sales . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
3. Total department store sales . . . . . . . . . . . . . . . . . . . . . . . . . . . .
D. Do the sales reported in
Book Figure
3
C represent book figures or estimates?
Estimate
E. What were the total e-commerce sales in
Dollars
. . . . . . . . . . . . . . .
Percent
OR
If e-commerce sales not available - What was the percent of total sales in
4
VALUE OF INVENTORIES
INCLUDE
3
%
C that represents e-commerce?
EXCLUDE
• The cost value of all merchandise for the end of the month
• Merchandise owned by this firm but held by others for consignment
• Merchandise under contract for sale
• Merchandise if title has passed to you, including merchandise in transit
• Inventory held in Foreign Trade Zones or in bond warehouses in the U.S.
• Items such as fixtures, equipment, and supplies not held for resale
• Merchandise owned by others such as those held on consignment
• Merchandise of leased departments and concessions operated by
other firms in this retail establishment
A. What was the value of merchandise inventories, regardless of where held, owned as of the end of the month?
1. Merchandise inventories in retail stores
Include leased departments and concessions operated by this firm in other
establishments. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2. Merchandise inventories in warehouses, offices, or in transit for distribution to retail
stores . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Dollars
3. Total inventories (if applicable, before Last-in, First-out (LIFO) adjustment) . . . . . .
Month
44521029
5
Day
B. Inventories were reported as of what date? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
REMARKS - Please use this space to explain any significant month-to-month changes, to clarify responses, or indicate where data were
estimated.
CONTACT INFORMATION
Name of person to contact regarding this report
Area code
Telephone
Number
-
Title
Extension
Area code
Fax
Number
-
DEFINITIONS OF E-COMMERCE SALES, AUXILIARY ESTABLISHMENTS, LEASED DEPARTMENTS AND CONCESSIONS
• E-commerce is the sale of goods and services where the buyer places an order, or the price and terms of the sale are negotiated, over an Internet, mobile device (MCommerce), extranet, EDI network, electronic mail, or other comparable online system. Payment may or may not be made online.
• Auxiliary Establishments are facilities primarily engaged in furnishing supporting services (such as warehouses, garages and central administrative offices) to this
firm's establishments.
• Leased Departments and Concessions are separate businesses that lease space on the premises of another business.
Public reporting burden for this collection of voluntary information is estimated to average 7 minutes per response, including the time for reviewing instructions,
searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this
burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to: Paperwork Project 0607-0717, U.S. Census Bureau,
4600 Silver Hill Road, AMSD-3K138, Washington, DC 20233. You may e-mail comments to [email protected]; use "Paperwork Project 0607-0717" 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 (OMB). The
8-digit OMB number appears in the top right corner on the front of this form.
File Type | application/pdf |
Author | busse002 |
File Modified | 2014-03-21 |
File Created | 2014-03-21 |