BLS_Phase2_v2 3705 Industry Classification Report

Industry Classification
Report

Bureau of Labor Statistics
U.S. Department of Labor
O.M.B. No. 1220-0141
Expires April 30, 2018

Please complete and return this form. If you need help completing this form, send an e-mail to
[email protected], or call toll free at 1-855-388-3196. Thank you!
1

What is your contact information?
Please provide contact information for the person who completed this form.
Name:
Business website:

Title:
Phone:
2

(

)

-

Email:

If the address below is not correct, please enter the updated address in the space provided.
Enter Address Corrections for Physical Location below

[FILL COMPANY NAME]
[FILL ADDRESS 1]
[FILL ADDRESS 2]
[CITY, STATE,ZIP]
[RUN_DESC]
3

Our records show the main business activities, products, goods, or services at the worksite listed in
Question 2 are [FILL. Is this correct?]
Yes
No  Please enter your correct economic activity in BOX A on Page 4
Listed Business Activities

4

Does this company have a single location (the worksite listed in Question 2), or is it part of a larger
enterprise with multiple locations?
Single Location

5

Multiple Locations
How many employees are employed at the worksite listed in Question 2?
Include:
• Full or part-time paid workers
• Workers on paid leave
• Workers assigned temporarily to other units
• Incorporated firms: paid owners, officers, and
staff

Do Not Include:
• Contractors and temporary employees not on your payroll
• Unpaid family workers
• Workers on unpaid leave
• Owners, proprietors, and partners of unincorporated firms
• Workers not covered by unemployment insurance

Enter Number of Employees
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BLS_Phase2_v2 3705

Activities at this Worksite
6

Are any products manufactured or any goods produced at the worksite listed in Question 2?
Yes, Go to 6a, then 6b
No, Go to 7



6a

Does the worksite listed in Question 2 manufacture any products or produce any goods for your
company, or for sale by your company?
Yes
No



6b

Does the worksite listed in Question 2 manufacture any products or produce any goods under
contract for other companies?
Yes
No

7

Does the worksite listed in Question 2 arrange for the manufacture of any products or the
production of any goods outside of the U.S., either by a manufacturing facility owned by your
company or by an independent manufacturer?
Yes
No

8

Does the worksite listed in Question 2 arrange for the manufacture of any products or the production
of any goods inside the U.S. by an independent manufacturer? Exclude products manufactured by
facilities owned by your company.
Yes
No
If you answered no to Questions 6, 7, and 8, please skip to Question 10.
If you answered yes to Questions 6, 7, or 8, please answer Question 9.

9

For the manufacturing activities
described above, does the worksite
listed in Question 2:

Yes, for all
products

Yes, for some No, not for
products
any products

Don’t
know

a. Determine the specifications or design
for manufactured products or goods?
b. Arrange for the manufacturing of
products or goods?
c. Own the products or goods?
d. Set the sales price on the products or
goods?
e. Arrange for the sale of the products or
goods?
f.

Assume any loss due to defective or
unsold products or goods?

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BLS_Phase2_v2 3705

Sources of Revenue
10

What percent of the total revenue for the worksite listed in Question 2 comes from each of the
below sources?
If you are unable to provide revenue percentage estimates, please complete BOX B on Page 4
Percent of
total revenue
a. Manufacturing at this worksite for your company

%

b. Manufacturing at this worksite for other companies

%

c. Manufacturing done outside the U.S. for your company

%

d. Manufacturing done by another, unaffiliated, company inside
the U.S. for your company

%



%

f. Largest single source of
non-manufacturing revenue, specify: 

%

e. Other manufacturing, specify:

g. All other revenue-generating activities

%
Total

11

1 0 0 %

In order to assign the correct North American Industry Classification System (NAICS) code to this
worksite, we need information on the products your company sells.
For all manufacturing activities described in Questions 6, 7, and 8, including those done at the
worksite listed in Question 2 and those done elsewhere under contract for the worksite, what are
the three best-selling product lines?
% of sales
For each product line, report
Product Line
 revenue

12

1.



%

2.



%

3.



%

If you have any comments about this report, please note them here:

Thank you for completing this report. Please return it using the postage-paid, return envelope.
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BLS_Phase2_v2 3705

BOX A

Only complete this if you marked 'NO' for Question 3 on Page 1.
Our records show the main business activities, products, goods, or services at the worksite
listed in Question 2 are:
[FILL]
If this is not correct, please enter your correct economic activity in the fields below.

Return to Question 4 on Page 1 to continue completing this form.

BOX B

From which of the following activities does the worksite in Question 2 generate revenue?
Mark all that apply.
Manufacturing at this worksite for your company
Manufacturing at this worksite for other companies
Manufacturing done outside the U.S. for your company
Manufacturing done by another, unaffiliated, company inside the U.S. for your company
Other manufacturing, specify:
Return to Question 11 on Page 3 to continue completing this form.

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BLS_Phase2_v2 3705