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

OMB No. 0607-0195: Approval Expires 10/31/2014
U.S. DEPARTMENT OF COMMERCE
Economics and Statistics Administration

U.S. CENSUS BUREAU
FORM

SA-42-AGBR

(DRAFT)

2014 ANNUAL WHOLESALE TRADE REPORT
AGENTS, BROKERS, REPRESENTATIVES, AND ELECTRONIC
MARKETS

DUE DATE

Need help or have questions?
Call 1-877-787-9860, option "3"
(8:30 a.m. - 4:30 p.m. ET, M-F)
or Visit
https://econhelp.census.gov/awts
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. 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:
https://econhelp.census.gov/awts

Return via Fax:
1-800-447-4613

To view survey results:
https://census.gov/wholesale

Username:
Password:
GENERAL INSTRUCTIONS
• This report should cover ALL agent, broker, representative, and electronic market locations in the United States
reporting payroll under the Employer Identification Number (EIN) as referenced in 2 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 2014, 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

ANNOUNCEMENTS AND SPECIAL INSTRUCTIONS

CONTINUE ON PAGE 2

Form SA-42-AGBR
1

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 - Go to

3

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 2014?
Yes
No - Go to

4

B. Which of the following organizational changes occurred in 2014?
Check all that apply. If more than one organizational change occurred during the reporting period, explain in
page 4.
Month

Acquisition
Sale
Merger

Day

7

on

Year

Date of organizational change . . . . . . . . . . . . . . . .
AND
Enter detailed information below

Divestiture
Name of company

EIN (9 digits)

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

City, town, village, etc.

State

ZIP Code

42004028

4

REPORTING PERIOD
NOTE: Calendar year data is preferred. If it is not available, please report for the fiscal year
that includes at least six months of data for the 2014 calendar year.
What time period is covered by the data provided in this report?
Calendar year - Go to

5

on the next page

2014
Beginning Date
Month Day
Year

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

Ending Date
Day
Year

CONTINUE ON PAGE 3

Form SA-42-AGBR
5

Page 3

(DRAFT)

SALES, RECEIPTS, OR REVENUE
INCLUDE
EXCLUDE
• All revenue from locations identified in 1
• Nonoperating receipts (such as interest income,
income from investments, and receipts from the
• Receipts from freight, installations, rentals,
rental or sale of real estate)
maintenance, repairs, alterations, storage, and other
such services
• Receipts from customers for carrying or other credit
changes
• 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 EIN
Mark "X"
if None

A. What were this EIN's commissions and selling or listing fees
earned in 2014? . . . . . . . . . . . . . . . . . . . . . . . . .
B. What were product sales of goods that this EIN owned (took
title to), if any, or other operating revenue earned in 2014? . .
C. What were the TOTAL commissions, fees, sales, and operating
revenue in 2014? ( 5 A + 5 B = 5 C) . . . . . . . . . . . . . . . .
D. What was the gross selling value of the goods this EIN earned
commission or fees for in Item 5 A in 2014?
Gross selling value is the total value of the goods sold
• Exclude commissions and fees reported in 5 A
• Include any e-commerce sales conducted for others . . . . . . . .

$ Bil.

Mil.

2014
Thou.

Dol.

.
.
.

.

E. What was the AVERAGE commission rate earned in 2014?
• 5 A divided by 5 D X 100
• Round to the nearest whole percent . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

2014
Percent

%

Have questions? Call 1-800-327-4389 (option 3)
6

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

EXCLUDE
• Bad debt/customer related loss
• Interest expenses
• Purchases of goods for resale or cost of goods sold
• Income taxes
• Impairment (reduction in value of long-lived assets
due to reappraisal)
• Transfers made within the company
$ Bil.

Mil.

2014
Thou.

Dol.

42004036

What were the total operating expenses for this EIN's agent,
broker, representative and electronic market locations ONLY
in 2014? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Mark "X"
if None

CONTINUE ON PAGE 4

Form SA-42-AGBR

Page 4

(DRAFT)

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

42004044

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

Area code
Telephone
E-mail address

Number

Title

Extension

Area code
Fax

-

Number

-

Website
www.

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 24 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.