BE-11 Claim BE-11 Claim for Not Filing

FORM

BE-11 Claim for Not Filing

(REV. 12/2013)

OMB No. 0608-0053: Approval Expires 12/31/2016

2013 ANNUAL SURVEY OF U.S. DIRECT INVESTMENT ABROAD
MANDATORY — CONFIDENTIAL
BE-11 Claim for Not Filing
Reporter ID Number
Mail reports to:

Name and address of U.S. business enterprise for which this claim
is filed — If the enterprise received a Form BE-11A but is exempt from filing,
enter below the Reporter name, address, and BEA assigned Identification Number
(Reporter ID) from the preprinted information provided in Part I, 1 , of Form
BE-11A. If a Form BE-11A was not received, enter name and address.

U.S. Department of Commerce
Bureau of Economic Analysis, BE-69(A)
Washington, DC 20230

Deliver reports to: U.S. Department of Commerce

Bureau of Economic Analysis, BE-69(A)

Shipping and Receiving, Section M-100

1441 L Street, NW

Washington, DC 20005
Fax reports to:

(202) 606-5312

Assistance:

E-mail:
Telephone:
Copies of form:

Name and address of U.S. Reporter

be10/[email protected]
(202) 606-5566
www.bea.gov/dia

Please include your BEA Identification Number
with all requests.

All persons, or their agents, who are contacted by BEA about
reporting in this survey, either by sending them report forms or by
written inquiry, must respond pursuant to section 801.3 of 15 C.F.R.,
part 801 and the survey instructions. They may respond by:

A BE-11, 2013 Annual Survey of U.S. Direct Investment Abroad, is
required from any U.S. person that had a foreign affiliate – that is, that
had direct or indirect ownership or control of at least 10 percent of the
voting stock of an incorporated foreign business enterprise or an
equivalent interest in an unincorporated foreign business enterprise –
at the end of its 2013 fiscal year, unless all of the person’s affiliates are
exempt. (The U.S. person’s 2013 fiscal year is defined to be the
person’s financial reporting year that has an ending date in calendar
year 2013.)

• filing the properly completed BE-11 report by May 30, 2014,
as required;
• completing and returning the “BE-11 Claim for Not Filing” by
May 30, 2014; or
• certifying in writing, by May 30, 2014, to the fact that the person
had no direct investment within the purview of the reporting
requirements of the BE-11 survey.

PERSON TO CONSULT CONCERNING QUESTIONS
ABOUT THIS REPORT — Enter name and address
0990

Name

0991

Address
Authorized official’s signature

0992

0993

0994

CERTIFICATION — The undersigned official certifies that
this report has been prepared in accordance with the
applicable instructions, is complete, and is substantially
accurate except that, in accordance with Part IV.E of the
Instruction Booklet, estimates may have been provided.

Area code

Telephone
number

Number

Extension

0995

Print or type name and title

0996

Telephone number

Date

0997

Fax number

May fax and/or e-mail be used in correspondence between your enterprise and BEA, including faxed reports, and/or to discuss
questions relating to this survey that may contain information about your company that you may consider confidential? NOTE: The internet and
telephone systems are not secure means of transmitting confidential information unless it is encrypted. If you choose to communicate with BEA via
fax or electronic mail, BEA cannot guarantee the security of the information during transmission, but will treat information we receive as confidential in
accordance with Section 5(c) of the International Investment and Trade in Services Survey Act.
0998

E-mail:

1

1

1 2

1000

Fax:

1
1

Yes (If yes, please print your e-mail address.)

0999

E-mail address (Please print)

1001

Fax number

0

No

1

Yes (If yes, please print your fax number.)

2

No

1

BASIS OF CLAIM FOR NOT FILING
Mark (X) and complete either A, B, or C
A.

B.

This U.S. person did not own or control, directly and/or indirectly, 10 percent or more of the voting securities of an incorporated foreign
business enterprise, or an equivalent interest in an unincorporated foreign business enterprise (including a branch or real estate held for other
than personal use) at the end of its 2013 fiscal year.
But did file the 2012 BE-11, Annual Survey of U.S. Direct Investment Abroad, with this Bureau.
This U.S. person did own or control, directly or indirectly, 10 percent or more of the voting securities of an incorporated
foreign business enterprise, or an equivalent interest in an unincorporated foreign business enterprise (including a branch
or real estate held for other than personal use) at the end of its 2013 fiscal year, but (Mark (X) one) –
1

None of its foreign affiliates are required to be reported on Form BE-11B, BE-11C, BE-11D, or BE-11E because all affiliates are
exempt. You must complete page 3 of this claim for those affiliates for which you received
a preprinted form. See Instruction Booklet, Section I.C., for exemption criteria.

2

Is fully consolidated in the BE-11 report for
another U.S. person – Give name and
address of that person and their BEA
Identification Number, if known.

Name
Address – Number and street or P.O. Box
City

State

ZIP Code

BEA Identification
Number
C.

Other – Specify and include reference to section of regulations or instructions on which claim is based.

MANDATORY — This survey is being conducted under the International Investment and Trade in Services Survey Act (P.L. 94-472, 90 Stat. 2059, 22
U.S.C. 3101–3108, as amended – hereinafter “the Act”), and the filing of reports is mandatory under Section 5(b)(2) of the Act (22 U.S.C. 3104).
CONFIDENTIALITY — The Act provides that your report to this Bureau is CONFIDENTIAL and may be used only for analytical or statistical
purposes. Without your prior written permission, the information filed in your report CANNOT be presented in a manner that allows it to be individually
identified. Your report CANNOT be used for purposes of taxation, investigation, or regulation. Copies retained in your files are immune from legal
process.
PENALTIES — Whoever fails to report shall be subject to a civil penalty of not less than $2,500, and not more that $25,000, and to injunctive relief
commanding such person to comply, or both. Whoever willfully fails to report shall be fined not more than $10,000 and, if an individual, may be
imprisoned for not more than one year, or both. Any officer, director, employee, or agent of any corporation who knowingly participates in such
violations, upon conviction, may be punished by a like fine, imprisonment, or both (22 U.S.C. 3105). These civil penalties are subject to inflationary
adjustments. Those adjustments are found in 15 C.F.R. 6.4.
Notwithstanding any other provision of the law, no person is required to respond to, nor shall any person be subject to a penalty for failure to comply
with, a collection of information subject to the requirements of the Paperwork Reduction Act, unless that collection of information displays a currently
valid OMB Control Number.
Remarks

Page 2

FORM BE-11 Claim for Not Filing (REV. 12/2013)

If you are claiming exemption based upon the criteria on page 2, B.1, complete the items below for those affiliates for which you received
preprinted forms. Copy the foreign affiliate name and Affiliate ID from the preprinted form and complete the remaining items.
1 Name of foreign affiliate:

a. Percent ownership at close of
fiscal year 2013 – Enter to the
nearest tenth of one percent . . . . . . . . .

___ ___ ___ . ___ %

$ Bil.

Affiliate ID:

2 Name of foreign affiliate:

3 Name of foreign affiliate:

4 Name of foreign affiliate:

c. Annual sales or gross operating
revenues, excluding sales taxes. . . . . . .

000

d. Net income (loss). . . . . . . . . . . . . . . . . .

000

a. Percent ownership at close of
fiscal year 2013 – Enter to the
nearest tenth of one percent . . . . . . . . .

___ ___ ___ . ___ %

5 Name of foreign affiliate:

FORM BE-11 Claim for Not Filing (REV. 12/2013)

Thous.

Dols.

000

c. Annual sales or gross operating
revenues, excluding sales taxes. . . . . . .

000

d. Net income (loss). . . . . . . . . . . . . . . . . .

000

a. Percent ownership at close of
fiscal year 2013 – Enter to the
nearest tenth of one percent . . . . . . . . .

___ ___ ___ . ___ %

Mil.

Thous.

Dols.

b. Total assets – Balance at
close of fiscal year. . . . . . . . . . . . . . . . .

000

c. Annual sales or gross operating
revenues, excluding sales taxes. . . . . . .

000

d. Net income (loss). . . . . . . . . . . . . . . . . .

000

a. Percent ownership at close of
fiscal year 2013 – Enter to the
nearest tenth of one percent . . . . . . . . .

___ ___ ___ . ___ %

Mil.

Thous.

Dols.

b. Total assets – Balance at
close of fiscal year. . . . . . . . . . . . . . . . .

000

c. Annual sales or gross operating
revenues, excluding sales taxes. . . . . . .

000

d. Net income (loss). . . . . . . . . . . . . . . . . .

000

a. Percent ownership at close of
fiscal year 2013 – Enter to the
nearest tenth of one percent . . . . . . . . .

___ ___ ___ . ___ %

$ Bil.

Affiliate ID:

Mil.

b. Total assets – Balance at
close of fiscal year. . . . . . . . . . . . . . . . .

$ Bil.

Affiliate ID:

Dols.

000

$ Bil.

Affiliate ID:

Thous.

b. Total assets – Balance at
close of fiscal year. . . . . . . . . . . . . . . . .

$ Bil.

Affiliate ID:

Mil.

Mil.

Thous.

Dols.

b. Total assets – Balance at
close of fiscal year. . . . . . . . . . . . . . . . .

000

c. Annual sales or gross operating
revenues, excluding sales taxes. . . . . . .

000

d. Net income (loss). . . . . . . . . . . . . . . . . .

000
Page 3

If you are claiming exemption based upon the criteria on page 2, B.1, complete the items below for those affiliates for which you received
preprinted forms. Copy the affiliate name and Affiliate ID from the preprinted form and complete the remaining items.
6 Name of foreign affiliate:

a. Percent ownership at close of
fiscal year 2013 – Enter to the
nearest tenth of one percent . . . . . . . . .

___ ___ ___ . ___ %

$ Bil.

Affiliate ID:

7 Name of foreign affiliate:

8 Name of foreign affiliate:

9 Name of foreign affiliate:

c. Annual sales or gross operating
revenues, excluding sales taxes. . . . . . .

000

d. Net income (loss). . . . . . . . . . . . . . . . . .

000

a. Percent ownership at close of
fiscal year 2013 – Enter to the
nearest tenth of one percent . . . . . . . . .

___ ___ ___ . ___ %

10 Name of foreign affiliate:

Thous.

Dols.

000

c. Annual sales or gross operating
revenues, excluding sales taxes. . . . . . .

000

d. Net income (loss). . . . . . . . . . . . . . . . . .

000

a. Percent ownership at close of
fiscal year 2013 – Enter to the
nearest tenth of one percent . . . . . . . . .

___ ___ ___ . ___ %

Mil.

Thous.

Dols.

b. Total assets – Balance at
close of fiscal year. . . . . . . . . . . . . . . . .

000

c. Annual sales or gross operating
revenues, excluding sales taxes. . . . . . .

000

d. Net income (loss). . . . . . . . . . . . . . . . . .

000

a. Percent ownership at close of
fiscal year 2013 – Enter to the
nearest tenth of one percent . . . . . . . . .

___ ___ ___ . ___ %

Mil.

Thous.

Dols.

b. Total assets – Balance at
close of fiscal year. . . . . . . . . . . . . . . . .

000

c. Annual sales or gross operating
revenues, excluding sales taxes. . . . . . .

000

d. Net income (loss). . . . . . . . . . . . . . . . . .

000

a. Percent ownership at close of
fiscal year 2013 – Enter to the
nearest tenth of one percent . . . . . . . . .

___ ___ ___ . ___ %

$ Bil.

Affiliate ID:

Mil.

b. Total assets – Balance at
close of fiscal year. . . . . . . . . . . . . . . . .

$ Bil.

Affiliate ID:

Dols.

000

$ Bil.

Affiliate ID:

Thous.

b. Total assets – Balance at
close of fiscal year. . . . . . . . . . . . . . . . .

$ Bil.

Affiliate ID:

Mil.

Mil.

Thous.

Dols.

b. Total assets – Balance at
close of fiscal year. . . . . . . . . . . . . . . . .

000

c. Annual sales or gross operating
revenues, excluding sales taxes. . . . . . .

000

d. Net income (loss). . . . . . . . . . . . . . . . . .

000

Additional foreign affiliates should be reported on additional copied sheets.
Page 4

FORM BE-11 Claim for Not Filing (REV. 12/2013)