2 Example Survey Questions

Generic Clearance for Questionnaire Pretesting Research

Attachment D - Example of Survey Questions

Econ Record Keep Study

OMB: 0607-0725

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Sample Survey Questions
Business Unit
NAICS Code:
NAICS Name:
SALES, SHIPMENTS, RECEIPTS, OR REVENUE
1

What were the sales of merchandise and other operating receipts in 2017?
(Exclude sales taxes or other taxes collected.)
$Bil.

$Mil.

$Thou.

REVENUES FROM ELECTRONIC SOURCES
2

Were there any revenues from customers entering orders directly on the firm's
websites or mobile applications in 2017?
Yes
No

3

Were there any revenues from customers entering orders directly on third-party
websites or mobile applications in 2017?
Yes
No

4

Were there any revenues from customers entering orders via other electronic
systems (such as private networks, dedicated lines, kiosks, etc.) in 2017?
Yes
No

5

Of the total 2017 revenues reported in 1, what was the dollar amount that was
from the revenues identified in Questions 2-4 above? Please provide an estimate
if exact figures are not available.
$Bil.

$Mil.

$Thou.

CAPITAL EXPENDITURES
6

What were the capital expenditures for the following items?
$Bil.
a. Structures (new) …………….
b. Structures (used) ……………
c. Equipment (new) …………….
d. Equipment (used) ……………
e. Other (new) …………………..
f. Other (used) ………………….
g. TOTAL CAPITAL
EXPENDITURES ………..

$Mil.

$Thou.

INVENTORY
7

What was the value of inventories (if applicable, before Last-in, First-out (LIFO)
adjustment) owned by this business unit for:
$Bil.

$Mil.

$Thou.

a. Finished goods (final output
of this business unit, but still
within ownership)?
b. Work-in-process (goods
that have been substantially
transformed in the
manufacturing process, but
are not yet the final output)?
c. Materials, supplies, fuels,
etc. (goods that are raw inputs
to the manufacturing process
and will be substantially
altered to produce the
company's output)?
8

What was the value of total inventories (if applicable, before Last-in, First-out
(LIFO) adjustment)?
$Bil.

9

$Thou.

What was the value of total inventories (if applicable, before Last-in, First-out
(LIFO) adjustment), warehoused in the US?
$Bil.

10

$Mil.

$Mil.

$Thou.

What was the value of inventories stored outside or en route to the 50 states and
the District of Columbia in 2017?
$Bil.

$Mil.

$Thou.


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File TitleAPPENDIX B - BUH Mockup Questions.pdf
Authormarqu324
File Modified2019-06-13
File Created2019-06-13

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