SA-722A Annual Services Report

U.S. DEPARTMENT OF COMMERCE
Economics and Statistics Administration

U.S. CENSUS BUREAU

Worksheet
FORM

SA-722A

(DRAFT)

DUE DATE

Call 1-877-787-9860 (option 2)
(8:00 a.m. - 5:00 p.m. ET, M-F)
or Visit
https://econhelp.census.gov/arts

WORKSHEET
DO NOT use this worksheet to respond to the survey, it is intended to assist you
with gathering and preparing your data prior to reporting online.
Please view the online report for specific instructions that may apply to your EIN
or firm.
Return to https://econhelp.census.gov/sas
_________________________________ when you are ready to report online.

YOUR RESPONSE IS REQUIRED
BY LAW. Title 13, United States
Code, Sections 131 and 182
authorizes this collection. Sections
224 and 225 requires businesses
and other organizations that
receive this questionnaire to
answer the questions and return
the report to the U.S. Census
Bureau. By Section 9 of 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/arts

Return via Fax:
1-800-447-4613

Report Online - Do Not Return

Need help or have questions?

2015 ANNUAL FOOD SERVICES REPORT

RESTAURANTS, FOOD SERVICE CONTRACTORS & DRINKING
PLACES

To view Survey Results:
census.gov/retail

Username:
Password:

72115017

INCLUDE
• All food services establishments located in the U.S. (including the District of Columbia) operated by this firm and
its subsidiaries.
• 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.
EXCLUDE
• Data for establishments operated by other firms, such as franchises.
• Departments and concessions operated by other firms in this firm's establishment(s).
• Data for establishments located in U.S. Territories (such as Puerto Rico, American Samoa, Guam, U.S. Virgin
Islands and Northern Mariana Islands).
ANNOUNCEMENTS AND SPECIAL INSTRUCTIONS

CONTINUE ON PAGE 2

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GENERAL INSTRUCTIONS
• Any significant change in this firm's operations should be noted in 14 .
• For establishments sold or acquired in 2015, report data only for the period the establishments were operated by
this firm.
• Estimates are acceptable if book figures are not available.
• Enter "0" where applicable.

Form SA-722A

Page 2

(DRAFT)

1

Not Applicable.

2

ORGANIZATIONAL CHANGE
A. Did this firm experience any acquisitions, sales, mergers, and/or divestitures in 2015?

No - Go to

3

B. Which of the following organizational changes occurred in 2015?
Check all that apply. If more than one organizational change occurred during the reporting period, explain in
Month

Acquisition
Sale
Merger

Day

14 .

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

State

ZIP Code

3

REPORTING PERIOD
NOTE: Calendar-year data are preferred. If this is not available, please report for the fiscal year
that includes at least six months of data for the 2015 calendar year.
What time period is covered by the data provided in this report?
Calendar year

2015
Beginning Date
Month

Year

. . . . . . . . . . . .
Month

NUMBER OF ESTABLISHMENTS

Day

Ending Date
Day
Year

Mark "X"

2015
Number

72115025

if None
How many food services establishments (including departments and concessions) did
this firm operate in 2015?
The remainder of this report refers to the establishments reported here. . . . . . . . . . . . . .

CONTINUE ON PAGE 3

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Fiscal or partial year - Report beginning and ending dates.

4

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Yes

Form SA-722A
5

Page 3

(DRAFT)

SALES, RECEIPTS, OR REVENUE
EXCLUDE
• Sales from auxiliary establishments
• Carrying or other finance charges
• Commissions (such as vending machine operators,
government lottery tickets, or other stores)
• Non-operating receipts (such as interest income,
income from investments, and receipts from the
rental or sale of real estate)
• Sales made by departments and concessions
operated by other firms in this firm's food services
establishment(s)
• Franchise revenues and royalties
DEDUCT
• Actual value of rebates and discounts granted to the
purchaser, even if granted as an increase in trade-in
allowances

SPECIAL INSTRUCTIONS
Contract feeding
If terms of contract are Include as sales Management fee basis . . . . . . . . . . Management fees plus reimbursement for the cost of food, labor,
and other operating expenses
Cost-plus basis . . . . . . . . . . . . . Sales to customers plus fees or supplements from clients
Profit-loss basis . . . . . . . . . . . . . All sales to customers
Mark "X"
if None

A. What was this firm's total revenue in 2015?

$ Bil.

Mil.

2015
Thou.

Dol.

$ Bil.

Mil.

2015
Thou.

Dol.

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INCLUDE
• Credit and cash net sales of merchandise
• Excise taxes (such as those on gasoline, liquor, and
tobacco) which are included in the cost of goods
purchased by this firm
• Receipts from the rentals of public rooms such as
ballrooms, conference rooms, etc.
• Sales of meals, alcoholic beverages, and other
merchandise
• Receipts from valet, laundry, parking, and other
guest services provided by this firm
• Leased departments and concessions operated in
other establishments

. . . . . . . . . . .

B. Did this firm collect any sales taxes in 2015?
Yes
No - Go to

6

6

E-COMMERCE
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 (M-Commerce), extranet, EDI network, electronic mail, or other
comparable online system. Payment may or may not be made online.
A. Did this firm have any e-commerce sales in 2015?

72115033

Yes
No - Go to

12

$ Bil.

Mil.

2015
Thou.

Dol.

B. What were the total e-commerce sales in 2015? . . . . . . . . . . . . .
7 – 11 Not Applicable.

CONTINUE ON PAGE 4

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C. What were the total sales taxes collected for this firm in 2015?
Exclude excise taxes. . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Form SA-722A

Page 4

(DRAFT)

12 OPERATING EXPENSES
EXCLUDE
• Bad debt
• Purchases of goods, including food, for resale or
cost of goods sold
• Income taxes
• Interest expenses
• Impairment (reduction in value of long-lived assets
due to reappraisal)
• Capitalized expenses (except payroll and fringe
benefits)
• Transfers made within the company
Mark "X"
if None

What were the total operating expenses for this firm in 2015?
If operating expenses are greater than sales, explain in 14 . . . . . . . . .

$ Bil.

Mil.

2015
Thou.

Dol.

13 Not Applicable.
14 REMARKS - Please use this space to explain any significant year-to-year changes, to clarify responses, or indicate where
data were estimated.

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

72115041

Area code
Telephone
E-mail address

Number

Title

Extension

Area code
Fax

-

Number

-

Website address
www.

THANK YOU for completing your 2015 ANNUAL FOOD SERVICES REPORT.
We suggest you keep a copy for your records.
Public reporting burden for this collection of information is estimated to average 17 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: ECON Survey Comments 0607-0013, U.S. Census Bureau, 4600 Silver Hill Road, Room EMD-8K122, Washington, DC
20233. You may e-mail comments to [email protected]. Be sure to use ECON Survey Comments 0607-0013 as the subject.
You are not required to respond to this collection of information if it does not display a valid approval number from the Office of Management
and Budget (OMB). The eight-digit OMB number is 0607-0013 and appears in the upper right corner of the electronic instrument screen.

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15 CONTACT INFORMATION

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INCLUDE
• Expenses arising from the normal course of
business
• Payroll
• Depreciation and amortization