Worksheet

Do Not Submit – For Informational Purposes ONLY.

Mailing this to Census does not fulfill your reporting obligation.

2 015 Annual Survey of Manufactures

Worksheet for Preparing Responses

Do not mail this worksheet. This worksheet is for preparation purposes only, to assist you in gathering information for Annual Survey of Manufactures. It cannot be used to submit data to the Census Bureau.

Please submit your data using our electronic reporting system at https://www.census.gov/asm. Your User ID and Password are found in the letter we mailed to you.

Your completed response is due by [month/day], 2016.

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 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. Further, copies retained in respondents' files are immune from legal process.

If you need assistance, visit our website (https://www.census.gov/asm), or call us at 1-800-233-6136 Monday through Friday, 8:00 a.m. to 4:30 p.m. Eastern Time. When calling, please refer to the name of the survey and the User ID provided on your letter.

Contents

Overview – Page 2-3

Who should report

Activities in-scope for the survey

Concept of “economic value”

Reporting period

Special instructions for ownership changes

Special instructions for establishments involved in assets leasing arrangements

Prior-year data

How to report dollar figures

Electronic reporting system and non-applicable questions

Item-specific instructions – Page 4-8

Establishment location information and Employer Identification Number (EIN)

Sales, revenues, receipts, and shipments

Employment and payroll

Overview

Who Should Report

The Annual Survey of Manufactures is conducted under an Act of Congress (Title 13, United States Code) which requires that a report be filed by every manufacturer who receives a report form.

If an establishment that is not in operation receives a report form, return the form with a notation of its condition in item X, Operational Status. If the establishment had custodial employees, capital expenditures, inventories, or any shipments from inventories, these should be reported in their proper sections.

Separate reports are required for each manufacturing establishment (plant) because data will be published for industries and states.

An establishment is a single physical location where manufacturing is performed. If your company operates at different physical locations, even if they are producing the same line of goods, a separate report must be filed for each location.

If your company operates in two or more distinct lines of manufacturing at the same location, a separate report must be filed for each activity.

Activities in-scope for the survey

Report all activities (manufacturing, fabricating, processing, and assembling) conducted within the

establishment.

INCLUDE

• Maintenance of plant and equipment

• Receiving and shipping activities

• Warehousing and storage

• Research

• Recordkeeping

• Health and safety

• Cafeteria (without seating) and other services unless operated as separate establishments

EXCLUDE

• Sales branches and sales offices

• Research laboratories

• Retail stores

• Mining activities and general administrative offices

The Manufacturing Sector also includes establishments engaged in the following activities:

• Apparel jobbing and contracting

• Assembling from purchased components

• Commission processing of materials owned by others

• Job casting, stamping, and machining

• Lapidary work

• Machine shops, including those operating on a job-order basis

• Manufacturing and delivering ready-mixed concrete

• Milk pasteurizing and bottling

• Plating, galvanizing, polishing, etc., of materials owned by others

• Poultry dressing

• Printing books, periodicals, etc.

• Repair of ships

• Research and development, engineering and other services directly related to aerospace industries

• Sawmills

• Seafoods, fresh-packaged or frozen

• Wood preserving

Concept of “Economic Value” (for multi-establishment companies only)

One of the important statistical measures of manufacturing activity is "value added by manufacture," which is derived by the U.S. Census Bureau from the figures reported for value of shipments, cost of materials, and inventories.

In order for statistics on value added and other subjects to be comparable from industry to industry, it is necessary that the operations of each establishment of a multiple-establishment organization be reported as though the establishment was a separate "economic" unit. This means that the value of interplant transfers and the cost of transferred materials within a company should include, in addition to direct costs of production, a reasonable proportion of "all other costs (including company overhead) and profits."

The establishment receiving such transfers should report them as materials consumed (or inventories of materials, etc.) at the same value plus the costs of freight and other direct handling charges. (See item X, part A, Shipments and Other Receipts; item X, Value of Inventories; and item X, part A, Selected Production Related Costs.)

Reporting Period

Report data for the calendar year. If calendar year book figures are not available except at considerable cost, reasonable estimates will be accepted. Indicate in item X, Certification, the exact dates covered.

If there was a change in the operator during the year or the establishment operated part of the year only, the data apply to the period of operation by your company only. Report in item X, Operational Status, any change of operator, and the name and address of the new operators.

Special Reporting Instructions for Ownership Changes

The establishment may have been purchased singly or as part of a parent company which was acquired by or merged with another company. Please make certain that the date of the change in ownership is recorded in item X, Operational Status.

If the establishment is filing for only part of the year, report as follows:

1. REPORT FOR THE OWNER WHO SOLD THE ESTABLISHMENT - Report any new or used capital expenditures, that occurred in the current year prior to the sale.

2. REPORT FOR THE BUYER - Report only the capital expenditures which occurred after the original purchase of the entire plant.

How to Report Dollar Figures

Dollar figures should be rounded to thousands of dollars, as shown below. Please report “0” or select the “Check if None” box for all items for which you are not reporting an amount greater than zero.

Check

if None 2015

If a dollar figure is $2,036,355.25: Report ­­ $ 2036,000.00

If a dollar figure is “0” (or less than $500.00): Report  [X] $ ,000.00

Establishments Involved with Assets Leasing Arrangements

If any building or equipment has been acquired this year under a capital lease, please report the cost (at the market value) as a capital expenditure in item X. Do not report the periodic payments made to the lessor. If the lease qualifies as an operating lease, do not include the value of the building and equipment as capital expenditures. Also, do not report the periodic payments made to the producer or the lessor as capital expenditures.

Prior Year Data and Other Pre-listed information

Where available, your establishment’s prior-year data are pre-listed in the electronic reporting system (not in this worksheet). The figures may differ from those actually reported because of the changes made by the U.S. Census Bureau as a result of correspondence or a comparison of prior data. Check these figures and make any necessary corrections as needed. If 2014 Inventories figures are not prelisted, report these figures in the appropriate sections as instructed.

Item Specific Instructions

MAILING ADDRESS:

Report Online – Do Not Return

MAILING ADDRESS

The reporting unit for this questionnaire is an establishment, which is generally a single physical location where business is conducted or where services or industrial operations are performed. Please make updates to the physical location address in the Physical Location Information section.

Attn: _______________________________

Name 1: ____________________________ Store/Plant: ________

Name 2: ____________________________

Street: _______________________________________________________

City: ____________________ State: _______ Zip: ___________

CFN: ____________________

EMPLOYER IDENTIFICATION NUMBER:

EMPLOYER IDENTIFICATION NUMBER VALIDATION

Is the Employer Identification Number (EIN) used on this establishment's latest 2015 Internal Revenue Service Form 941, Employer’s Quarterly Tax Return?

□ Yes

□ No

EMPLOYER IDENTIFICATION NUMBER:

EMPLOYER IDENTIFICATION NUMBER

What is this establishment’s 9-digit Employer Identification Number (EIN) used on the latest 2015 Internal Revenue Service Form 941, Employer’s Quarterly Tax Return?

EIN: ________________

OPERATIONAL STATUS:

OPERATIONAL STATUS

Which of the following best describes this establishment’s operational status at the end of 2015?

Check only ONE box.

□ In operation

Report Online – Do Not Return

□ Under construction, development, or exploration

□ Temporarily or seasonally inactive

□ Ceased operation

□ Sold or leased to another operator

OPERATIONAL STATUS:

CEASED OPERATION DATE

When did this establishment cease operation?

MMDDYYYY: ________________

OPERATIONAL STATUS:

SOLD OPERATION DATE AND INFORMATION

When was this establishment sold or leased to another operator?

MMDDYYYY: _________________

What is the name, address, and 9-digit Employer Identification Number (EIN) of this establishment's new owner or operator?

Name of new owner/operator:

Mailing address (Number and street, P.O. Box, etc.):

City, town, village: ____________________ State: ________ ZIP: ___________

EIN:

MONTHS IN OPERATION:

MONTHS IN OPERATION

How many months was this establishment in operation during 2015?

Check if None □ Number:_____

ADDITIONAL REPORTING GUIDELINES:

ADDITIONAL REPORTING GUIDELINES

Report Online – Do Not Return

Prior Year Data: Where available, your establishment’s Prior Year data is prelisted in the 2014 column. The figures may differ from those actually reported because of the changes made by the U.S. Census Bureau as a result of correspondence or a comparison of prior data. Check these figures and make any necessary corrections as needed. If 2014 Inventories figures are not prelisted, report these figures in the appropriate sections as instructed.

How to Report Dollar Figures:

Dollar figures should be rounded to thousands of dollars

EXAMPLE: Check if None 2015

If a dollar figure is $2,036,355.25: Report □ $2,036,000.00

If a dollar figure is “0” (or less than $500.00): Report X $ ,000.00

SALES, SHIPMENTS, RECEIPTS, OR REVENUE:

SALES, SHIPMENTS, RECEIPTS, OR REVENUE

What was the total value of products shipped and other receipts?

Report details in the DETAIL SALES, SHIPMENTS, RECEIPTS, OR REVENUE section.

Exclude:

• Freight charges

• Excise Taxes

Check if None 2015 2014

□ $ ,000.00 $ ,000.00

SALES, SHIPMENTS, RECEIPTS, OR REVENUE:

EXPORTS

What was the value of products exported?

This is a breakout of the $ ,000.00 reported in total value of products shipped and other receipts in the SALES, SHIPMENTS, RECEIPTS, OR REVENUE area.

Include:

• Shipments to customers in the Commonwealth of Puerto Rico and U.S. possessions

• Products shipped to exporters or other wholesalers for export

  

  Report Online – Do Not Return

• Products sold to the U.S. Government to be shipped to foreign governments

Exclude:

• Products shipped for further manufacture, assembly or fabrication in the U.S.

Check if None 2015 2014

□ $ ,000.00 $ ,000.00

SALES, SHIPMENTS, RECEIPTS, OR REVENUE:

PRODUCTS SHIPPED FOR FURTHER MANUFACTURE

What was the market value of products shipped to other domestic plants of your company for further assembly, fabrication, or manufacture?

This is a breakout of the $ ,000.00 reported in total value of products shipped and other receipts in the SALES, SHIPMENTS, RECEIPTS, OR REVENUE area.

Check if None 2015 2014

□ $ ,000.00 $ ,000.00

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