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pdfU.S. DEPARTMENT OF COMMERCE
Economics and Statistics Administration
U.S. CENSUS BUREAU
Attachment C
2014 ANNUAL SURVEY OF MANUFACTURES
FORM
MA-10000(L)
OMB No. 0607-0449: Approval Expires 11/30/2014
(DRAFT)
MA-10000
Need help or have questions?
Read the accompanying information
sheet(s) before answering the
questions.
Visit econhelp.census.gov/cosasm
- OR Call:
Mail your completed form to:
U.S. CENSUS BUREAU
1201 East 10th Street
Jeffersonville, IN 47132-0001
(Please correct any errors in this mailing address.)
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. Further, copies retained in respondents'
files are immune from legal process.
• Use blue or black ballpoint pen.
• Do not use pencil or felt-tip pen.
• Do not put slashes through 0 or 7.
• Please center numbers in
their respective boxes.
• Place an "X" inside the box.
Examples:
Please read the accompanying instructions before answering the questions. The reporting unit for this form is
an establishment which is generally a single physical location where business is conducted or where services or
industrial operations are performed. For further clarification, see information sheet(s).
1
EMPLOYER IDENTIFICATION NUMBER
Is the Employer Identification Number (EIN) shown to the left of the mailing address the same as the one used for this
establishment on its latest 2014 Internal Revenue Service Form 941, Employer's Quarterly Federal Tax Return?
10000016
0021
2
Yes - Go to
2
0022
No - Enter current EIN (9 digits)
-
0025
PHYSICAL LOCATION
A. Is this establishment's physical location the same as shown in the mailing address?
(P.O. Box and rural route addresses are not physical locations.)
0031
0032
Yes - Go to line B
No - Enter
physical
location
0035
Number and street
0036
City, town, village, etc.
0037
State
0038
ZIP Code
CONTINUE WITH
PENALTY FOR FAILURE TO REPORT
2
ON PAGE 2
CONTINUE ON NEXT PAGE
Form MA-10000(L)
If not shown, please enter your 11-digit Census File
Number (CFN) from the mailing address.
2
PHYSICAL LOCATION - Continued
B. Is this establishment physically located inside the legal boundaries of the city, town, village, etc.?
(Mark "X" only ONE box.)
0041
Yes
0042
No
0043
No legal boundaries
0044
Do not know
0024
Do not know
C. In what type of municipality is this establishment physically located?
(Mark "X" only ONE box.)
0046
3
City, village, or
borough
0047
Town or township
0048
Other
OPERATIONAL STATUS
Which of the following best describes this establishment's operational status at the end of 2014?
(Mark "X" only ONE box.)
0011
In operation
0016
Under construction, development, or exploration
0013
Temporarily or seasonally inactive
0014
Ceased operation - Enter date at right.
0015
Sold or leased to another operator - Enter date at right
AND enter name and address of new owner or operator
and Employer Identification Number (EIN) below.
0060
Month
Day
Year
0018
Name of new owner or operator
0061
EIN (9 digits)
0062
Mailing address (Number and street, P.O. Box, etc.)
0063
City, town, village, etc.
0064
State
0065
ZIP Code
4
Number of months in operation during 2014 (If none, mark "X" and go to
10000024
Mark "X"
if None
MONTHS IN OPERATION
30 .)
. . . . . . . . . .
2014
Number
0002
Where available, this form shows your establishment's prior year data in the 2013 column. The figures
may differ from those actually reported because of changes made by the U.S. Census Bureau as a result
of correspondence or a comparison with prior data. Check these figures and make any necessary
corrections. If 2013 Inventories figures are not printed on your form, report these figures in 9 , and if
applicable, 10 , 11 , and 12 .
CONTINUE ON NEXT PAGE
Form MA-10000(L)
If not shown, please enter your 11-digit Census File
Number (CFN) from the mailing address.
EXAMPLE:
HOW TO
REPORT
DOLLAR
FIGURES
5
Dollar figures should be rounded to
thousands of dollars (Divide dollar
amount by 1,000):
Mark "X"
if None
$2,036,000.00 / 1,000 = $2,036:
Report
If a dollar value is "0" (or less than
$500.00):
Report
2014
Mil.
$ Bil.
2
Thou.
0 3 6
EXAMPLE
SALES, SHIPMENTS, RECEIPTS, OR REVENUE
A. Total value of products shipped and other
receipts (Exclude freight charges and excise
taxes. Report detail in 22 .) . . . . . . . . . .
Mark "X"
if None
$ Bil.
2014
Mil.
2013
$ Thou.
Thou.
0100
B. Value of products exported (This is a breakout
of the value reported on line A.)
Report the value of products shipped for
export. (Include shipments to customers in
the Commonwealth of Puerto Rico and U.S.
possessions, as well as the value of products
shipped to exporters or other wholesalers for
export. Also, include the value of products
sold to the U.S. Government to be shipped
to foreign governments. Exclude products
shipped for further manufacture, assembly, or
fabrication in the United States.) . . . . . . .
0130
C. Shipments to other domestic plants of your
company for further assembly, fabrication, or
manufacture
1. Is this the only establishment of this firm?
0907
Yes - Go to
0908
No - Go to line C2
6
2. Market value of products shipped to
other domestic plants of your company
for further assembly, fabrication, or
manufacture (This is a breakout of the
value reported on line A.) . . . . . . . .
10000032
6
0905
E-SHIPMENTS
A. Did this plant use any electronic network to control or coordinate the flow of any of the shipments of goods reported
in 5 , line A? Or, were the orders for any of the shipments reported in 5 , line A, received over an electronic network?
Electronic networks include:
• Electronic Data Interchange (EDI)
• E-mail
• Internet
• Extranet
• Other online systems
0181
Yes - Go to line B
0182
No - Go to
7
B. Percent of total reported in 5 , line A, that were ordered, or whose movement
was controlled or coordinated over electronic networks (Report whole
percents. Estimates are acceptable.) . . . . . . . . . . . . . . . . . . . . .
2014
Percent
0109
2013
Percent
%
%
CONTINUE ON NEXT PAGE
Form MA-10000(L)
If not shown, please enter your 11-digit Census File
Number (CFN) from the mailing address.
7
EMPLOYMENT AND PAYROLL
Include:
• Full- and part-time employees working at this establishment whose payroll was reported on Internal
Revenue Service Form 941, Employer's Quarterly Federal Tax Return, and filed under the Employer
Identification Number (EIN) shown to the left of the mailing address or corrected in 1 .
• Spread on stock options that are taxable to employees as wages.
Exclude (Report the following in 16 C, lines 1 or 9.):
• Full- or part-time leased employees whose payroll was filed under an employee leasing company's EIN.
• Temporary staffing obtained from a staffing service.
• Purchased professional and technical services.
For further clarification, see information sheet(s).
A. Number of employees
a. March 12
. . . . . . . . . . . . . . . . . . . .
0325
b. June 12 . . . . . . . . . . . . . . . . . . . . .
0324
c. September 12 . . . . . . . . . . . . . . . . . .
0344
d. December 12 . . . . . . . . . . . . . . . . . . .
0347
2. Add lines A1a through A1d . . . . . . . . . . . .
0329
3. Average annual production workers (Divide line A2 by
4 - round to nearest whole number.) . . . . . . . . .
0335
4. All other employees for pay period including March 12
0336
5. TOTAL (Add lines A3 and A4.) . . . . . . . . . . . .
0337
B. Payroll before deductions (Exclude
employer's cost for fringe benefits.)
Mark "X"
if None
10000040
1. Annual payroll
a. Production workers . . . . . . . . . .
0304
b. All other employees
. . . . . . . . .
0305
c. TOTAL (Add lines B1a and B1b.) . . .
0300
2. First quarter payroll (January-March 2014)
2014
Number
Mark "X"
if None
1. Number of production workers for pay periods
including:
$ Bil.
2014
Mil.
2013
Number
Thou.
2013
$ Thou.
0310
Mark "X"
if None
C. Number of hours worked by production workers (Annual
hours worked by production workers reported on lines
A1a through A1d.) . . . . . . . . . . . . . . . . . . .
CONTINUE WITH
7
2014
Hours
2013
Hours
Thou.
Thou.
0200
ON PAGE 5
CONTINUE ON NEXT PAGE
Form MA-10000(L)
If not shown, please enter your 11-digit Census File
Number (CFN) from the mailing address.
7
EMPLOYMENT AND PAYROLL - Continued
10000057
D. Employer's annual cost for fringe benefits - Employer's annual cost for legally required programs and programs
not required by law.
1. Health insurance - Insurance premiums
on hospitals, medical plans, and single
service plans such as dental, vision, and
prescription drug plans. (Include premium
2014
2013
equivalents for self-insured plans and fees
Mark "X"
if None
paid to third party administrators (TPAs).
$ Bil.
Mil.
Thou.
$ Thou.
Exclude disbursement from trusts or funds
to satisfy health insurance claims. Do not
include employee contributions.) . . . . . 0333
8
2. Pension plans
a. Defined benefit pension plans - Costs
for both qualified and non-qualified
defined pension plans. Pension
plans that specify the benefit to be
paid to employees upon retirement,
generally either a specific amount
or a percentage of compensation.
Employer contributions are based on
actuarial computations that include the
employee's compensation and years of
service and are not allocated to specific
accounts maintained for employees. . .
0335
b. Defined contribution plans - Costs
under defined contribution plans.
Pension plans that define the employer
contributions to a separate account
provided for each employee. The
employee "benefit" at retirement
depends on the amount contributed
and the results of the account's
activity. Examples include profit
sharing plans, money purchase (e.g.,
401k, 403b) and stock bonus plans
(e.g., ESOPs). . . . . . . . . . . . . .
0337
3. Payroll taxes, employer paid
insurance premiums (excluding
health), and other employer paid
benefits - Include legally-required fringe
benefits (e.g., Social Security, workers'
compensation insurance, unemployment
tax, state disability insurance programs,
Medicare). Include benefits for life
insurance, "quality of life" benefits
(e.g., childcare assistance, subsidized
commuting, etc.), employer contributions
to pre-tax benefit accounts (e.g., health
savings accounts), education assistance,
and other benefits not specified above.
Exclude disbursements from trusts or
funds to satisfy health insurance claims. .
0339
4. TOTAL (Add lines D1 through D3.) . . . .
0220
Not Applicable.
CONTINUE ON NEXT PAGE
Form MA-10000(L)
If not shown, please enter your 11-digit Census File
Number (CFN) from the mailing address.
9
VALUE OF INVENTORIES
A. Did this establishment own inventories, regardless of where held, at the end of 2014 and/or 2013?
0486
Yes - Go to line B
0487
No - Go to
13
B. Report inventories owned by this establishment as of December 31 before Last-in, First-out (LIFO) adjustment (if any).
Mark "X"
if None
End of 2014
Mil.
$ Bil.
Thou.
Mark "X"
if None
$ Bil.
End of 2013
Mil.
Thou.
1. Finished goods . . .
0461
0471
0463
0473
0462
0472
0460
0470
2. Work-in-process . . .
3. Materials, supplies,
fuels, etc. . . . . . .
4. TOTAL(Add lines B1
through B3.) . . . . .
10 INVENTORIES BY VALUATION METHOD (non-LIFO methods)
Report how much of the inventory reported in
Mark "X"
if None
$ Bil.
9
, line B4, is subject to the following valuation methods.
End of 2014
Mil.
Thou.
Mark "X"
if None
$ Bil.
End of 2013
Mil.
Thou.
A. First-in, First-out (FIFO) .
0498
0496
0502
0500
0506
0504
0487
0485
0499
0509
B. Average cost . . . . . .
C. Standard cost
. . . . .
D. Other non-LIFO valuation
method(s) - Specify method
0895
10000065
E. TOTAL (Add lines A
through D.) . . . . . . .
CONTINUE ON NEXT PAGE
Form MA-10000(L)
If not shown, please enter your 11-digit Census File
Number (CFN) from the mailing address.
11 INVENTORIES BY LAST-IN, FIRST-OUT (LIFO) VALUATION METHOD
A. Did this establishment use the Last-in, First-out (LIFO) method of valuation for any inventories?
Yes - Go to line B
0481
No - Go to
12
0482
B. Of the value on
9
B4, report:
Mark "X"
if None
1.
Amount subject to
LIFO (gross LIFO
amount) . . . . . .
2.
Amount not subject
to LIFO (Should
equal 10 , line E.) . .
3.
TOTAL(Add lines 1
and 2; should equal
9 , line B4.) . . . .
C. LIFO reserve
$ Bil.
End of 2014
Mil.
Mark "X"
if None
Thou.
0465
0475
0539
0553
0510
0508
0466
0476
$ Bil.
End of 2013
Mil.
Thou.
. . . . . .
12 INVENTORIES OUTSIDE OF THE UNITED STATES
A. Of the total inventories reported in 9 , line B4, were any stored or en route OUTSIDE the 50 U.S. states and the
District of Columbia?
0256
Yes - Go to line B
B. Report the total value
of these inventories (Do
not report inventory
held in Foreign Trade
Zones or in bonded
warehouses in the U.S.)
(Please see
Mark "X"
if None
0261
$ Bil.
No - Go to
End of 2014
Mil.
Thou.
13
Mark "X"
if None
$ Bil.
End of 2013
Mil.
Thou.
0260
10000073
http://
enforcement.trade.gov/
ftzpage/info/ftzstart.html
for more detailed
definitions.)
0257
CONTINUE ON NEXT PAGE
Form MA-10000(L)
If not shown, please enter your 11-digit Census File
Number (CFN) from the mailing address.
13 CAPITAL EXPENDITURES
(Refer to the instructions on how to report leasing arrangements.)
A. Capital expenditures for new and used
depreciable assets spent in 2014
1. Capital expenditures for new and used
buildings and other structures (Exclude
land.) . . . . . . . . . . . . . . . . . .
0525
2. Capital expenditures for new and used
machinery and equipment . . . . . . . .
0530
3. TOTAL (Add lines A1 and A2.) . . . . . .
0520
Mark "X"
if None
$ Bil.
2014
Mil.
Thou.
2013
$ Thou.
Mark "X"
if None
$ Bil.
2014
Mil.
Thou.
2013
$ Thou.
B. Breakdown of expenditures for new and used
machinery and equipment by type (Reported
on line A2.)
1. Automobiles, trucks, etc., for highway use
0522
2. Computers and peripheral data processing
equipment . . . . . . . . . . . . . . .
0523
3. All other expenditures for machinery and
equipment . . . . . . . . . . . . . . .
0524
4. TOTAL (Add lines B1 through B3, should
equal 13 , line A2.) . . . . . . . . . . . .
0529
14 RENTAL PAYMENTS
(Exclude capital leases which are leases with a
contract to own at the end of the lease. Include
operating leases.)
A. Rental or lease of buildings, job-site trailers
and other structures (Include land.) . . . . .
0551
B. Rental or lease of machinery and equipment
(Include construction equipment, tools, office
equipment, furniture, and vehicles.) . . . . .
C. TOTAL (Add lines A and B.) . . . . . . . . .
0550
10000081
15 Not Applicable.
CONTINUE ON NEXT PAGE
Form MA-10000(L)
If not shown, please enter your 11-digit Census File
Number (CFN) from the mailing address.
16 SELECTED EXPENSES
Mark "X"
if None
A. Selected production related costs
1. Cost of materials, parts, containers,
packaging, etc. used . . . . . . . . . . .
2. Cost of products bought and sold without
further processing (Report sales in 22
under census product code 9998991.) . . .
4. Cost of purchased electricity (Report
comparable quantity on line B1.) . . . . .
0425
5. Cost of work done for you by others on
your materials . . . . . . . . . . . . . .
0424
6. TOTAL (Add lines A1 through A5.)
0420
Mark "X"
if None
1. Purchased electricity (Quantity comparable
to cost reported on line A4.) . . . . . . . .
0436
2. Generated electricity (Gross less generating
station use.) . . . . . . . . . . . . . . .
0437
10000099
3. Electricity sold or transferred to other
establishments (Also include on lines B1 or
B2.) . . . . . . . . . . . . . . . . . . .
Thou.
2013
$ Thou.
Thou.
2013
Kilowatt-hours
Thou.
0426
0430
B. Quantity of Electricity
2014
Mil.
0421
3. Cost of purchased fuels consumed for heat,
power, or the generation of electricity . . .
. . . .
$ Bil.
Bil.
2014
Kilowatt-hours
Mil.
0438
CONTINUE WITH
16
ON PAGE 10
CONTINUE ON NEXT PAGE
Form MA-10000(L)
If not shown, please enter your 11-digit Census File
Number (CFN) from the mailing address.
16 SELECTED EXPENSES - Continued
C. Other operating expenses paid by this establishment
1.
2.
3.
4.
5.
6.
7.
8.
10000107
9.
Temporary staff and leased employee expense Total costs paid to Professional Employer
Organizations (PEOs) and staffing agencies
for personnel. (Include all charges for payroll,
benefits and services.) . . . . . . . . . . . . .
Mark "X"
if None
2014
Mil.
Thou.
2013
$ Thou.
0176
Expensed equipment - Expensed computer
hardware and other equipment (e.g., copiers,
fax machines, telephones, shop and lab
equipment, CPUs, monitors) (Report packaged
software on line C3.) . . . . . . . . . . . . .
0403
Expensed purchases of software - Purchases
of prepackaged, custom coded or vendor
customized software (Include software
developed or customized by others, web-design
services and purchases, licensing agreements,
upgrades of software; and maintenance fees
related to software upgrades and alterations.)
0188
Data processing and other purchased
computer services (Include computer facilities
management services, computer input
preparation, data storage, computer time rental,
optical scanning services, and other computerrelated advice and services, including training.
Exclude expensed integrated systems, repair
and maintenance of computer equipment,
payroll processing and credit card transaction
fees, and expenses for telecommunication
services, e.g., Internet, connectivity, telephone.)
0198
Purchased communication services - Telephone,
cellular, and fax services; computer-related
communications (e.g., Internet, connectivity,
online) and other wired and wireless
communication services. . . . . . . . . . . .
0427
Purchased repairs and maintenance to buildings
and/or machinery and equipment (Exclude
materials, parts, and supplies used for repairs
and maintenance performed by this firm's
employees.) . . . . . . . . . . . . . . . . .
0401
Water, sewer, refuse removal, and other nonelectric utility payments (Report electric utility
payments in 16 , line A4.) (Include the cost of
hazardous waste removal.) . . . . . . . . . .
Purchased advertising and promotional
services (Include marketing and public relations
services.) . . . . . . . . . . . . . . . . . . .
$ Bil.
0407
0409
Purchased professional and technical services
(Include management consulting, accounting,
auditing, bookkeeping, legal, actuarial, payroll
processing, architectural, engineering, and other
professional services. Exclude salaries paid to
your own employees for these services.) . . . .
0216
10. Governmental taxes and license fees Payments to government agencies for taxes and
licenses (Include business and property taxes.
Exclude income taxes.) . . . . . . . . . . . .
0405
11. All other operating expenses not reported
elsewhere (Exclude purchases of merchandise
for resale and nonoperating expenses.) Specify
0417
0415
12. TOTAL (Add lines C1 through C11.) . . . . . .
0422
17 – 21 Not Applicable.
CONTINUE ON NEXT PAGE
Form MA-10000(L)
If not shown, please enter your 11-digit Census File
Number (CFN) from the mailing address.
22 DETAIL OF SALES, SHIPMENTS, RECEIPTS, OR REVENUE
General - The manufactured products and services listed below are generally made in your industry. If you make products that are
not listed, please enter a description of your products in column (a) and enter their value in column (c) in the blank lines
provided in Item 22 . If additional lines are needed please use the "REMARKS" section. PLEASE DO NOT COMBINE PRODUCT LINES.
If the information as requested cannot be taken directly from your book records, REASONABLE ESTIMATES ARE ACCEPTABLE.
Valuation of Products - Report the value of the products shipped and services performed at the net selling value, f.o.b. plant to the
customer; i.e., after discounts and allowances, and exclusive of freight charges and excise taxes. Report separately for each major kind of
product. Include the value of products exported and interplant transfers in the appropriate product line(s). Exports and interplant transfers
should also be reported separately in 5 .
Contract Work - REPORT PRODUCTS MADE BY OTHERS FOR YOU FROM YOUR MATERIALS on the specific lines as if they were made
in this establishment. On the other hand, DO NOT REPORT on the specific product lines PRODUCTS THAT YOU MADE FROM MATERIALS
OWNED BY OTHERS. Report only the amount that you received for "commission or contract receipts" under Census code 9998992.
Resales - DO NOT REPORT on the specific product lines those PRODUCTS BOUGHT AND SOLD OR TRANSFERRED FROM OTHER
ESTABLISHMENTS OF YOUR COMPANY AND SOLD WITHOUT FURTHER MANUFACTURE. Report only a value under Census code
9998991, "Resales." Report the corresponding cost in 16 , line A2.
Products and services
Product Class
code
(a)
(b)
Products shipped and other receipts, including interplant
transfers and exports
Value, f.o.b. plant
2014
2013
(c)
(d)
$ Bil.
Mil.
Thou.
$ Thou.
018
026
034
042
059
10000115
067
075
083
091
CONTINUE ON NEXT PAGE
Form MA-10000(L)
If not shown, please enter your 11-digit Census File
Number (CFN) from the mailing address.
23 – 29 Not Applicable.
REMARKS (Please use this space for any explanations that may be essential in understanding your reported data.)
$$CENSUS_REMARKS$$
30 CERTIFICATION - This report is substantially accurate and was prepared in accordance with the instructions.
Is the time period covered by this report a calendar
year?
10000123
Yes
Month
No - Enter time period covered
Telephone
-
Year
TO
Title
Number
-
Month
FROM
Name of person to contact regarding this report
Area code
Year
Extension
-
Area code
Fax
Internet e-mail address
Number
Month
Day
Year
Date
completed
Thank you for completing your 2014 ANNUAL SURVEY OF MANUFACTURES form.
PLEASE RETAIN A COPY OF THIS FORM FOR YOUR RECORDS AND RETURN THE ORIGINAL.
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Author | brown538 |
File Modified | 2015-03-04 |
File Created | 2014-07-16 |