MA-1000(L) 2014 Annual Survey Of Manufactures

Annual Survey of Manufactures

Attachment C. MA-10000

Annual Survey of Manufactures

OMB: 0607-0449

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U.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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