Form
Approved OMB
No. 0570-0007
United States Department of Agriculture
Rural Development
COOPERATIVE STATISTICS, 20__
Fishery Co-ops
If address is incorrect,
please correct mailing label.
Is this address your headquarters?
YES NO
Your help is needed in developing and maintaining complete and accurate nationwide statistics on cooperatives for use in education, research, and decision-making. The data you provide will remain confidential as provided for by law. Your contribution to this effort is very important. A copy of our report will be sent to you. If you have any questions related to this survey of cooperatives or about cooperatives in general, contact Eldon Eversull at (202) 690-1415 or send e-mail to [email protected].
business year during 20__? MONTH
(103)
(Include only members entitled to vote for directors.) NUMBER
(226)
$
3. a. VALUE OF FISH AND/OR SHELLFISH SOLD?
(513)
$
b. SALES OF SUPPLIES (INPUTS)?
4. Number of full-time and part-time and/or seasonal employees your cooperative operated with during
(101)
(972)
FULL-TIME? PART-TIME AND/OR SEASONAL?
(NOTE: If you attach a consolidated annual or audit report, fill in only information requested that is not included in the consolidated annual or audit report.)
5. Please provide the amounts for these balance sheet items for your business year that ended in 20__.
(114)
$
(108)
$
b. INVESTMENTS IN ALL OTHER CO-OPS (Include CoBank.)?
(115)
$
(107)
$
(116)
$
e. CURRENT LIABILITIES?
(109)
$
f. TOTAL LIABILITIES?
Office
use only
g. ALLOCATED MEMBER EQUITIES?
(118)
$
h. UNALLOCATED MEMBER EQUITIES (Retained Earnings)?
(110)
$
i. TOTAL NET WORTH (TOTAL EQUITY)?
Office
use only
j. TOTAL LIABILITIES AND NET WORTH (Equals Total Assets)?
6. From your income statement, please provide the following for your business year that ended in 20__.
(124)
$
and patronage refunds.)?
(131)
$
b. COST OF GOODS SOLD?
Office
use only
c. GROSS MARGIN (Total sales minus cost of goods sold)?
(106)
$
(Include service revenues, storage and handling fees, etc.)?
Office
use only
e. GROSS REVENUE (Gross Margin plus Service Receipts and other Income)?
f. TOTAL WAGES AND BENEFITS EXPENSE (Include payroll
(123)
$
other related benefits.)?
(120)
$
g. DEPRECIATION EXPENSE?
(121)
$
h. INTEREST EXPENSE?
Office
use only
i. OTHER EXPENSES?
(125)
$
j. TOTAL EXPENSES (Include Operating and all Other Expenses)?
Office
use only
k. NET MARGINS FROM OPERATIONS (Local Savings)?
l. TOTAL PATRONAGE REFUNDS AND DIVIDENDS RECEIVED
(113)
$
cooperatives, less any equity write-offs.)?
m. NONOPERATING INCOME (Include sale of assets, discontinued operations,
(136)
$
or losses not already accounted for)?
(112)
$
n. NET INCOME BEFORE TAXES?
(135)
$
o. INCOME TAXES?
(122)
$
p. TOTAL NET INCOME (OR LOSS)?
7. REPORTED BY: TITLE PHONE ( ) -
FAX ( ) - DATE E-MAIL ADDRESS
COOPERATIVE’S INTERNET HOME-PAGE ADDRESS
Please attach the enclosed return mailing label to your envelope and return this questionnaire along with a copy of your 20__ annual report to:
USDA/RBS, STOP 3256, 1400 INDEPENDENCE AVE., SW, WASHINGTON, DC 20250-3256
(If you would like your annual or audit report returned to you, please let us know.)
THANK YOU!
According
to the Paperwork Reduction Act of 1995, no person is required to
respond to a collection of information especially if the form fails
to display a valid OMB control number. The valid OMB control number
for this information collection is 0570-0007. The time required to
complete this information collection is estimated to average 30
minutes per response, including the time for reviewing instructions,
searching existing data sources, gathering and maintaining the data
needed, and completing and reviewing the information collection.
Your help is needed in developing and maintaining complete and
accurate nationwide statistics on farmer, rancher, and aquacultural
associations or cooperatives. The data you provide will remain
confidential as provided for by law.
File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
Author | eldon.eversull |
File Modified | 0000-00-00 |
File Created | 2021-01-22 |