2012 Economic Census of Island Areas

2017 Economic Census of Island Areas

IA Attachment C

2012 Economic Census of Island Areas

OMB: 0607-0937

Document [pdf]
Download: pdf | pdf
Attachment C
Department of Commerce
United States Census Bureau
OMB Information Collection Request
2017 Economic Census of Island Areas
OMB Control Number 0607-0937
Information Sheets
Information Sheet for Utilities and Transportation and Warehousing
Information Sheet for Construction
Information Sheet for Manufacturing
Information Sheet for Wholesale Trade
Information Sheet for Retail Trade
Information Sheet for Other Services
Information Sheet for Finance, Insurance, Real Estate, and Rental and Leasing
Information Sheet for Accommodation Services

92101_I

U.S. DEPARTMENT OF COMMERCE
Economics and Statistics Administration
U.S. Census Bureau

(2/2017)

2017 ECONOMIC CENSUS
U.S. Territories
Utilities and Transportation and Warehousing
INFORMATION SHEET
Need help or have questions about filling out the form?
Visit econhelp.census.gov or
Call 1-800-233-6136, between 8:00 a.m. and 6:00 p.m., Eastern time, Monday through Friday.
Please reference your 11-digit Census File Number (CFN) printed on each form with all communications.

the Internal Revenue Service (IRS) Form 941-PR or
941-SS, Employer’s Quarterly Federal Tax Return,
or Form 944-PR or 944-SS, Employer’s Annual
Federal Tax Return). Indicate in item 30 the exact
dates covered.

The Utilities and Transportation and Warehousing sectors
of the 2017 Economic Census include establishments
primarily engaged in the following:


Utilities– electric, gas, and water.



Transportation– transit, ground passenger, air, water,
pipeline, and scenic and sightseeing transportation,
trucking, warehousing, and storage.



If an establishment stopped operating before January 1,
2017, indicate action and date in item 3, mark “X” the
box to indicate “none” in item 4, and continue to
item 30.

If an establishment is NOT engaged in one of these kinds
of businesses, DESCRIBE its business or activity in
ITEM 19 AND COMPLETE the report form as accurately
as possible.



If an establishment was closed, sold, or leased to
another company or organization during 2017, complete
the report form for the portion of 2017 that the
establishment was operating as part of your company or
organization.

DEFINITION OF ESTABLISHMENT



Dollar figures should be rounded to the nearest
thousand as illustrated on the report form.



If there are any questions or if any communication
regarding this report form is necessary, reference the
11-digit Census File Number (CFN) shown in the mailing
address.



Please photocopy each completed report form for your
records and return the original.



Public reporting burden for this collection of information
is estimated to average one hour 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: Paperwork Project 0607-0937, U.S. Census
Bureau, 4600 Silver Hill Road, AMSD-3K138,
Washington, DC 20233. You may e-mail comments to
[email protected]; use “Paperwork Project
0607-0937" as the subject.



Response to this collection of information is required
unless it does not display a valid approval number from
the Office of Management (OMB). The OMB eight-digit
number appears on the welcome screen or in the upper
right corner of the paper report form.

An establishment is generally a single physical location
where business is conducted or where services or
industrial operations are performed. This includes all
selling and service locations of a company and any other
facilities such as warehouses, administrative offices,
terminals, etc., that were in operation at any time during
2017. Permanent (or temporary) locations with no paid
employees (such as unmanned warehouses) are not
considered separate establishments.
GENERAL INSTRUCTIONS


Complete a separate report form for each
establishment owned or controlled by your company
or organization. If you did not receive a separate report
form for each establishment, visit our web site at
econhelp.census.gov or call 1-800-233-6136, between
8:00 a.m. and 6:00 p.m., Eastern time, Monday through
Friday, to request additional report forms.



Each report form should cover calendar year
2017. If book figures are not available,
estimates are acceptable. However, if the
accounting fiscal year is different from the
calendar year, fiscal year figures will be
acceptable for all items except payroll (calendar
year figures for payroll should be available from

92101

Page 1

PLEASE CONTINUE ON REVERSE

INSTRUCTIONS FOR SELECTED ITEMS
2.

PHYSICAL LOCATION

Answer all sections (A and B) of item 2 even if the mailing
address shown is correct.
3.



In operation – The establishment was open and
actively conducting business on December 31, 2017.



Temporarily or seasonally inactive – Although not
conducting business at the end of 2017, the
establishment will eventually reopen and conduct
business under the same Employer Identification
Number (EIN). Examples include businesses or
establishments that close during the “off-season” or that
temporarily close for remodeling. Complete all items on
the form for the portion of 2017 during which the
establishment was active.





5.

Consulting fees received for counseling and advising
clients on aspects of the operation of businesses.



Agency or brokerage commissions and fees for
arranging transportation of freight and cargo.



Rental revenue from leasing of vehicles, equipment,
instruments, tools, etc., marketed under operating
leases.



Fair sales value of merchandise marketed in 2017 under
capital, finance, or “full-payout” leases.

OPERATIONAL STATUS

Mark “X” the ONE box that best describes the operational
status of the establishment at the end of 2017.





Exclude:

SALES, SHIPMENTS, RECEIPTS, OR REVENUE
IN 2017

For establishments that generate no revenue, report zero
and explain in the remarks section at the end of the report
form.
Include:

Total value of service contracts.



Amounts received for work subcontracted to others and
from repair services provided to others.

92101

Rents and revenue from departments or concessions
that are operated by others.



All cash or noncash subsidies from any municipal,
commonwealth or federal agency.
E-COMMERCE SALES, SHIPMENTS, RECEIPTS,
OR REVENUE IN 2017

Include:

Other status – The establishment’s operational status
at the end of 2017 is not accurately described above.
Please specify a description of the establishment’s
operational status in the space provided.





E-commerce transactions are transactions completed over
an Internet, electronic mail, Extranet, Electronic Data
Interchange (EDI) network, or other online system.

Sold or leased to another operator – The
establishment was sold or leased to another company or
organization. Provide the month, day, and year that
the change occurred and indicate the name, address,
and EIN of the new owner or operator. Complete all
items on the form for the portion of 2017 prior to the
change in operator.

Gross revenue from services provided, for the use of
facilities, and from merchandise sold in 2017, whether or
not payment was received in 2017.

Sales and other taxes collected directly from customers
and paid directly to a municipal, commonwealth or
federal tax agency.

6.

Ceased operation – The establishment has gone out of
business or closed and does not plan to reopen. Provide
the month, day, and year that the establishment
ceased operation. Complete all items on the form for the
portion of 2017 during which the establishment was in
operation.





Page 2



Revenue generated from agreements negotiated online
between buyer and seller on price and term of a transfer
of ownership of, or rights to use, goods or services.



Online sales of goods or services, regardless of whether
payment is made online.



Commissions or fees from the use of online services
(e.g., computerized reservation systems, financial
transaction processing systems, etc.) where the order or
contact was negotiated online.



Commissions or fees from online trading of securities or
other financial products (e.g., insurance. loans, etc.).



Commissions or fees from selling or from facilitating the
sale of third party products (e.g., click-throughs on
advertisements or referral fees) through the
establishment’s Web site.



Revenue generated from telephone transactions using
interactive voice response systems.



Shipping and handling receipts for online orders.

PLEASE CONTINUE ON NEXT PAGE

Exclude:


Online payments from customers where the order or
contract was not negotiated online.



Commissions or fees from the provision of
telecommunications and related infrastructure systems
(e.g., data transfer, Web hosting, Internet access, etc.)
where the order or contract was not negotiated online.



7.



Compensation paid to sales agents as reported on
Internal Revenue Service Form 941-PR or 941-SS,
Employer’s Quarterly Federal Tax Return, or Form
944-PR or 944-SS, Employer’s Annual Federal Tax
Return.



The spread on stock options that is taxable to employees
as income.

Exclude:

Orders for goods or services placed over facsimile
machines or switched telephone network.
EMPLOYMENT AND PAYROLL

If employees worked at more than one location, report
employment and payroll for employees at the ONE location
where they spent most of their working time.
A. Number of paid employees



Payments to or withdrawals by proprietors or partners of
an unincorporated business.



Annuities or supplemental unemployment
compensation benefits, even if income tax was withheld.



Payroll of departments or concessions operated by other
companies at the establishment.



Compensation paid to agents not considered employees
of the firm on Internal Revenue Service Form 941-PR or
941-SS, Employer’s Quarterly Federal Tax Return, or
Form 944-PR of 944-SS, Employer’s Annual Federal Tax
Return (e.g., real estate agents, independent insurance
agents).

Report number of paid employees for pay period including
March 12, 2017.
Include:


C. Employer’s cost for benefits

All full- and part-time employees working at this
establishment whose payroll was reported on Internal
Revenue Service Form 941-PR or 941-SS, Employer’s
Quarterly Federal Tax Return, or Form 944-PR or 944SS, Employer’s Annual Federal Tax Return, and filed
under the Employer Identification Number (EIN) shown
in the mailing address or corrected in item 1.



Salaried officers and executives of a corporation.



Salaried member of a professional service organization
or association.



Employees on paid sick leave, paid holidays, and paid
vacation.

Include:


Legally required employer’s cost for benefits (employer
payments for Social Security, Medicare, unemployment
compensation, workmen’s compensation, and local
disability programs, if required). Also include any legally
required employer’s cost for benefits under non FICA
regulations.



Voluntarily provided benefits (payments for life
insurance, medical insurance, pensions, welfare
benefits, union-negotiated benefits, and other benefits).

13. CAPITAL EXPENDITURES AND DEPRECIATION
CHARGES

Exclude:


Temporary staffing obtained from a staffing service.

A. Capital expenditures



Employees of departments or concessions operated by
other companies at this establishment.



Proprietors or partners of an unincorporated business.



Unpaid family members.

B. Payroll before deductions

Report expenditures made during 2017 to purchase
buildings or structures, including improvements and
repairs, and machinery and equipment that are chargeable
to the fixed assets accounts and for which depreciation
accounts are maintained. Also include the cost of buildings
or structures and machinery and equipment acquired as
the lessee under capital lease agreements entered into
during 2017.

Include:

B. Depreciation charges



Wages, salaries, tips, vacation allowances, bonuses,
commissions, and other compensation paid to
employees during 2017, whether or not subject to
income or FICA tax.



Salaries of officers and executives of a corporation.



Employee contributions to qualified pension plans.

92101

Report depreciation charges taken against tangible assets
owned and used by your firm, tangible assets and
improvements owned by your firm under leaseholds,
tangible assets obtained, as the lessee, through capital
lease agreements in 2017.

Page 3

PLEASE CONTINUE ON REVERSE

16. SELECTED EXPENSES

E.

Costs refer to the amount actually paid or payable after
discounts, including freight and other direct charges
incurred in acquiring the item or service.

Report total amount paid for the maintenance and repair of
buildings, structures, offices, and their integral parts.
Include the cost of purchased services from other
companies that are paid directly by this establishment for
janitorial, refuse removal, and other services.

A. Communication services
Report cost of communication services, including
telephone, cellular phones, Internet, fax, and the cost for
the contracts.

F.

Maintenance and repair of buildings, structures,
offices and their integral parts

All other operating expenses

Include all the other operating expenses incurred by the
establishment, such as payroll, benefits, utilities,
depreciation. Do not include capital expenditures, interest,
and/or bad debt.

B. Computer services
Report the cost of all computer services. Include data
processing and computer software.

G. Interest paid
Include all the interest that was paid in 2017.

C. Office supplies
Report the cost of office supplies.

19. PRINCIPAL KIND OF BUSINESS

D. Maintenance and repair of machinery and
equipment

Choose the PRINCIPAL kind of business that best
describes the establishment in 2017. If none of the provided
selections seem appropriate, mark “X” the box next to
“Other kind of business or activity,” at the end of item 19
and provide a specific description of the primary business
activity.

Report total amount paid for the maintenance and repair of
the machinery and/or equipment during 2017.

92101

Page 4

92301_I

U.S. DEPARTMENT OF COMMERCE
Economics and Statistics Administration

(2/2017)

U.S. Census Bureau

2017 ECONOMIC CENSUS
CONSTRUCTION
INFORMATION SHEET
Need help or have questions about filling out the form?
Visit econhelp.census.gov or
Call 1-800-233-6136, between 8:00 a.m. and 6:00 p.m., Eastern time, Monday through Friday.
Please reference your 11-digit Census File Number (CFN) printed on each form with all communications.

GENERAL INSTRUCTIONS




Complete a separate report form for each establishment
owned or controlled by your company or
organization. If you did not receive a separate report
form for each establishment, visit our web site at
econhelp.census.gov or call 1-800-233-6136, between
8:00 a.m. and 6:00 p.m., Eastern time, Monday through
Friday, to request additional report forms.
Each report form should cover calendar year 2017. If
book figures are not available, estimates are
acceptable. However, if the accounting fiscal year is
different from the calendar year, fiscal year figures
will be acceptable for all items except payroll
(calendar year figures for payroll should be available
from the Internal Revenue Service (IRS) Form 941-PR
or 941-SS, Employer’s Quarterly Federal Tax Return,
or Form 944-PR or 944-SS, Employer’s Annual
Federal Tax Return). Indicate in item 30 the exact
dates covered.



If an establishment stopped operating before January
1, 2017, indicate action and date in item 3, mark “X”
the box to indicate “none” in item 4, and continue to
item 30.



If an establishment was closed, sold, or leased to
another company or organization during 2017,
complete the report form for the portion of 2017 that
the establishment was operating as part of your
company or organization.



Dollar figures should be rounded to the
nearest thousand as illustrated on the report
form.



If there are any questions or if any communication
regarding this report form is necessary, reference
the

11-digit Census File Number (CFN) shown in the mailing
address.


Please photocopy each completed report form for
your records and return the original.



Public reporting burden for this collection of
information is estimated to average one hour 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: Paperwork Project 0607-0937, U.S. Census
Bureau, 4600 Silver Hill Road, AMSD-3K138,
Washington, DC 20233. You may e-mail comments to
[email protected]; use “Paperwork Project 06070937" as the subject.



Response to this collection of information is required
unless it does not display a valid approval number
from the Office of Management (OMB). The OMB
eight-digit number appears on the welcome screen or
in the upper right corner of the paper report form.
In operation – The establishment was open and
actively conducting business on December 31,
2017.


INSTRUCTIONS FOR SELECTED ITEMS
2.

PHYSICAL LOCATION



Temporarily or seasonally inactive – Although not
conducting business at the end of 2017, the
establishment will eventually reopen and conduct
business under the same Employer Identification
Number (EIN). Examples include businesses or
establishments that close during the “off-season” or that
temporarily close for remodeling. Complete all items on
the form for the portion of 2017 during which the
establishment was active.



Ceased operation – The establishment has gone out
of business or closed and does not plan to reopen.
Provide the month, day, and year that the

Answer all sections (A and B) of item 2 even if the mailing
address shown is correct.
3.

OPERATIONAL STATUS

Mark “X” the ONE box that best describes the operational
status of the establishment at the end of 2017.

establishment ceased operation. Complete all items on
the form for the portion of 2017 during which the
establishment was in operation.

prior to the change in operator.


Other status – The establishment’s operational
status at the end of 2017 is not accurately described
above. Please specify a description of the
establishment’s operational status in the space
provided.

Sold or leased to another operator – The
establishment was sold or leased to another company
or organization. Provide the month, day, and year
that the change occurred and indicate the name,
address, and EIN of the new owner or operator.
Complete all items on the form for the portion of 2017
ITEM 5. SALES OR RECEIPTS IN 2017

Exclude:

5A. Receipts, billings, or sales for construction work



Online payments from customers where the order or
contract was not negotiated online.



Sales from goods or services placed over facsimile
machines or switched telephone networks.



Report your 2017 receipts for construction work.
Include:


Receipts or billings for construction work under any
type of contract – general, special trade, design-build,
construction management, engineer-construct,
turnkey, etc.

ITEM 7: EMPLOYMENT AND PAYROLL



Sales of houses and other buildings you built
which were sold during 2017.

If employees worked at more than one location, report
employment and payroll for employees at the ONE location
where they spent most of their working time.



Cost of labor, materials, overhead, and normal profit.

Include:



Work on new construction, additions, alterations,
reconstruction, maintenance, repairs and service
work.



All full- and part-time employees working at this
establishment whose payroll was reported on Internal
Revenue Service (IRS) Form 941-PR, Employer’s
Quarterly Federal Tax Return or Form 944-PR,
Employer’s Annual Federal Tax Return, and filed under
the Tax ID/ Employer Identification Number (EIN) listed
in the EMPLOYER IDENTIFICATION NUMBER (TAX ID)
area.



If the legal form of organization for this business is a
corporation, the reporting of other employees and
other payroll at this domestic reporting unit is required.
If payroll and employment for this Tax ID/EIN are zero,
please indicate if the Tax ID/EIN is a joint venture in the
remarks section



All persons on paid sick leave, paid holidays, and paid
vacation during the year at this domestic reporting unit

5D. E-commerce sales



Salaried officers and executives of a corporation.

E-commerce transactions are transactions completed over
an Internet, electronic mail, Extranet, Electronic Data
Interchange (EDI) network, or other online system.

Exclude:

Exclude


The cost of land other than site preparation.



The purchase cost or estimated value of raw land
from the value of construction work.

5B. Receipts for all other business activities
Report the receipts for all other business activities done
by this establishment in 2017. Exclude non-operating
income such as interest, dividends, or the sale of fixed
assets.
5C. Add lines 5A and 5B.

Include:


Sales or receipts generated as a result of e-commerce
transactions or agreements negotiated online,
including electronic mail (e-mail), between the
customer and this establishment on the price or terms
of construction work accepted, regardless of whether
payment is made online.



Online orders accepted by the corporate office
but completed by this establishment.



Sales generated from telephone transactions
using interactive voice response systems.

92301_I



Subcontractors and their employees



Temporary staffing obtained from a staffing service.



Purchased or managed services, such as janitorial,
guard, or landscape services.



Professional or technical services purchased from
another firm, such as software consulting, computer
programming, engineering, or accounting services.



Proprietors or partners of an unincorporated business.



Unpaid family members.

A1. Number of paid construction workers
Page 2

PLEASE CONTINUE ON NEXT PAGE

Report number of paid construction workers for the
quarterly periods including the 12th of March, June,
September, and December 2017.

B.HOURS WORKED BY CONSTRUCTION WORKERS
Report hours worked only for the construction workers
reported in item 7A1.

A4. All other paid employees

Include:

Report all other employees (including those engaged in
supervision above the line-supervisor level (workingforeman level), sales, clerical, advertising, credit collection,
installation, servicing of own products, executive,
purchasing, finance, legal, professional and technical
personnel, office staff, and others engaged in
nonconstruction activities.) for pay period including
March 12, 2017.



Hours worked during four specific pay periods
including the 12th of March, June, September, and
December 2017



Overtime hours as actual hours worked not as
straight- time equivalent hours.

Exclude: Hours paid for vacations, holidays (unless
actually worked), or sick leave.
C. Payroll before deductions
Report only for employees reported on lines A1 and A4.
Include:


Wages, salaries, tips, vacation allowances,
bonuses, commissions, and other compensation
paid to employees during 2017, whether or not
subject to income or FICA tax.



Salaries of officers and executives of a corporation.



Employee contributions to qualified pension plans.

Exclude:


Payments to or withdrawals by proprietors or partners
of an unincorporated business.



Annuities or supplemental unemployment
compensation benefits, even if income tax was
withheld.



Employer’s cost for payroll taxes and benefits.

D. Employer’s cost for benefits
Include:

92301_I

Page 3



Legally required employer’s cost for benefits
(employer payments for Social Security, Medicare,
unemployment compensation, workmen’s
compensation, and local disability programs, if
required). Also include any legally required
employer’s cost for benefits under non FICA
regulations.



Voluntarily provided benefits (payments for life
insurance, medical insurance, pensions, welfare
benefits, union-negotiated benefits, and other
benefits).

PLEASE CONTINUE ON REVERSE

13. ASSETS, CAPITAL EXPENDITURES,
AND DEPRECIATION CHARGES

D. Capital expenditures for USED
buildings, structures, machinery and
equipment

A. Gross value of depreciable assets

Include used automobiles, trucks, etc., major repairs
and improvements and software, computers and
peripherals, current expenditures for property,
equipment, and capital improvements that were or will
be chargeable to the fixed asset accounts and for which
depreciation accounts are ordinarily maintained.
Additions to construction-in- progress for company
owned projects lasting more than one year that will be
added, as depreciable assets should be reported
currently rather than once the project has been
completed and is in use. Include the cost of capital
improvements that were made during 2017 which
increased the value of property or adapted it for another
use. Capital expenditures for leasehold improvements
(made to property leased from others) are also included.

Depreciable assets are the buildings, structures,
machinery, and equipment owned by this establishment
or its parent for which depreciation accounts are
ordinarily maintained. If this establishment is part of a
multi- establishment company, the parent company
should assign to each establishment building and
equipment that the establishment is responsible for as if
it owned them.
This establishment should include these as part of its
beginning balances, additions, and disposals as
appropriate as well as the allocation of related
depreciation expenses. For example, if this
establishment maintained a tenant relationship with the
parent company or a subsidiary, and paid “rent” for the
use of either buildings or equipment, do not report the
value of this “rent”. Instead, in item 13 report the gross
value of the assets made available to this establishment
as a result of this “rental” agreement as if the
establishment owned them.

E.

Include depreciable assets sold, retired, scrapped,
destroyed, lost, or otherwise disposed of that should
also include acquisition cost of transfers or depreciable
assets to assets held for sale and reductions in value
due to impairment.

Include:


Gross value of depreciable assets

Assets acquired through capital leases. If any building
or equipment has been acquired under a capital
leasing arrangement that meets the criteria set down
by the Financial Accounting Standards Board (FASB),
please report the original cost or market value as a
fixed asset and as a capital expenditure if acquired in
2017. If the lease qualifies as an operating lease, do
not include the value of the building and equipment as
a fixed asset or capital expenditure.

G. Depreciation charges
Report depreciation charges for the year relating to the
assets allocated to the reporting establishment by a
parent or affiliate.
14. RENTAL PAYMENTS



Assets acquired or produced to be leased to others
as the lessor under an operating lease.

If this establishment is part of a multi-establishment
company or a subsidiary rented property for the use of
this establishment and paid the rent, the rent should be
reported in item 14 as if the establishment paid it.



Capital expenditures for construction in progress
incurred in prior periods. Report current capital
expenditures in line 13B even if not completed
and operational.

However, if this establishment rented buildings or
equipment from the parent or affiliate as a tenant, then
the value of assets should be reported in item 13.
Exclude capital leases (leases with a contract to own at
the end of the lease) as well as rentals of assets owned
by parent reported in item 13.

Exclude:


The cost of land, but INCLUDE the value of
land development.



Assets leased to others under capital
lease arrangements.

16. SELECTED EXPENSES
This section is intended to complete a comprehensive
reporting of operating costs and expenses incurred by
this establishment not already identified for collection
on the form. Certain costs of construction and
expenses were already collected in item 7, item 13,
and item 14 on the form.

C. Capital expenditures for NEW buildings,
structures, machinery and equipment, and
job- site vehicles
Include new construction spending, software, computers
and peripherals. Exclude maintenance and repair for which
depreciation accounts are ordinarily maintained. Additions
to construction-in-progress for company owned projects
lasting more than one year that will be added, as
depreciable assets should be reported currently rather than
once the project has been completed and is in use. Include
the value of depreciable assets acquired through mergers
and acquisitions.
92301_I

A1. Cost of materials, parts, and supplies
Report job-site, general office, and all other material, part,
and supply costs relating to the construction and other
business activities of this establishment.

Page 4

PLEASE CONTINUE ON NEXT PAGE

provided selections seem appropriate, mark “X” the box
next to “Other kind of business or activity,” at the end of
item 19

Include:


Equipment purchased by this establishment that was
installed in a building as an integral part of its
structure, such as elevators, air conditioning
equipment, etc.



Costs after discounts for the materials, parts, and
supplies that were purchased by this establishment
or obtained from other establishments of your
company.



Freight and other direct charges for the materials,
parts, and supplies used in 2017.



Expendable tools that were charged to current
accounts in 2017.

A2. Cost of construction work subcontracted out to
others
Include your payments to subcontractors for construction
work.
Exclude the cost of non-construction work subcontracted
out unless it is incidental to the primary construction
activities of the subcontractor. Services such as
abatement, refuse removal, design work or surveying
should be reported in 16B.
B. Selected purchased services
Include costs for each of the services purchased from
other companies that are paid directly or incurred by a
parent or affiliate for this establishment and have not been
reported elsewhere in the form which are considered as
overhead or non-job related.
Exclude:


Salaries paid to employees of this establishment for
any professional and/or technical services.



Materials, parts, and supplies used for repairs
and maintenance performed by this
establishment’s employees.



Lease and rental payments for equipment,
building, other structure, or land by this
establishment and reported item 14, Rental
Payments.



Cost of construction activities subcontracted to
others and reported in item 16A, line 2.



Cost of any utility payments if payments are included
in a lease or rental payment and reported in item 14 or
gasoline, fuels, and energy reported in item 16A.



Income taxes, purchases of merchandise for resale,
bad debts, impairment charges, interest and other
non- operating expenses.

19. PRINCIPAL KIND OF BUSINESS
Choose the PRINCIPAL kind of business that best
describes the establishment in 2017. If none of the
92301_I

Page 5

PLEASE CONTINUE ON REVERSE

and provide a specific description of the primary business
activity.
22. DETAIL OF SALES OR RECEIPTS IN 2017 –
KIND OF BUSINESS
The kind of business activities reported in item 22 should
be consistent with item 5, line C. That is, the sum of the
percentages reported in 22A for construction activities
should equal the percentage obtained when the total
dollar value of construction activities in 5A is divided by
the total reported in 5C.
For example, if you reported $75,000 in 5A and $100,000
in 5C, then the sum of the percentages reported in 22A
should equal 75%. The sum of the percentages reported
in 22B for other business activities should equal the
percent obtained when the dollar value of 5B is divided
by that of 5C. The sum of the entries in 22A AND 22B
should equal 100%.
A. Construction work activities
Report only the main activities for which you were
contracted. Work which was incidental to the primary
activities of jobs should not be reported separately. For
example,


If you were contracted to design and build, do not
separate out the design part from the construction
work.



If you were contracted to shingle a roof, do not
separate out incidental gutter and downspout
installation.



If you were working as a general contractor, do
not separate out carpentry work, excavation
work, etc.



If this establishment engaged in construction activities
that are not listed on the form, please enter a
description of the construction activity in the “Other
kinds of construction” write-in box, along with a
percentage of the total value of business for that
specified activity.

B. Other business activity
Report any non-construction activities. If the activity is not
listed on the form, please enter a description of the nonconstruction activity in the “Other business activities”
write- in box, along with a percentage of the value of total
business for that specified activity.
23. SOURCES OF SALES AND RECEIPTS
This question requests that the amount reported in 5A
be broken down by type of construction for buildings
and other types of construction. Estimate the percent of
the dollar value of construction work reported in 5A
according to the specified types of construction:

92301_I

Page 6

PLEASE CONTINUE ON NEXT PAGE

New construction – the original construction work done
on a project including all finishing work on the original
building or structure. Land development work on the site
and demolition of existing structures are included in new
construction.

Maintenance and repair work – incidental construction
work which keeps a property in ordinary working condition.
Excluded are trash removal, lawn maintenance and
landscaping, and cleaning and janitorial services.

Additions, alterations, or reconstruction –
construction work which adds to the value or useful life of
an existing building or structure, or which adapts a building
or structure to a new or different use. Included are "major
replacements" of building systems such as the installation
of a new roof or cooling system and the resurfacing of
streets or highways. This contrasts to the repair of a hole in
a roof or the routine patching of highways and streets,
which would be classified as maintenance and repair.

26. SPECIAL INQUIRIES
A. Ownership of construction projects
General contractors and finance source such as lending
institutions are not normally owners. Work on highways
should be reported as Gov

ernment-owned construction.

92301_I

Page 7

PLEASE CONTINUE ON REVERSE

93101_I

U.S. DEPARTMENT OF COMMERCE
Economics and Statistics Administration
U.S. Census Bureau

(2/2017)

2017 ECONOMIC CENSUS
U.S. Territories
MANUFACTURING
INFORMATION SHEET
Need help or have questions about filling out the form?
Visit econhelp.census.gov or
Call 1-800-233-6136, between 8:00 a.m. and 6:00 p.m., Eastern time, Monday through Friday.
Please reference your 11-digit Census File Number (CFN) printed on each form with all communications.
acceptable. However, if the accounting fiscal year is
different from the calendar year, fiscal year figures will
be acceptable for all items except payroll (calendar year
figures for payroll should be available from the Internal
Revenue Service (IRS) Form 941-PR or 941-SS,
Employer’s Quarterly Federal Tax Return, or Form 944PR or 944-SS, Employer’s Annual Federal Tax Return).
Indicate in item 30 the exact dates covered.

The 2017 Economic Census covers establishments
primarily engaged in the following areas of economic
activity:
Manufacturing The manufacturing activity involves the
mechanical, physical, or chemical transformation of
materials, substances, or components into new products.
Mining - The mining activity involves establishments that
extract naturally occurring mineral solids. The term mining
is used in the broad sense to include quarrying.
If an establishment is NOT engaged in one of these kinds
of businesses, DESCRIBE its business or activity in
ITEM 19 AND COMPLETE the report form as accurately
as possible.
DEFINITION OF ESTABLISHMENT
An establishment is generally a single physical location
where business is conducted or where services or
industrial operations are performed.
Manufacturing - Is generally a single physical location
where manufacturing is performed. This includes all
locations of a company or organization, including
administrative offices that were in operation at any time
during 2017.
Mining - Is a physical location that primarily performs
exploration and other mining and quarrying support
services for operators of mineral properties.



If an establishment stopped operating before January 1,
2017, indicate action and date in item 3, mark “X” the
box to indicate “none” in item 4, and continue to
item 30.



If an establishment was closed, sold, or leased to
another company or organization during 2017, complete
the report form for the portion of 2017 that the
establishment was operating as part of your company or
organization.



Dollar figures should be rounded to the nearest
thousand as illustrated on the report form.



If there are any questions or if any communication
regarding this report form is necessary, reference the
11-digit Census File Number (CFN) shown in the mailing
address.



Please photocopy each completed report form for your
records and return the original.



Public reporting burden for this collection of information
is estimated to average one hour 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: Paperwork Project 0607-0937, U.S. Census
Bureau, 4600 Silver Hill Road, AMSD-3K138,
Washington, DC 20233. You may e-mail comments to
[email protected]; use “Paperwork Project
0607-0937" as the subject.



Response to this collection of information is required
unless it does not display a valid approval number from
the Office of Management (OMB). The OMB eight-digit
number appears on the welcome screen or in the upper
right corner of the paper report form.

GENERAL INSTRUCTIONS




Complete a separate report form for each
establishment owned or controlled by your company
or organization. If you did not receive a separate report
form for each establishment, visit our web site at
econhelp.census.gov or call 1-800-233-6136, between
8:00 a.m. and 6:00 p.m., Eastern time, Monday through
Friday, to request additional report forms.
Each report form should cover calendar year 2017. If
book figures are not available, estimates are

93101_I

Page 1

PLEASE CONTINUE ON REVERSE

INSTRUCTIONS FOR SELECTED ITEMS
2.

Exclude:

PHYSICAL LOCATION

Answer all sections (A and B) of item 2 even if the mailing
address shown is correct.
3.



Shipping and freight charges.



Excise and other taxes collected and paid directly to the
commonwealth or federal tax agency.

D. Receipts for resales
Include the sale value of products bought and resold
without further processing. Cost of all products resold is to
be included in item 16B.

OPERATIONAL STATUS

Mark “X” the ONE box that best describes the operational
status of the establishment at the end of 2017.


In operation – The establishment was open and
actively conducting business on December 31, 2017.

6.



Temporarily or seasonally inactive – Although not
conducting business at the end of 2017, the
establishment will eventually reopen and conduct
business under the same Employer Identification
Number (EIN). Examples include businesses or
establishments that close during the “off-season” or that
temporarily close for remodeling. Complete all items on
the form for the portion of 2017 during which the
establishment was active.

E-commerce transactions are transactions completed over
an Internet, electronic mail, Extranet, Electronic Data
Interchange (EDI) network, or other online system.



Ceased operation – The establishment has gone out of
business or closed and does not plan to reopen. Provide
the month, day, and year that the establishment
ceased operation. Complete all items on the form for the
portion of 2017 during which the establishment was in
operation.



Sold or leased to another operator – The
establishment was sold or leased to another company or
organization. Provide the month, day, and year that
the change occurred and indicate the name, address,
and EIN of the new owner or operator. Complete all
items on the form for the portion of 2017 prior to the
change in operator.



5.

E-COMMERCE SALES, SHIPMENTS, RECEIPTS,
OR REVENUE IN 2017

Include:


Online orders accepted for work from customers.



Online orders accepted by the corporate office but
completed by this establishment.



Any agreement negotiated online, including electronic
mail (e-mail) between the customer and this
establishment on the price and/or terms of a transfer of
goods or services.



Telephone transactions using interactive voice response
systems.

Exclude:

Other status – The establishment’s operational status
at the end of 2017 is not accurately described above.
Please specify a description of the establishment’s
operational status in the space provided.



Online payments of billing where the order or contract
was not negotiated online.



Online orders or contracts placed over facsimile
machines or switched telephone networks.

7.

EMPLOYMENT AND PAYROLL

If employees worked at more than one location, report
employment and payroll for employees at the ONE location
where they spent most of their working time.

SALES, SHIPMENTS, RECEIPTS, OR REVENUE
IN 2017

A. Total value of shipments

Include:

Report the total value of products shipped. Value is
defined as net selling value f.o.b. plant to the customer
after discount and allowances.



All full- and part-time employees working at this
establishment whose payroll was reported on Internal
Revenue Service Form 941-PR or 941-SS, Employer’s
Quarterly Federal Tax Return, or Form 944-PR or 944SS, Employer’s Annual Federal Tax Return, and filed
under the Employer Identification Number (EIN) shown
in the mailing address or corrected in item 1.



Non-resident workers, whether or not FICA taxes were
withheld.



Employees on paid sick leave, paid holidays, and paid
vacation.

Include:


The value of all products shipped including interplant
transfers.



Products made elsewhere for this establishment on a
contract basis from materials supplied by this
establishment.

93101_I

Page 2

PLEASE CONTINUE ON NEXT PAGE

Exclude:

C. Employer’s cost for benefits



Subcontractors and their employees

Include:



Temporary staffing obtained from a staffing service.





Agriculture workers from fruit or vegetable canning or
freezing plants with farms associated with their
operations.



Fishing crews from fish canning, freezing, or packaging
plants with fishing operations associated with the plant.

Legally required cost for benefits (employer payments
for Social Security, Medicare, unemployment
compensation, workmen’s compensation, and local
disability programs, if required). Also include any legally
required employer’s cost for benefits under non FICA
regulations.



Voluntarily provided benefits (payments for life
insurance, medical insurance, pensions, welfare
benefits, union-negotiated benefits, and other benefits).



Proprietors or partners of an unincorporated business.



Unpaid family members.
8.

A1. Number of paid production workers
Include:


Production workers on the payroll of this establishment
during quarterly periods including the 12th of March,
June, September, and December, 2017.



Workers up through the line-supervisor level, engaged in
fabricating, processing, assembling, inspecting, packing,
warehousing, shipping (but not delivering),
maintenance, repair and other closely associated
services.



HOURS WORKED BY PRODUCTION WORKERS

Report hours worked only for the construction workers
reported in item 7A1.
Include:


Hours worked during four specific pay periods including
the 12th of March, June, September, and December 2017



Overtime hours as actual hours worked not as straighttime equivalent hours.

Exclude hours paid for vacations, holidays (unless actually
worked), or sick leave.

Truck drivers delivering ready-mixed concrete

A4. All other paid employees
9. INVENTORIES

Nonproduction employees including those engaged in
supervision above the line-supervisor level, sales, clerical,
advertising, credit collection, installation, servicing of own
products, executive, purchasing, finance, legal, professional
and technical personnel.

Report the value of inventories the establishment owned on
December 31, 2017 and on December 31, 2016. Exclude the
value of inventories held at the establishment but owned by
others.

B. Payroll before deductions

Report inventories using current cost, if using Last In - First
Out (LIFO) method of valuation will need to adjust to obtain
First In - First Out (FIFO) or current cost method of valuation.

Report only for employees reported on lines A1 and A4.
Include:


A – D. Report total inventories and inventories by stage of
fabrication.

Wages, salaries, tips, vacation allowances, bonuses,
commissions, and other compensation paid to
employees during 2017, whether or not subject to
income or FICA tax.



Salaries of officers and executives of a corporation.



Employee contributions to qualified pension plans.

13. CAPITAL EXPENDITURES, AND DEPRECIATION
CHARGES
A and B. Capital expenditures
Report expenditures made during 2017 on NEW and
USED buildings and structures and machinery and
equipment that are chargeable to the fixed assets accounts
and for which depreciation accounts are maintained. Also
include the cost of buildings and structures and machinery
and equipment acquired as the lessee under capital lease
agreements entered into during 2017.

Exclude:


Payments to or withdrawals by proprietors or partners of
an unincorporated business.



Annuities or supplemental unemployment
compensation benefits, even if income tax was withheld.



Employer’s cost for payroll taxes and benefits.

93101_I

Page 3

PLEASE CONTINUE ON REVERSE

D. Depreciation charges

H. Interest paid

Report depreciation charges taken against tangible assets
owned and used by your firm, tangible assets and
improvements owned by your firm under leaseholds, and
tangible assets obtained, as the lessee, through capital
lease agreements in 2017.

Include all the interest that was paid in 2017.
19. PRINCIPAL KIND OF BUSINESS
Choose the PRINCIPAL kind of business that best
describes the establishment in 2017. If none of the provided
selections seem appropriate, mark “X” the box next to
“Other kind of business or activity,” at the end of item 19
and provide a specific description of the primary business
activity.

16. SELECTED EXPENSES
Costs refer to the amount actually paid or payable after
discounts, including freight and other direct charges
incurred in acquiring the item or service.
A. Materials, parts, containers, and supplies

26. SPECIAL INQUIRIES

Report cost of physical goods used or put into production;
exclude services used or overhead charges.

A. Value of products shipped and contract work
performed by customer location

B. Products bought and sold

Report the location of the customer to whom the products
were shipped or sold.

Report the cost of all products bought and resold in the
same condition as when purchased and not made part of
another product manufactured by this establishment. Total
sales value of all products resold is to be included in item
5D.

B. Distribution of shipments and contract work
performed for customers in this U.S. territory by
class of customer
For customers located in this U.S. territory, report the
value of shipments and contract work by class of
customer.

C. Purchased fuels
Report total amount actually paid or payable during 2017
for all fuels consumed for heat, power, or the generation of
electricity. Report cost of fuels consumed as raw materials
in item 16A.

B1. Wholesalers
In addition to sales to merchant wholesalers, include sales
that were made through agents, brokers, and commission
merchants.

D. Purchased electricity

B2. Retailers

Report total amount paid or payable for electric energy
purchased during 2017.
E.

Sales to all types of retailers (that is, retail chain
organizations, independent stores, or department stores)
that normally buy for resale to household consumers.

Contract work and nonproduction labor

B3. Household consumers

Cost of purchased services from other companies that are
paid directly by this establishment for janitorial, refuse
removal, temporary staffing, accounting and bookkeeping,
and other services.
F.

Sales to household consumers buying for personal
consumption.
B4. Commonwealth government

Contract labor for production

Include sales to t t his U.S. territory’s Government.
B5. Construction companies

Include the cost of contract employees, who are not on your
payroll, but are supplied through a contract with another
company to perform specific jobs related to production. The
cost of materials worked on by these production workers
should be included in item 16A.

Include only sales for construction purposes.
B6. Other manufacturing establishments
Include sales to manufacturers located in this U.S. territory.

G. All other operating expenses

B7. Other customers

Include all the other operating expenses incurred by the
establishment, such as payroll, benefits, utilities,
depreciation. Do not include capital expenditures, interest,
and/or bad debt.

Include sales to all other customers not specified above.

93101_I

Page 4

94201_I

U.S. DEPARTMENT OF COMMERCE
Economics and Statistics Administration
U.S. Census Bureau

(2/2017)

2017 ECONOMIC CENSUS
U.S. Territories
Wholesale Trade
INFORMATION SHEET
Need help or have questions about filling out the form?
Visit econhelp.census.gov or
Call 1-800-233-6136, between 8:00 a.m. and 6:00 p.m., Eastern time, Monday through Friday.
Please reference your 11-digit Census File Number (CFN) printed on each form with all communications.
The 2017 Economic Census covering the Wholesale Trade
sector includes establishments primarily engaged in the
selling or arranging the purchase or sale of goods, selling
goods for resale, selling capital or durable non-consumer
goods, and selling raw and intermediate materials and
supplies used in production.

8:00 a.m. and 6:00 p.m., Eastern time, Monday through
Friday, to request additional report forms.


Each report form should cover calendar year 2017. If
book figures are not available, estimates are
acceptable. However, if the accounting fiscal year is
different from the calendar year, fiscal year figures will
be acceptable for all items except payroll (calendar year
figures for payroll should be available from the Internal
Revenue Service (IRS) Form 941-PR or 941-SS,
Employer’s Quarterly Federal Tax Return, or Form 944PR or 944-SS, Employer’s Annual Federal Tax Return).
Indicate in item 30 the exact dates covered.



If an establishment stopped operating before January 1,
2017, indicate action and date in item 3, mark “X” the
box to indicate “none” in item 4, and continue to
item 30.



If an establishment was closed, sold, or leased to
another company or organization during 2017, complete
the report form for the portion of 2017 that the
establishment was operating as part of your company or
organization.



Dollar figures should be rounded to the nearest
thousand as illustrated on the report form.



If there are any questions or if any communication
regarding this report form is necessary, reference the
11-digit Census File Number (CFN) shown in the mailing
address.



Please save, print or photocopy each completed report
form for your records and return the original.



Public reporting burden for this collection of information
is estimated to average one hour 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: Paperwork Project 0607-0937, U.S. Census
Bureau, 4600 Silver Hill Road, AMSD-3K138,
Washington, DC 20233. You may e-mail comments to
[email protected]; use “Paperwork Project
0607-0937 as the subject.

Most wholesale establishments exhibit the following
characteristics:




Wholesalers usually operate from a warehouse or office.
These warehouses and offices are characterized by
having little or no display merchandise. In addition,
neither the design nor the location of the premises is
intended to solicit walk-in traffic.
Wholesalers do not usually use advertising directed to
the general public. Customers are generally reached
initially via telephone, in-person marketing, or by
specialized advertising.

If an establishment is NOT engaged in one of these kinds
of businesses, DESCRIBE its business or activity in
ITEM 19A AND COMPLETE the report form as
accurately as possible.
DEFINITION OF ESTABLISHMENT
An establishment is generally a single physical location
where business is conducted or where services or industrial
operations are performed. This includes all selling and
service locations and any other facilities, such as
warehouses or administrative offices that were in
operation at any time during 2017. Locations with no
employees (such as unmanned warehouses) are not
considered separate establishments. Report separate data
for each establishment.
GENERAL INSTRUCTIONS


Complete a separate report form for each
establishment owned or controlled by your company
or organization. If you did not receive a separate report
form for each establishment, visit our web site at
econhelp.census.gov or call 1-800-233-6136, between

94201_I

Page 1

PLEASE CONTINUE ON REVERSE



Response to this collection of information is required
unless it does not display a valid approval number from
the Office of Management (OMB). The OMB eight-digit
number appears on the welcome screen or in the upper
right corner of the paper report form.

Include:


Cash and credit sales of merchandise sold in 2017,
whether or not payment was received in 2017.



Receipts for delivery, installation, maintenance, repair,
alteration, storage, and other services provided in 2017,
whether or not payment was received in 2017.



Answer all sections (A and B) of item 2 even if the mailing
address shown is correct.

The gross selling value of goods that the establishment
sold or purchased on a commission, brokerage,
consignment, or agency basis for others.



The actual value of trade-ins taken as partial payment for
other merchandise.

3. OPERATIONAL STATUS



Receipts from the rental and leasing of merchandise.



Excise taxes (such as those on gasoline, liquor, and
tobacco) which are paid by the manufacturer and
included in the cost of goods purchased.



Liquor and tobacco tax stamps, taxes, and licenses sold.



Shipping and handling receipts collected from
customers.

INSTRUCTIONS FOR SELECTED ITEMS
2.

PHYSICAL LOCATION

Mark “X” the ONE box that best describes the operational
status of the establishment at the end of 2017.


In operation – The establishment was open and
actively conducting business on December 31, 2017.



Temporarily or seasonally inactive – Although not
conducting business at the end of 2017, the
establishment will eventually reopen and conduct
business under the same Employer Identification
Number (EIN). Examples include businesses or
establishments that close during the “off-season” or that
temporarily close for remodeling. Complete all items on
the form for the portion of 2017 during which the
establishment was active.







5.

Exclude:

Ceased operation – The establishment has gone out of
business or closed and does not plan to reopen. Provide
the month, day, and year that the establishment
ceased operation. Complete all items on the form for the
portion of 2017 during which the establishment was in
operation.
Sold or leased to another operator – The
establishment was sold or leased to another company or
organization. Provide the month, day, and year that
the change occurred and indicate the name, address,
and EIN of the new owner or operator. Complete all
items on the form for the portion of 2017 prior to the
change in operator.



Sales and other taxes collected directly from customers
and paid directly to the commonwealth or federal tax
agency.



Receipts from carrying and other credit charges.



Nonoperating income from sources such as
investments, rental or sale of real estate, and interest.



Commissions received for selling and buying goods.



Refund or allowances for returned merchandise.



Transfers (billings) to other establishments in the
company.

B. Commissions for the sale of merchandise
Answer “Yes” if the establishment earned a commission
or brokerage fee for transactions negotiated for others.
C. Gross selling value

Other status – The establishment’s operational status
at the end of 2017 is not accurately described above.
Please specify a description of the establishment’s
operational status in the space provided.

Report the market value of products bought or sold by
others on which the establishment earned a commission
or fee.
If actual sales are unavailable, estimate the value by
dividing actual commissions received by the average
percentage charged for sales activity.

SALES, SHIPMENTS, RECEIPTS, OR REVENUE
IN 2017

For example, if commissions received totaled $200,000 and
the average commission is estimated as 5 percent, then
the gross selling value is $4,000,000 ($200,000/.05).

A. Sales and operating receipts
Report total sales of merchandise and other operating
receipts in thousands of dollars for the calendar year 2017.

D. Commissions received
Report the amount of commissions, brokerage, or agency
fees received for transactions reported in item 5C.

94201_I

Page 2

PLEASE CONTINUE ON NEXT PAGE

Note: Items F and G apply only to multi-establishment
firms.
F.

7. EMPLOYMENT AND PAYROLL
If employees worked at more than one location, report
employment and payroll for employees at the ONE location
where they spent most of their working time.

Percent of products sold by this establishment
that were manufactured or mined

A. Number of paid employees

Report the percentage of total sales (as reported in
item 5A) accounted for by products which were mined or
manufactured in the United States, Puerto Rico, U.S.
territories, or its Foreign Trade Zones by your firm
(including parent, subsidiaries, and corporate affiliates).

Report number of paid employees for pay period including
March 12, 2017.
Include:

G. Value of transfers



All full- and part-time employees working at this
establishment whose payroll was reported on Internal
Revenue Service Form 941-PR or 941-SS, Employer’s
Quarterly Federal Tax Return, or Form 944-PR or 944SS, Employer’s Annual Federal Tax Return, and filed
under the Employer Identification Number (EIN) shown
in the mailing address or corrected in item 1.

E-commerce transactions are transactions completed over
an Internet, electronic mail, Extranet, Electronic Data
Interchange (EDI) network, or other online system.



Non-resident workers, whether or not FICA taxes were
withheld.



Salaried officers and executives of a corporation.

Include:



Employees on paid sick leave, paid holidays, and paid
vacation.

Report the fair sales value of goods transferred to
establishments owned by this firm.
6.





E-COMMERCE SALES, SHIPMENTS, RECEIPTS,
OR REVENUE IN 2017

The gross selling value of business conducted on a
commission basis over the Internet, Extranet, EDI
network, electronic mail, or other online system.

Exclude:

Sales generated from agreements negotiated online
between buyer and seller on price and terms of a
transfer of ownership of, or rights to use, goods or
services.



Temporary staffing obtained from a staffing service.



Employees of departments or concessions operated by
other companies at this establishment.



Proprietors or partners of an unincorporated business.
Unpaid family members.



Online sales of goods or services, regardless of whether
payment is made online.





Receipts generated from selling or from facilitating the
sale of third party products (e.g., click-throughs on
advertisements or referral fees) through the
establishment’s web site.

Include:



Sales generated from telephone transactions using
interactive voice response systems.



Shipping and handling receipts for online orders.

B. Payroll before deductions

Exclude:



Wages, salaries, tips, vacation allowances, bonuses,
commissions, and other compensation paid to
employees during 2017, whether or not subject to
income or FICA tax.



Salaries of officers and executives of a corporation.



Employee contributions to qualified pension plans.



Online payments from customers where the order or
contract was not negotiated online.



Provisions of telecommunications and related
infrastructure systems (e.g., data transfer, Web hosting,
Internet access, etc.) where the order or contract was
not negotiated online.



Payments to or withdrawals by proprietors or partners of
an unincorporated business.



Annuities or supplemental unemployment
compensation benefits, even if income tax was withheld.

Sales from orders for goods or services placed over
facsimile machines or switched telephone networks.



Payrolls of departments or concessions operated by
other companies at the establishment.



94201_I

Exclude:

Page 3

PLEASE CONTINUE ON REVERSE

16. SELECTED EXPENSES

C. Employer’s cost for benefits
Include:




Costs refer to the amount actually paid or payable after
discounts, including freight and other direct charges
incurred in acquiring the item or service.

Legally required cost for benefits (employer payments
for Social Security, Medicare, unemployment
compensation, workmen’s compensation, and local
disability programs, if required). Also include any legally
required employer’s cost for benefits under non FICA
regulations.

A. Communication services
Report cost of communication services, including
telephone, cellular phones, Internet, fax, and the cost for
the contracts.

Voluntarily provided benefits (payments for life
insurance, medical insurance, pensions, welfare
benefits, union-negotiated benefits, and other benefits).

B. Computer services
Report the cost of all computer services. Include data
processing and computer software.
C. Office supplies

9. INVENTORIES

Report the cost of the office supplies

A. Inventories at the end of 2017 and/or 2016
If the establishment had inventories at the end of either
2017 or 2016, answer “Yes.”

D. Maintenance and repair of machinery and
equipment

B. Total inventories

Report total amount paid for the maintenance and repair of
the machinery and/or equipment during 2017.

Report the value of merchandise inventories the
establishment owned on December 31, 2017 and on
December 31, 2016. Exclude the value of inventories held
at the establishment but owned by others.

E.

Report total amount paid for the maintenance and repair of
buildings, structures, offices, and their integral parts.
Include the cost of purchased services from other
companies that are paid directly by this establishment for
janitorial, refuse removal, and other services.

Report inventories using current cost, if using Last In - First
Out (LIFO) method of valuation will need to adjust to
obtain First In - First Out (FIFO) or current cost method of
valuation.

F.

C. Value of inventories outside this U.S. territory

Products bought for resale

Report the cost of all products bought and resold in the
same condition as when purchased.

Report the total value of inventories stored or “en route”
OUTSIDE this U.S. territory on December 31, 2017 and on
December 31, 2016.

G. All other operating expenses
Include all the other operating expenses incurred by the
establishment, such as payroll, benefits, utilities,
depreciation. Do not include capital expenditures, interest,
and/or bad debt.

13. CAPITAL EXPENDITURES AND DEPRECIATION
CHARGES

H. Interest paid

A. Capital expenditures

Include all the interest that was paid in 2017.

Report expenditures made during 2017 to purchase
buildings or structures, including improvements and
repairs, and machinery and equipment that are chargeable
to the fixed assets accounts and for which depreciation
accounts are maintained. Also include the cost of buildings
or structures and machinery and equipment acquired as
the lessee under capital lease agreements entered into
during 2017.

19A. PRINCIPAL KIND OF BUSINESS
Choose the PRINCIPAL kind of business that best
describes the establishment in 2017. If none of the provided
selections seem appropriate, mark “X” the box next to
“Other kind of business,” at the end of item 19A and
provide a specific description of the primary business
activity.

B. Depreciation charges
Report depreciation charges taken against tangible assets
owned and used by your firm, tangible assets and
improvements owned by your firm under leaseholds, and
tangible assets obtained, as the lessee, through capital
lease agreements in 2017.

94201_I

Maintenance and repair of buildings, structures,
offices and their integral parts

Page 4

PLEASE CONTINUE ON NEXT PAGE

electronic means and operates on a commission or fee
basis.

19B. PRINCIPAL TYPE OF OPERATION
Mark “X” only one PRINCIPAL type of operation for this
establishment.

Other broker or agent such as real estate, mortgage, or
loan. Please specify type in space provided.

Merchant wholesaler - A company or establishment
engaged in buying merchandise on its own account
produced by other firms and selling them using the
wholesale method.


D. Percent of sales and receipts generated from
exports

Importer - Purchasing and selling merchandise made
outside of this U.S. territory and that does not bear
the importer’s own brand name.



Exporter - Purchasing goods in This U.S. territory
from unrelated firms and selling them for delivery in
this U.S. territory



Merchant wholesale distributor or jobber - Buying
merchandise from unrelated domestic manufactures and
selling the goods to customers in this U.S. territory.



20. CLASS OF CUSTOMER

Estimate the percentage of sales and receipts generated
from exports, NOT THE PERCENTAGE OF
TRANSACTIONS.
Include exports from this U.S. territory to foreign countries,
the United States, and U.S. territories.
E.

Percent of total sales by class of customer

Estimate the percentage of this establishment’s total sales
by class of customer, excluding the percentage reported in
line D. Total in line 14 should be 100%.

Own-brand importer and marketer - A company or
establishment that deals primarily or exclusively in the
parent company’s own branded products manufactured
outside this U.S. territory.

E1. Household consumers

Manufacturers’ sales branch or office Establishments owned by firms or corporately affiliated
with a manufacturer primarily engaged in selling goods
mined or manufactured by the parent in the United States
or this U.S. territory.

Include sales to individuals or employees buying for
personal consumption.

Agent, broker, or commission merchant - A company
or establishment primarily engaged in buying and selling
merchandise on a commission, brokerage, or agency basis
for others rather than dealing primarily on its own account.

Include sales to all types of retailers (that is, retail chain
organizations independent stores, or department stores)
that normally buy for resale to household consumers.









E2. Retailers

E3. Wholesalers

Auction company - Selling merchandise for the
account of others at wholesale from a permanent
location by the auction method.

In addition to sales to merchant wholesalers, include sales
that were made through agents, brokers, and commission
merchants.

Broker, representing buyers and sellers - Buying
and selling merchandise on a brokerage basis for others
in this U.S. territory market, but not receiving goods on
consignment.

E4. Repair shops for use in repair work
Include sales to all types of repair facilities.

Commission merchant - Receiving goods on
consignment and selling them on a commission basis in
this U.S. territory market.

E5. Manufacturing and mining industrial users for
use as input goods in production

Import agent - Representing, on an agency basis,
domestic firms selling foreign-made merchandise for
delivery inside this U.S. territory and collecting a
commission for the sale of goods.



Export agent - Representing on an agency basis,
domestic firms selling this U.S. territory
merchandise for delivery and collecting a
commission for the sale of goods.



Manufacturers’ agent - Selling merchandise on a
commission basis for a limited number of manufacturers
on a continuing agency basis.

Include sales to manufacturers located in this U.S. territory.
E6. Restaurants, hotels, food services, and contract
feeding
Include sales to caterers, contract feeders, and all eating
and drinking establishments.
E7. Businesses for end use in their own operation,
not for resale or production
Include sales to laboratories, institutions, public utilities,
service businesses, and other such users that are buying
for business use rather than for resale.

Electronic market - Business-to-business marketplace
that facilitates the sale of goods via the Internet or other
94201_I

Page 5

PLEASE CONTINUE ON REVERSE

E8. Building contractors, heavy construction, and
special trade contractors

26. SPECIAL INQUIRIES
A. Employment by Primary Function

Include only sales for construction purposes.

Indicate the number of employees, as reported in item 7A
by the employee’s primary function.

E9. Farmers for use in farm production

A1. Selling

Include only sales of products for use in agricultural
production.
E10. Federal government

Include employees engaged in sales activities, traveling
salespeople, truck salespeople, and selling employees
working out of their homes.

Include sales to the Federal government (including military
post exchanges, General Services Administration, U.S.
Postal Service, and other agencies).

A2. Sales support
Include employees:

E11. Commonwealth government


Engaged in sales support activities such as office and
clerical, warehouse, customer service, maintenance, and
delivery.



Engaged in sorting, grading, or packaging activities in
conjunction with sales operations.



Who provide services to this establishment such as
janitorial or repair.

Include sales to this U.S. territory's government.
E12. Municipal governments
Include sales to the Municipal governments.
E13. Other
Report the percentage of sales not elsewhere classified
and describe the type of customer.

A3. General support of other establishments
Include supporting functions of other establishments in the
company such as headquarters employees, regional or
district managers who control more than just this
establishment, corporate accountants, researchers, and
central warehouse employees.

22. DETAIL OF SALES, SHIPMENTS, RECEIPTS, OR
REVENUE IN 2017


Report either in thousands of dollars OR as a whole
percent of total sales as illustrated on the report form. It
is not necessary to report in both dollars and
percentages. Percentages are preferable.

A4. Packaging
Report the number of employees engaged in packaging.



Estimates are acceptable, but please do not
combine data for two or more lines.

A5. Production



If the establishment sold merchandise not covered in the
prelisted categories, report the sales of such
merchandise on the “Miscellaneous commodities” line
and specify principal lines with their estimated sales or
percent of sales.

Report the number of employees engaged in production
work.





A6. Assembly
Report the number of employees who combine parts into a
finished product that can stand alone.

Receipts for rentals, storage, repair work, and service
contracts should be reported on the “Nonmerchandise
receipts” line at the end of the listing. Do not include
such receipts with the commodity sales.

A7. Other
Report the number of employees not elsewhere classified
including employees engaged in agricultural, construction,
or other activities.

The sum of commodity lines reported should equal 100
percent (or the amount reported in item 5A if the lines
are reported in dollars).

94201_I

Page 6

94401_I

U.S. DEPARTMENT OF COMMERCE
Economics and Statistics Administration
U.S. Census Bureau

(2/2017)

2017 ECONOMIC CENSUS
U.S. Territories
Retail Trade
INFORMATION SHEET
Need help or have questions about filling out the form?
Visit econhelp.census.gov or
Call 1-800-233-6136, between 8:00 a.m. and 6:00 p.m., Eastern time, Monday through Friday.
Please reference your 11-digit Census File Number (CFN) printed on each form with all communications.

The Retail Trade Economic Census of U.S. Territories
includes establishments primarily engaged in the
following:


Retail Trade – Selling merchandise, generally without
transformation, and rendering services incidental to the
sale of merchandise.

If an establishment is NOT engaged in this kind of
business activity, DESCRIBE its business or activity in
ITEM 19 AND COMPLETE the report form as accurately
as possible.
DEFINITION OF ESTABLISHMENT
An establishment is generally a single physical location
where business is conducted or where services or
industrial operations are performed. This includes all
locations of a company or organization, including
administrative offices that were in operation at any time
during 2017.



If an establishment stopped operating before January 1,
2017, indicate action and date in item 3, mark “X” the
box to indicate “none” in item 4, and continue to
item 30.



If an establishment was closed, sold, or leased to
another company or organization during 2017, complete
the report form for the portion of 2017 that the
establishment was operating as part of your company or
organization.



Dollar figures should be rounded to the nearest
thousand as illustrated on the report form.



If there are any questions or if any communication
regarding this report form is necessary, reference the
11-digit Census File Number (CFN) shown in the mailing
address.



Please save, print or photocopy each completed report
form for your records and return the original.



Public reporting burden for this collection of information
is estimated to average one hour 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: Paperwork Project 0607-0937, U.S. Census
Bureau, 4600 Silver Hill Road, AMSD-3K138,
Washington, DC 20233. You may e-mail comments to
[email protected]; use “Paperwork Project
0607-0937" as the subject.



Response to this collection of information is required
unless it does not display a valid approval number from
the Office of Management (OMB). The OMB eight-digit
number appears on the welcome screen or in the upper
right corner of the paper report form.

GENERAL INSTRUCTIONS


Complete a separate report form for each
establishment owned or controlled by your company
or organization. If you did not receive a separate report
form for each establishment, visit our web site at
econhelp.census.gov or call 1-800-233-6136, between
8:00 a.m. and 6:00 p.m., Eastern time, Monday through
Friday, to request additional report forms.
 Each report form should cover calendar year
2017. If book figures are not available, estimates
are acceptable. However, if the accounting fiscal
year is different from the calendar year, fiscal year
figures will be acceptable for all items except
payroll (calendar year figures for payroll should be
available from the Internal Revenue Service (IRS)
Form 941-PR or 941-SS, Employer’s Quarterly
Federal Tax Return, or Form 944-PR or 944-SS,
Employer’s Annual Federal Tax Return). Indicate in
item 30 the exact dates covered.

94401_I

Page 1

PLEASE CONTINUE ON REVERSE

INSTRUCTIONS FOR SELECTED ITEMS
2.

PHYSICAL LOCATION

Answer all sections (A and B) of item 2 even if the mailing
address shown is correct.
3.



Receipts from the rental of vehicles, equipment,
instruments, tools, and other merchandise.



Motor vehicle transportation charges, dealer preparation
charges, and dealer installed options.



Fair sales value of motor vehicles marketed under leases
negotiated in 2017, regardless of whether the
establishment holds the lease.



Sales of motor vehicles formerly used for rental or
leasing.



Total value of service contracts.

OPERATIONAL STATUS

Mark “X” the ONE box that best describes the operational
status of the establishment at the end of 2017.


In operation – The establishment was open and
actively conducting business on December 31, 2017.



Commissions received for the arrangement of financing
and the sale of credit life insurance.



Temporarily or seasonally inactive – Although not
conducting business at the end of 2017, the
establishment will eventually reopen and conduct
business under the same Employer Identification
Number (EIN). Examples include businesses or
establishments that close during the “off-season” or that
temporarily close for remodeling. Complete all items on
the form for the portion of 2017 during which the
establishment was active.



Amounts received from customers for layaway
purchases.



Excise taxes (such as those on gasoline, liquor, and
tobacco) paid by the manufacturer or wholesaler and
included in the cost of goods purchased by the
establishment.



Fees for processing money orders and cashing checks.

Ceased operation – The establishment has gone out of
business or closed and does not plan to reopen. Provide
the month, day, and year that the establishment
ceased operation. Complete all items on the form for the
portion of 2017 during which the establishment was in
operation.



Shipping and handling receipts.







5.

Exclude:

Sold or leased to another operator – The
establishment was sold or leased to another company or
organization. Provide the month, day, and year that
the change occurred and indicate the name, address,
and EIN of the new owner or operator. Complete all
items on the form for the portion of 2017 prior to the
change in operator.
Other status – The establishment’s operational status
at the end of 2017 is not accurately described above.
Please specify a description of the establishment’s
operational status in the space provided.

•

Sales and other taxes collected directly from
customers and paid directly to a commonwealth or
federal tax agency.

•

Gross sales and receipts of departments or
concessions operated by other companies at this
establishment.

•

Receipts from carrying and other credit charges.

•

Commissions or receipts from the sale of government
lottery tickets.

•

Non-operating income from sources such as
investments, rental or sale of real estate, and interest.

•

Automotive dealers only – Receipts from customers
for tag and title fees, licenses, etc., forwarded to a
commonwealth licensing agency.

SALES, SHIPMENTS, RECEIPTS, OR REVENUE
IN 2017

Deduct:

Include:


Cash and credit sales of merchandise sold in 2017,
whether or not payment was received in 2017.



Receipts for delivery, installation, maintenance, repair,
alteration, storage, and other services provided in 2017,
whether or not payment was received in 2017.



The establishment’s share of sales and receipts from
departments, concessions, and vending and amusement
machines operated by other companies at this
establishment.

94401_I

•

Refunds and allowances for returned merchandise.

•

Automotive dealers only – Discounts granted to the
purchaser as an increase in trade-in allowance over
fair market value and manufacturer’s rebates and
incentives.

Do no deduct fair market value of trade-ins taken as
partial payment.

Page 2

PLEASE CONTINUE ON NEXT PAGE

6.

E-COMMERCE SALES, SHIPMENTS, RECEIPTS,
OR REVENUE IN 2017

Include:


All full- and part-time employees working at this
establishment whose payroll was reported on Internal
Revenue Service Form 941-PR or 941-SS, Employer’s
Quarterly Federal Tax Return, or Form 944-PR or 944SS, Employer’s Annual Federal Tax Return, and filed
under the Employer Identification Number (EIN) shown
in the mailing address or corrected in item 1.



Non-resident workers, whether or not FICA taxes were
withheld.



Salaried officers and executives of a corporation.



Employees on paid sick leave, paid holidays, and paid
vacation.

E-commerce transactions are transactions completed over
an Internet, electronic mail, Extranet, Electronic Data
Interchange (EDI) network, or other online system.
Include:


Sales generated from agreements negotiated online,
between buyer and seller on price and term of a transfer
of ownership of, or rights to use, goods or services.



Online sales of goods or services, regardless of whether
payment is made online.



Commissions or fees from the use of online services
(e.g., computerized reservation systems, financial
transaction processing systems, etc.) where the order or
contract was negotiated online.

Exclude:


Temporary staffing obtained from a staffing service.



Commissions or fees from online trading of securities or
other financial products (e.g., insurance, loans, etc.).



Employees of departments or concessions operated by
other companies at this establishment.



Commissions or fees from selling or from facilitating the
sale ofthird party products (e.g., click-throughs on
advertisements or referral fees) through the
establishment’s web site.



Proprietors or partners of an unincorporated business.



Unpaid family members.




B. Payroll before deductions

Sales generated from telephone transactions using
interactive voice response systems.

Include:

Shipping and handling receipts for online orders.



Wages, salaries, tips, vacation allowances, bonuses,
commissions, and other compensation paid to
employees during 2017, whether or not subject to
income or FICA tax.



Salaries of officers and executives of a corporation.



Employee contributions to qualified pension plans.

Exclude:







Online payments from customers where the order or
contract was not negotiated online.
Commissions or fees from the use of online services
(e.g., computerized reservation systems, financial
transaction processing systems, etc.) where the order or
contract was not negotiated online.

Exclude:

Commissions or fees from the provision of
telecommunications and related infrastructure systems
(e.g., data transfer, Web hosting, Internet access, etc.)
where the order or contract was not negotiated online.
Sales from orders for goods or services placed over
facsimile machines or switched telephone networks.



Payments to or withdrawals by proprietors or partners of
an unincorporated business.



Annuities or supplemental unemployment
compensation benefits, even if income tax was withheld.



Payrolls of departments or concessions operated by
other companies at the establishment.

C. Employer’s cost for benefits
7.

EMPLOYMENT AND PAYROLL

Include:

If employees worked at more than one location, report
employment and payroll for employees at the ONE location
where they spent most of their working time.



Legally required employer’s cost for benefits (employer
payments for Social Security, Medicare, unemployment
compensation, workmen’s compensation, and local
disability programs, if required). Also include any legally
required employer’s cost for benefits under non FICA
regulations.



Voluntarily provided benefits (payments for life
insurance, medical insurance, pensions, welfare
benefits, union-negotiated benefits, and other benefits).

A. Number of paid employees
Report number of paid employees for pay period including
the March 12, 2017.

94401_I

Page 3

PLEASE CONTINUE ON REVERSE

9.

INVENTORIES

D. Maintenance and repair of machinery and
equipment

A. Inventories at the end of 2017 and/or 2016

Report total amount paid for the maintenance and repair of
the machinery and/or equipment during 2017.

If the establishment had inventories at the end of either
2017 or 2016, answer “Yes.”

E.

B. Total inventories

Maintenance and repair of buildings, structures,
offices and their integral parts

Report total amount paid for the maintenance and repair of
buildings, structures, offices, and their integral parts.
Include the cost of purchased services from other
companies that are paid directly by this establishment for
janitorial, refuse removal, and other services.

Report the total value of merchandise inventories the
establishment owned on December 31, 2017 and on
December 31, 2016. Exclude the value of inventories held
at the establishment but owned by others.
Report inventories using current cost, if using Last In - First
Out (LIFO) method of valuation will need to adjust to
obtain First In - First Out (FIFO) or current cost method of
valuation.

F.

Merchandise bought for resale

Report the cost of all merchandise bought and resold in the
same condition as when purchased.
G. All other operating expenses

13. CAPITAL EXPENDITURES AND DEPRECIATION
CHARGES

Include all the other operating expenses incurred by the
establishment, such as payroll, benefits, utilities,
depreciation. Do not include capital expenditures, interest,
and/or bad debt.

A. Capital expenditures
Report expenditures made during 2017 to purchase
buildings or structures, including improvements and
repairs, and machinery and equipment that are chargeable
to the fixed assets accounts and for which depreciation
accounts are maintained. Also include the cost of buildings
or structures and machinery and equipment acquired as
the lessee under capital lease agreements entered into
during 2017.

H. Interest paid
Include all the interest that was paid in 2017.
19. PRINCIPAL KIND OF BUSINESS
Choose the PRINCIPAL kind of business that best
describes the establishment in 2017. If none of the provided
selections seem appropriate, mark “X” the box next to
“Other kind of business,” at the end of item 19 and provide
a specific description of the primary business activity.

B. Depreciation charges
Report depreciation charges taken against tangible assets
owned and used by your firm, tangible assets and
improvements owned by your firm under leaseholds,
tangible assets obtained, as the lessee, through capital
lease agreements in 2017.

20. CLASS OF CUSTOMER

16. SELECTED EXPENSES

D. Percent of sales and receipts generated from
exports

Costs refer to the amount actually paid or payable after
discounts, including freight and other direct charges
incurred in acquiring the item or service.

Estimate the percentage of sales and receipts generated
from exports, NOT THE PERCENTAGE OF
TRANSACTIONS.

A. Communication services

Include exports from This U.S. territory to foreign countries,
the United States, and U.S. territories.

Report cost of communication services, including
telephone, cellular phones, Internet, fax, and the cost for
the contracts.

E.

Percent of total sales by class of customer

Estimate the percentage of this establishment’s total sales
by class of customer, excluding the percentage reported in
line D. Total in line 8 should be 100%.

B. Computer services
Report the cost of all computer services. Include data
processing and computer software.
C. Office supplies
Report the cost of office supplies.

94401_I

Page 4

PLEASE CONTINUE ON NEXT PAGE

E1. Household consumers

E7. Other

Include sales to individuals or employees buying for
personal consumption.

Report the percentage of sales not elsewhere classified and
describe the type of customer.

E2. Retailers
22. DETAIL OF SALES, SHIPMENTS, RECEIPTS, OR
REVENUE IN 2017

Include sales to all types of retailers (that is, retail chain
organizations independent stores, or department stores)
that normally buy for resale to household consumers.



In addition to sales to merchant wholesalers, include sales
that were made through agents, brokers, and commission
merchants.

Report either in thousands of dollars OR as a whole
percent of total sales as illustrated on the report form. It
is not necessary to report in both dollars and
percentages. Percentages are preferable.



E4. Manufacturing and mining industrial users for
use as input goods in production

Estimates are acceptable, but please do not combine
data for two or more lines.



If the establishment sold merchandise not covered in the
prelisted categories, report the sales of such
merchandise on the “All other merchandise” line and
specify principal lines with their estimated sales or
percent of sales.



Receipts for rentals, storage, repair work, and service
contracts should be reported on the “Nonmerchandise
receipts” line at the end of the listing. Do not include
such receipts with the merchandise sales.



The sum of merchandise lines reported should equal 100
percent (or the amount reported in item 5 if the lines are
reported in dollars).

E3. Wholesalers

Include sales to manufacturers located in this U.S.
territory.
E5. Restaurants, hotels, food services, and contract
feeding
Include sales to caterers, contract feeders, and all eating
and drinking establishments.
E6. Governmental bodies
Include sales to the Federal government (including military
post exchanges, General Services Administration (GSA),
U.S. Postal Service, and other agencies), this U.S. territory
government, and Municipal governments.

94401_I

Page 5

95101_I

U.S. DEPARTMENT OF COMMERCE
Economics and Statistics Administration
U.S. Census Bureau

(2/2017)

2017 ECONOMIC CENSUS
U.S. Territories

Other Services
INFORMATION SHEET
Need help or have questions about filling out the form?
Visit econhelp.census.gov or
Call 1-800-233-6136, between 8:00 a.m. and 6:00 p.m., Eastern time, Monday through Friday.
Please reference your 11-digit Census File Number (CFN) printed on each form with all communications.

The services sectors of the 2017 Economic Census
includes establishments primarily engaged in the
following areas of economic activity:


Publishing



Motion picture and Sound recording



Broadcasting and Telecommunications



Information services and Data processing services



Management of companies and enterprises (including
holding companies)



Professional, Scientific, and Technical services



Administrative and support



Waste management and Remediation services



Educational services



Health care and Social assistance



Arts, Entertainment, and Recreation



Repair and maintenance



Personal services



Other services, except Public Administration

Locations with no paid employees, including broadcasting
antennas, telephone relay and switching stations, and
other similar facilities, are not considered separate
establishments.
DEFINITION OF HOLDING COMPANY
A holding company is a company primarily engaged in
holding securities of (or other equity interests in)
companies and enterprises for the purpose of owning a
controlling interest or influencing the management
decisions of these firms. They do not administer, oversee,
and manage other establishments of the company or
enterprise whose securities they hold.
DEFINITION OF ENTERPRISE SUPPORT
ESTABLISHMENT
An enterprise support establishment is an
establishment that is primarily engaged in performing
management, supervision, general administrative
functions, and supporting services for other
establishments of the same enterprise, rather than for the
other general public or other business firms.
DEFINITION OF ENTERPRISE

If an establishment is NOT engaged in one of these kinds
of businesses, DESCRIBE its business or activity in ITEM
19 AND COMPLETE the report form as accurately as
possible.

An enterprise or company is a business, service, or
membership organization consisting of one or more
establishments within the United States or a U.S.
Territory under common ownership or control. It includes
establishments of subsidiary companies, where there is
more than 50 percent ownership, as well as
establishments of firms which the enterprise has the
power to direct or cause the direction of management and
policies.

DEFINITION OF ESTABLISHMENT
An establishment is generally a single physical location
where business is conducted or where services or
industrial operations are performed. This includes all
locations of a company or organization, including
administrative offices, warehouses, etc. that were in
operation at any time during 2017.

95101_I

Page 1

PLEASE CONTINUE ON REVERSE

GENERAL INSTRUCTIONS




Complete a separate report form for each
establishment owned or controlled by your company
or organization. If you did not receive a separate report
form for each establishment, visit our web site at
econhelp.census.gov or call 1-800-233-6136, between
8:00 a.m. and 6:00 p.m., Eastern time, Monday through
Friday, to request additional report forms.

If an establishment stopped operating before January 1,
2017, indicate action and date in item 3, mark “X” the
box to indicate “none” in item 4, and continue to
item 30.



If an establishment was closed, sold, or leased to
another company or organization during 2017, complete
the report form for the portion of 2017 that the
establishment was operating as part of your company or
organization.



Dollar figures should be rounded to the nearest
thousand as illustrated on the report form.



If there are any questions or if any communication
regarding this report form is necessary, reference the
11-digit Census File Number (CFN) shown in the mailing
address.



Please save, print or photocopy each completed report
form for your records and return the original.



2.

3.

OPERATIONAL STATUS

Mark “X” the ONE box that best describes the operational
status of the establishment at the end of 2017.

Public reporting burden for this collection of information
is estimated to average one hour 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: Paperwork Project 0607-0937, U.S. Census
Bureau, 4600 Silver Hill Road, AMSD-3K138,
Washington, DC 20233. You may e-mail comments to
[email protected]; use “Paperwork Project
0607-0937" as the subject.



In operation – The establishment was open and
actively conducting business on December 31, 2017.



Temporarily or seasonally inactive – Although not
conducting business at the end of 2017, the
establishment will eventually reopen and conduct
business under the same Employer Identification
Number (EIN). Examples include businesses or
establishments that close during the “off-season” or that
temporarily close for remodeling. Complete all items on
the form for the portion of 2017 during which the
establishment was active.



Ceased operation – The establishment has gone out of
business or closed and does not plan to reopen. Provide
the month, day, and year that the establishment
ceased operation. Complete all items on the form for the
portion of 2017 during which the establishment was in
operation.



Sold or leased to another operator – The
establishment was sold or leased to another company or
organization. Provide the month, day, and year that
the change occurred and indicate the name, address,
and EIN of the new owner or operator. Complete all
items on the form for the portion of 2017 prior to the
change in operator.



Other status – The establishment’s operational status
at the end of 2017 is not accurately described above.
Please specify a description of the establishment’s
operational status in the space provided.

5.

SALES, SHIPMENTS, RECEIPTS, OR REVENUE
IN 2017

Include:

Response to this collection of information is required
unless it does not display a valid approval number from
the Office of Management (OMB). The OMB eight-digit
number appears on the welcome screen or in the upper
right corner of the paper report form.

95101_I

PHYSICAL LOCATION

Answer all sections (A and B) of item 2 even if the mailing
address shown is correct.

Each report form should cover calendar year 2017. If
book figures are not available, estimates are
acceptable. However, if the accounting fiscal year is
different from the calendar year, fiscal year figures will
be acceptable for all items except payroll (calendar year
figures for payroll should be available from the Internal
Revenue Service (IRS) Form 941-PR or 941-SS,
Employer’s Quarterly Federal Tax Return, or Form 944PR or 944-SS, Employer’s Annual Federal Tax Return).
Indicate in item 30 the exact dates covered.





INSTRUCTIONS FOR SELECTED ITEMS

Page 2



Gross receipts from services provided, from the use of
facilities, and from merchandise sold in 2017, whether or
not payment was received in 2017.



Advertising agencies, travel industries, and other service
establishments operating on a commission basis commissions, fees, and other operating income, NOT
gross billings or sales.



Advertising sales



Sales of goods and services marketed through sales
offices.

PLEASE CONTINUE ON NEXT PAGE



Sales to and receipts from FOREIGN parent firms,
subsidiaries, branches, etc.



Commissions or fees from online trading of securities or
other financial products (e.g., insurance, loans, etc.).



This establishment’s share of receipts from departments,
concessions, and vending and amusement machines
operated by others.





Receipts from the rental and leasing of vehicles,
equipment, instruments, tools, etc.

Commissions or fees from selling or from facilitating the
sale of third party products (e.g., click-throughs on
advertisements or referral fees) through the
establishment’s web site.



Total value of service contracts. Market value of
compensation received in lieu of cash.

Sales generated from telephone transactions using
interactive voice response systems.



Shipping and handling receipts for online orders.



Amounts received for work subcontracted to others.

Exclude:



Dues and assessments from members and affiliates.





The Management of Companies and Enterprises Sector,
Public broadcast stations and libraries should include
contributions, gifts, grants, and income from interest,
rental of real estate, and dividends; all others should
exclude such revenues.

Online payments from customers where the order or
contract was not negotiated online.



Commissions or fees from the use of online services
(e.g., computerized reservation systems, financial
transaction processing systems, etc.) where the order or
contract was not negotiated online.



Commissions or fees from the provision of
telecommunications and related infrastructure systems
(e.g., data transfer, Web hosting, Internet access, etc.)
where the order or contract was not negotiated online.



Sales from orders for goods or services placed over
facsimile machines or switched telephone networks.





Independent artists, writers, and performers should
report royalties.



The Management of Companies and Enterprises Sector
should report franchise sales and fees and royalties.

Exclude:


Sales and other taxes collected directly from customers
or clients and paid directly to a commonwealth or
federal tax agency.



Gross receipts from departments or concessions
operated by others.



Intra-company transfers.



Sales of used equipment previously rented or leased to
customers.

A. Number of paid employees



Other non-operating income.

Report number of paid employees for pay period including
March 12, 2017.

6.

7.

If employees worked at more than one location, report
employment and payroll for employees at the ONE location
where they spent most of their working time.

Include:

E-COMMERCE SALES, SHIPMENTS, RECEIPTS,
OR REVENUE IN 2017



All full- and part-time employees working at this
establishment whose payroll was reported on Internal
Revenue Service Form Form 941-PR or 941-SS,
Employer’s Quarterly Federal Tax Return, or Form 944PR or 944-SS, Employer’s Annual Federal Tax Return,
and filed under the Employer Identification Number
(EIN) shown in the mailing address or corrected in item
1.



Non-resident works, whether or not FICA taxes were
withheld.



Salaried officers and executives of a corporation.



Employees on paid sick leave, paid holidays, and paid
vacation.

E-commerce transactions are transactions completed over
an Internet, electronic mail, Extranet, Electronic Data
Interchange (EDI) network, or other online system.
Include:


Sales generated from agreements negotiated online,
between buyer and seller on price and term of a transfer
of ownership of, or rights to use, goods or services.



Online sales of goods or services, regardless of whether
payment is made online.



Service receipts or revenue made through online
services (e.g., computerized reservation systems,
financial transaction processing systems, etc.) where
the order or contract was negotiated online.

95101_I

EMPLOYMENT AND PAYROLL

Page 3

PLEASE CONTINUE ON REVERSE

Exclude:


Temporary staffing obtained from a staffing service.



Employees of departments or concessions operated by
other companies at this establishment.



Proprietors or partners of an unincorporated business.

B. Depreciation charges
Report depreciation charges taken against tangible assets
owned and used by your firm, tangible assets and
improvements owned by your firm under leaseholds,
tangible assets obtained, as the lessee, through capital
lease agreements in 2017.

B. Payroll before deductions

16. SELECTED EXPENSES
Costs refer to the amount actually paid or payable after
discounts, including freight and other direct charges
incurred in acquiring the item or service.

Include:


Wages, salaries, tips, vacation allowances, bonuses,
commissions, and other compensation paid to
employees during 2017, whether or not subject to
income or FICA tax.



Salaries of officers and executives of a corporation.



Employee contributions to qualified pension plans.



The spread on stock options that is taxable to employees
as income.

A. Communication services
Report cost of communication services, including
telephone, cellular phones, Internet, fax, and the cost for
the contracts.
B. Computer services
Report the cost of all computer services. Include data
processing and computer software.

Exclude:

C. Office supplies



Payments to or withdrawals by proprietors or partners of
an unincorporated business.



Annuities or supplemental unemployment
compensation benefits, even if income tax was withheld.

D. Maintenance and repair of machinery and
equipment



Payroll of departments or concessions operated by other
companies at the establishment.

Report total amount paid for the maintenance and repair of
the machinery and/or equipment during 2017.

Report the cost of office supplies.

C. Employer’s cost for benefits

E.

Include:

Report total amount paid for the maintenance and repair of
buildings, structures, offices, and their integral parts.
Include the cost of purchased services from other
companies that are paid directly by this establishment for
janitorial, refuse removal, and other services.





Legally required employer’s cost for benefits (employer
payments for Social Security, Medicare, unemployment
compensation, workmen’s compensation, and local
disability programs, if required). Also include any legally
required employer’s cost for benefits under non FICA
regulations.

F.

Maintenance and repair of buildings, structures,
offices, and their integral parts

All other operating expenses

Include all the other operating expenses incurred by the
establishment, such as payroll, benefits, utilities,
depreciation. Do not include capital expenditures, interest,
and/or bad debt.

Voluntarily provided benefits (payments for life
insurance, medical insurance, pensions, welfare
benefits, union-negotiated benefits, and other benefits).

G. Interest paid
Include all the interest that was paid in 2017.

13. CAPITAL EXPENDITURES AND DEPRECIATION
CHARGES
A. Capital expenditures

19. PRINCIPAL KIND OF BUSINESS

Report expenditures made during 2017 to purchase
buildings or structures, including improvements and
repairs, and machinery and equipment that are chargeable
to the fixed assets accounts and for which depreciation
accounts are maintained. Also include the cost of buildings
or structures and machinery and equipment acquired as
the lessee under capital lease agreements entered into
during 2017.

Choose the PRINCIPAL kind of business that best
describes the establishment in 2017. If none of the provided
selections seem appropriate, mark “X” the box next to
“Other kind of business or activity,” at the end of item 19
and provide a specific description of the primary business
activity.

95101_I

Page 4

95201_I

U.S. DEPARTMENT OF COMMERCE
Economics and Statistics Administration
U.S. Census Bureau

(5/2017)

2017 ECONOMIC CENSUS
U.S. Territories
Finance, Insurance, Real Estate, and Rental and Leasing
INFORMATION SHEET
Need help or have questions about filling out the form?
Visit econhelp.census.gov or
Call 1-800-233-6136, between 8:00 a.m. and 6:00 p.m., Eastern time, Monday through Friday.
Please reference your 11-digit Census File Number (CFN) printed on each form with all communications.
The Finance and Insurance and Real Estate and Rental and
Leasing sectors of the 2017 Economic Census includes
establishments primarily engaged in the following areas
of economic activity:


Financial services – banks; credit unions; savings
institutions; finance, mortgage, and loan companies;
securities and commodities brokers, dealers, and
exchanges; holding companies, investment companies,
pension fund administrators.



Insurance carriers, agents (agencies), and brokers
(brokerages).



Real estate operators and lessors; listing, sales, and
rental agents (agencies); property management; and
other real estate services.



Auto and truck rental and leasing; computer and other
equipment rental and leasing; video tape rental; and
other rental and leasing services.

If an establishment is NOT engaged in one of these kinds
of businesses, DESCRIBE its business or activity in
ITEM 19 AND COMPLETE the report form as accurately
as possible.
DEFINITION OF ESTABLISHMENT
An establishment is generally a single physical location
where business is conducted or where services or
industrial operations are performed. This includes all
selling and service locations of a company and any other
facilities such as bank branches, administrative offices, etc.
Permanent (or temporary) locations with no paid
employees (such as automated teller machines) are not
considered separate establishments.

GENERAL INSTRUCTIONS


Complete a separate report form for each
establishment owned or controlled by your company
or organization. If you did not receive a separate report
form for each establishment, visit our web site at
econhelp.census.gov or call 1-800-233-6136, between
8:00 a.m. and 6:00 p.m., Eastern time, Monday
through Friday, to request additional report forms.

95201_I

Page 1



Each report form should cover calendar year 2017. If
book figures are not available, estimates are
acceptable. However, if the accounting fiscal year is
different from the calendar year, fiscal year figures will
be acceptable for all items except payroll (calendar year
figures for payroll should be available from the Internal
Revenue Service (IRS) Form 941-PR or 941-SS,
Employer’s Quarterly Federal Tax Return, or Form 944
or 944-SS, Employer’s Annual Federal Tax Return).
Indicate in item 30 the exact dates covered.



If an establishment stopped operating before January 1,
2017, indicate action and date in item 3, mark “X” the
box to indicate “none” in item 4, and continue to
item 30.



If an establishment was closed, sold, or leased to
another company or organization during 2017, complete
the report form for the portion of 2017 that the
establishment was operating as part of your company or
organization.



Dollar figures should be rounded to the nearest
thousand as illustrated on the report form.



If there are any questions or if any communication
regarding this report form is necessary, reference the
11-digit Census File Number (CFN) shown in the mailing
address.



Please save, print or photocopy each completed report
form for your records and return the original.



Public reporting burden for this collection of information
is estimated to average one hour 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: Paperwork Project 0607-0937, U.S. Census
Bureau, 4600 Silver Hill Road, AMSD-3K138,
Washington, DC 20233. You may e-mail comments to
[email protected]; use “Paperwork Project
0607-0937" as the subject.

PLEASE CONTINUE ON REVERSE



Response to this collection of information is required
unless it does not display a valid approval number from
the Office of Management (OMB). The OMB eight-digit
number appears on the welcome screen or in the upper
right corner of the paper report form.

INSTRUCTIONS FOR SELECTED ITEMS
2.

3. OPERATIONAL STATUS



In operation – The establishment was open and
actively conducting business on December 31, 2017.



Temporarily or seasonally inactive – Although not
conducting business at the end of 2017, the
establishment will eventually reopen and conduct
business under the same Employer Identification
Number (EIN). Examples include businesses or
establishments that close during the “off-season” or that
temporarily close for remodeling. Complete all items on
the form for the portion of 2017 during which the
establishment was active.



5.



Net gains (losses) from the sale of real property owned
by the establishment for investment, rent, or lease (NOT
gross sales).



Gross sales (NOT net gains (losses)) of real property
developed or buildings built by the establishment for
sale.



Gross rents from real property leased by the
establishment to others.



Rents from departments or concessions operated by
other companies at the establishments.

Exclude:

Mark “X” the ONE box that best describes the operational
status of the establishment at the end of 2017.



Commissions and fees received from all sources,
including fees earned for exchanging currencies, selling
money orders, and cashing checks.

PHYSICAL LOCATION

Answer all sections (A and B) of item 2 even if the mailing
address shown is correct.







Revenue or other taxes collected directly from
customers and paid directly to a commonwealth or
federal tax agency.



Revenue of departments or concessions operated by
other companies at the establishment.

6.

E-COMMERCE SALES, SHIPMENTS, RECEIPTS,
OR REVENUE IN 2017

E-commerce transactions are transactions completed over
an Internet, electronic mail, Extranet, Electronic Data
Interchange (EDI) network, or other online system.

Ceased operation – The establishment has gone out of
business or closed and does not plan to reopen. Provide
the month, day, and year that the establishment
ceased operation. Complete all items on the form for the
portion of 2017 during which the establishment was in
operation.

Include:


Revenue generated from agreements negotiated online
between buyer and seller on price and term of a transfer
of ownership of, or rights to use, goods or services.

Sold or leased to another operator – The
establishment was sold or leased to another company or
organization. Provide the month, day, and year that
the change occurred and indicate the name, address,
and EIN of the new owner or operator. Complete all
items on the form for the portion of 2017 prior to the
change in operator.



Online sales of goods or services, regardless of whether
payment is made online.



Commissions or fees from the use of online services
(e.g., computerized reservation systems, financial
transaction processing systems, etc.) where the order or
contact was negotiated online.

Other status – The establishment’s operational status
at the end of 2017 is not accurately described above.
Please specify a description of the establishment’s
operational status in the space provided.



Commissions or fees from online trading of securities or
other financial products (e.g., insurance. loans, etc.).



Commissions or fees from selling or from facilitating the
sale of third party products (e.g., click-throughs on
advertisements or referral fees) through the
establishment’s Web site.



Revenue generated from telephone transactions using
interactive voice response systems.



Shipping and handling receipts for online orders.

SALES, SHIPMENTS, RECEIPTS, OR REVENUE
IN 2017

For establishments that generate no revenue, report zero
and explain in the remarks section at the end of the report
form.

Exclude:

Include:





Interest, dividends, royalties, net realized capital gains
(losses).

95201_I

Page 2

Online payments from customers where the order or
contract was not negotiated online.

PLEASE CONTINUE ON NEXT PAGE





7.

Commissions or fees from the provision of
telecommunications and related infrastructure systems
(e.g., data transfer, Web hosting, Internet access, etc.)
where the order or contract was not negotiated online.



Employee contributions to qualified pension plans.



The spread on stock options that is taxable to employees
as income.

Order for goods or services placed over facsimile
machines or switched telephone networks.



Compensation paid to sales agents as reported on
Internal Revenue Service Form 941, Employer’s
Quarterly Federal Tax Return, or Form 944,
Employer’s Annual Federal Tax Return.

EMPLOYMENT AND PAYROLL

Exclude:

If employees worked at more than one location, report
employment and payroll for employees at the ONE location
where they spent most of their working time.



Payments to or withdrawals by proprietors or partners of
an unincorporated business.



Annuities or supplemental unemployment
compensation benefits, even if income tax was withheld.



Payrolls of departments or concessions operated by
other companies at the establishment.



Compensation paid to agents not considered employees
of the firm on Internal Revenue Service Form 941-PR or
941-SS, Employer’s Quarterly Federal Tax Return, or
Form 944-PR or 944-SS, Employer’s Annual Federal Tax
Return (e.g., real estate agents, independent insurance
agents).

A. Number of paid employees
Report number of paid employees for pay period including
the March 12, 2017.
Include:


All full- and part-time employees working at this
establishment whose payroll was reported on Internal
Revenue Service Form 941-PR or 941-SS, Employer’s
Quarterly Federal Tax Return, or Form 944-PR or 944SS, Employer’s Annual Federal Tax Return, and filed
under the Employer Identification Number (EIN) shown
in the mailing address or corrected in item 1.



Salaried officers and executives of a corporation.



Salaried member of a professional service organization
or association.



Agents considered employees of the firm.



Employees on paid sick leave, paid holidays, and paid
vacation.

C. Employer’s cost for benefits
Include:

Exclude:


Temporary staffing obtained from a staffing service.



Employees of departments or concessions operated by
other companies at this establishment.



Proprietors or partners of an unincorporated business.



Unpaid family members.



Agents not considered employees of the firm on Internal
Revenue Service Form 941-PR or 941-SS, Employer’s
Quarterly Federal Tax Return, or Form 944-PR or 944-SS,
Employer’s Annual Federal Tax Return (e.g., real estate
agents, independent insurance agents).



Salaries of officers and executives of a corporation.

95201_I



Voluntarily provided benefits (payments for life
insurance, medical insurance, pensions, welfare
benefits, union-negotiated benefits, and other benefits).

A. Capital expenditures
Report expenditures made during 2017 to purchase
buildings or structures, including improvements and
repairs, and machinery and equipment that are chargeable
to the fixed assets accounts and for which depreciation
accounts are maintained. Also include the cost of buildings
or structures and machinery and equipment acquired as
the lessee under capital lease agreements entered into
during 2017.
B. Depreciation charges
Report depreciation charges taken against tangible assets
owned and used by your firm, tangible assets and
improvements owned by your firm under leaseholds,
tangible assets obtained, as the lessee, through capital
lease agreements in 2017.

Include:
Wages, salaries, tips, vacation allowances, bonuses,
commissions, and other compensation paid to
employees during 2017, whether or not subject to
income or FICA tax.

Legally required employer’s cost for benefits (employer
payments for Social Security, Medicare, unemployment
compensation, workmen’s compensation, and local
disability programs, if required). Also include any legally
required employer’s cost for benefits under non FICA
regulations.

13. CAPITAL EXPENDITURES AND DEPRECIATION
CHARGES

B. Payroll before deductions





Page 3

PLEASE CONTINUE ON REVERSE

16. SELECTED EXPENSES

E.

Costs refer to the amount actually paid or payable after
discounts, including freight and other direct charges
incurred in acquiring the item or service.

Report total amount paid for the maintenance and repair of
buildings, structures, offices, and their integral parts.
Include the cost of purchased services from other
companies that are paid directly by this establishment for
janitorial, refuse removal, and other services.

A. Communication services
Report cost of communication services, including
telephone, cellular phones, Internet, fax, and the cost for
the contracts.

F.

All other operating expenses

Include all the other operating expenses incurred by the
establishment, such as payroll, benefits, utilities,
depreciation. Do not include capital expenditures, interest,
and/or bad debt.

B. Computer services
Report the cost of all computer services. Include data
processing and computer software.

G. Interest paid

C. Office supplies

Include all the interest that was paid in 2017.

Report the cost of office supplies.
D. Maintenance and repair of machinery and
equipment

19. PRINCIPAL KIND OF BUSINESS

Report total amount paid for the maintenance and repair of
the machinery and/or equipment during 2017.

95201_I

Maintenance and repair of buildings, structures,
offices and their integral parts

Choose the PRINCIPAL kind of business that best
describes the establishment in 2017. If none of the provided
selections seem appropriate, mark “X” the box next to
“Other kind of business or activity,” at the end of item 19
and provide a specific description of the primary business
activity.

Page 4

97201_I

U.S. DEPARTMENT OF COMMERCE
Economics and Statistics Administration
U.S. Census Bureau

(2/2017)

2017 ECONOMIC CENSUS
U.S. Territories
Accommodation Services
INFORMATION SHEET
Need help or have questions about filling out the form?
Visit econhelp.census.gov or
Call 1-800-233-6136, between 8:00 a.m. and 6:00 p.m., Eastern time, Monday through Friday.
Please reference your 11-digit Census File Number (CFN) printed on each form with all communications.

The Accommodation Services Sector of the 2017
Economic Census includes establishments primarily
engaged in providing lodging or short-term
accommodations and complementary services.
If an establishment is NOT engaged in this kind of
business activity, DESCRIBE its business or activity in
ITEM 19 AND COMPLETE the report form as accurately
as possible.
DEFINITION OF ESTABLISHMENT
An establishment is generally a single physical location
where business is conducted or where services or
industrial operations are performed. This includes all
locations of a company or organization, including
administrative offices that were in operation at any time
during 2017.
GENERAL INSTRUCTIONS


Complete a separate report form for each
establishment owned or controlled by your company
or organization. If you did not receive a separate report
form for each establishment, visit our web site at
econhelp.census.gov or call 1-800-233-6136, between
8:00 a.m. and 6:00 p.m., Eastern time, Monday through
Friday, to request additional report forms.



Each report form should cover calendar year 2017. If
book figures are not available, estimates are
acceptable. However, if the accounting fiscal year
is different from the calendar year, fiscal year
figures will be acceptable for all items except
payroll (calendar year figures for payroll should be
available from the Internal Revenue Service (IRS)
Form 941-PR or 941-SS, Employer’s Quarterly
Federal Tax Return, or Form 944-PR or 944-SS,
Employer’s Annual Federal Tax Return). Indicate in
item 30 the exact dates covered.

97201_I

Page 1



If an establishment stopped operating before January 1,
2017, indicate action and date in item 3, mark “X” the
box to indicate “none” in item 4, and continue to
item 30.



If an establishment was closed, sold, or leased to
another company or organization during 2017, complete
the report form for the portion of 2017 that the
establishment was operating as part of your company or
organization.



Dollar figures should be rounded to the nearest
thousand as illustrated on the report form.



If there are any questions or if any communication
regarding this report form is necessary, reference the
11-digit Census File Number (CFN) shown in the mailing
address.



Please save, print or photocopy each completed report
form for your records and return the original.



Public reporting burden for this collection of information
is estimated to average one hour 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: Paperwork Project 0607-0937, U.S. Census
Bureau, 4600 Silver Hill Road, AMSD-3K138,
Washington, DC 20233. You may e-mail comments to
[email protected]; use “Paperwork Project
0607-0937" as the subject.



Response to this collection of information is required
unless it does not display a valid approval number from
the Office of Management (OMB). The OMB eight-digit
number appears on the welcome screen or in the upper
right corner of the paper report form.

PLEASE CONTINUE ON REVERSE

INSTRUCTIONS FOR SELECTED ITEMS
2.

PHYSICAL LOCATION

Answer all sections (A and B) of item 2 even if the mailing
address shown is correct.
3.



Receipts from the rental of vehicles, equipment,
instruments, tools, and other merchandise.



Motor vehicle transportation charges, dealer preparation
charges, and dealer installed options.



Fair sales value of motor vehicles marketed under leases
negotiated in 2017, regardless of whether the
establishment holds the lease.



Sales of motor vehicles formerly used for rental or
leasing.



Total value of service contracts.

OPERATIONAL STATUS

Mark “X” the ONE box that best describes the operational
status of the establishment at the end of 2017.


In operation – The establishment was open and
actively conducting business on December 31, 2017.



Commissions received for the arrangement of financing
and the sale of credit life insurance.



Temporarily or seasonally inactive – Although not
conducting business at the end of 2017, the
establishment will eventually reopen and conduct
business under the same Employer Identification
Number (EIN). Examples include businesses or
establishments that close during the “off-season” or that
temporarily close for remodeling. Complete all items on
the form for the portion of 2017 during which the
establishment was active.



Amounts received from customers for layaway
purchases.



Excise taxes (such as those on gasoline, liquor, and
tobacco) paid by the manufacturer or wholesaler and
included in the cost of goods purchased by the
establishment.



Fees for processing money orders and cashing checks.

Ceased operation – The establishment has gone out of
business or closed and does not plan to reopen. Provide
the month, day, and year that the establishment
ceased operation. Complete all items on the form for the
portion of 2017 during which the establishment was in
operation.



Shipping and handling receipts.







5.

Exclude:

Sold or leased to another operator – The
establishment was sold or leased to another company or
organization. Provide the month, day, and year that
the change occurred and indicate the name, address,
and EIN of the new owner or operator. Complete all
items on the form for the portion of 2017 prior to the
change in operator.
Other status – The establishment’s operational status
at the end of 2017 is not accurately described above.
Please specify a description of the establishment’s
operational status in the space provided.

•

Sales and other taxes collected directly from
customers and paid directly to a commonwealth or
federal tax agency.

•

Gross sales and receipts of departments or
concessions operated by other companies at this
establishment.

•

Receipts from carrying and other credit charges.

•

Commissions or receipts from the sale of government
lottery tickets.

•

Non-operating income from sources such as
investments, rental or sale of real estate, and interest.

•

Automotive dealers only – Receipts from customers
for tag and title fees, licenses, etc., forwarded to a
commonwealth licensing agency.

SALES, SHIPMENTS, RECEIPTS, OR REVENUE
IN 2017

Deduct:

Include:


Cash and credit sales of merchandise sold in 2017,
whether or not payment was received in 2017.



Receipts for delivery, installation, maintenance, repair,
alteration, storage, and other services provided in 2017,
whether or not payment was received in 2017.



The establishment’s share of sales and receipts from
departments, concessions, and vending and amusement
machines operated by other companies at this
establishment.

97201_I

•

Refunds and allowances for returned merchandise.

•

Automotive dealers only – Discounts granted to the
purchaser as an increase in trade-in allowance over
fair market value and manufacturer’s rebates and
incentives.

Do no deduct fair market value of trade-ins taken as
partial payment.

Page 2

PLEASE CONTINUE ON NEXT PAGE

6.

E-COMMERCE SALES, SHIPMENTS, RECEIPTS,
OR REVENUE IN 2017

Include:


All full- and part-time employees working at this
establishment whose payroll was reported on Internal
Revenue Service Form 941-PR or 941-SS, Employer’s
Quarterly Federal Tax Return, or Form 944-PR or 944SS, Employer’s Annual Federal Tax Return, and filed
under the Employer Identification Number (EIN) shown
in the mailing address or corrected in item 1.



Non-resident workers, whether or not FICA taxes were
withheld.



Salaried officers and executives of a corporation.



Employees on paid sick leave, paid holidays, and paid
vacation.

E-commerce transactions are transactions completed over
an Internet, electronic mail, Extranet, Electronic Data
Interchange (EDI) network, or other online system.
Include:


Sales generated from agreements negotiated online,
between buyer and seller on price an term of a transfer
of ownership of, or rights to use, goods or services.



Online sales of goods or services, regardless of whether
payment is made online.



Commissions or fees from the use of online services
(e.g., computerized reservation systems, financial
transaction processing systems, etc.) where the order or
contract was negotiated online.

Exclude:


Temporary staffing obtained from a staffing service.



Commissions or fees from online trading of securities or
other financial products (e.g., insurance, loans, etc.).



Employees of departments or concessions operated by
other companies at this establishment.



Sales, shipments, receipts, revenue, and fees made from
the sale of third party products through the
establishment’s web site.



Proprietors or partners of an unincorporated business.



Unpaid family members.



Sales generated from telephone transactions using
interactive voice response systems.

B. Payroll before deductions



Shipping and handling receipts for online orders.

Include:

Exclude:


Online payments from customers where the order or
contract was not negotiated online.



Commissions or fees from the use of online services
(e.g., computerized reservation systems, financial
transaction processing systems, etc.) where the order or
contract was not negotiated online.





7.



Wages, salaries, tips, vacation allowances, bonuses,
commissions, and other compensation paid to
employees during 2017, whether or not subject to
income or FICA tax.



Salaries of officers and executives of a corporation.



Employee contributions to qualified pension plans.

Exclude:

Commissions or fees from the provision of
telecommunications and related infrastructure systems
(e.g., data transfer, Web hosting, Internet access, etc.)
where the order or contract was not negotiated online.
Sales from orders for goods or services placed over
facsimile machines or switched telephone networks.



Payments to or withdrawals by proprietors or partners of
an unincorporated business.



Annuities or supplemental unemployment
compensation benefits, even if income tax was withheld.



Payrolls of departments or concessions operated by
other companies at the establishment.

C. Employer’s cost for

EMPLOYMENT AND PAYROLL

benefits Include:

If employees worked at more than one location, report
employment and payroll for employees at the ONE location
where they spent most of their working time.



Legally required employer’s cost for benefits (employer
payments for Social Security, Medicare, unemployment
compensation, workmen’s compensation, and local
disability programs, if required). Also include any legally
required employer’s cost for benefits under non FICA
regulations.



Voluntarily provided benefits (payments for life
insurance, medical insurance, pensions, welfare
benefits, union-negotiated benefits, and other benefits).

A. Number of paid employees
Report number of paid employees for pay period including
the March 12, 2017.

97201_I

Page 3

PLEASE CONTINUE ON REVERSE

D. Maintenance and repair of machinery and
equipment

13. CAPITAL EXPENDITURES AND DEPRECIATION
CHARGES

Report total amount paid for the maintenance and repair of
the machinery and/or equipment during 2017.

A. Capital expenditures

E.

Report expenditures made during 2017 to purchase
buildings or structures, including improvements and
repairs, and machinery and equipment that are chargeable
to the fixed assets accounts and for which depreciation
accounts are maintained. Also include the cost of buildings
or structures and machinery and equipment acquired as
the lessee under capital lease agreements entered into
during 2017.

Report total amount paid for the maintenance and repair of
buildings, structures, offices, and their integral parts.
Include the cost of purchased services from other
companies that are paid directly by this establishment for
janitorial, refuse removal, and other services.
F.

Maintenance and repair of buildings, structures,
offices and their integral parts

Merchandise bought for resale

Report the cost of all merchandise bought and resold in the
same condition as when purchased.

B. Depreciation charges
Report depreciation charges taken against tangible assets
owned and used by your firm, tangible assets and
improvements owned by your firm under leaseholds,
tangible assets obtained, as the lessee, through capital
lease agreements in 2017.

G. All other operating expenses
Include all the other operating expenses incurred by the
establishment, such as payroll, benefits, utilities,
depreciation. Do not include capital expenditures, interest,
and/or bad debt.

16. SELECTED EXPENSES

H. Interest paid

Costs refer to the amount actually paid or payable after
discounts, including freight and other direct charges
incurred in acquiring the item or service.

Include all the interest that was paid in 2017.
19. PRINCIPAL KIND OF BUSINESS

A. Communication services

B. Computer services

Choose the PRINCIPAL kind of business that best
describes the establishment in 2017. If none of the provided
selections seem appropriate, mark “X” the box next to
“Other kind of business,” at the end of item 19 and provide
a specific description of the primary business activity.

Report the cost of all computer services. Include data
processing and computer software.

20. CLASS OF CUSTOMER

Report cost of communication services, including
telephone, cellular phones, Internet, fax, and the cost for
the contracts.

C. Office supplies

D. Percent of sales and receipts generated from
exports

Report the cost of office supplies.

Estimate the percentage of sales and receipts generated
from exports, NOT THE PERCENTAGE OF
TRANSACTIONS.
Include exports to foreign countries, the United States, and
U.S. territories.
E.

Percent of total sales by class of customer

Estimate the percentage of this establishment’s total sales
by class of customer, excluding the percentage reported in
line D. Total in line 8 should be 100%.

97201_I

Page 4

PLEASE CONTINUE ON NEXT PAGE

E1. Household consumers

E7. Other

Include sales to individuals or employees buying for
personal consumption.

Report the percentage of sales not elsewhere classified and
describe the type of customer.

E2. Retailers
22. DETAIL OF SALES, SHIPMENTS, RECEIPTS, OR
REVENUE IN 2017

Include sales to all types of retailers (that is, retail chain
organizations independent stores, or department stores)
that normally buy for resale to household consumers.



In addition to sales to merchant wholesalers, include sales
that were made through agents, brokers, and commission
merchants.

Report either in thousands of dollars OR as a whole
percent of total sales as illustrated on the report form. It
is not necessary to report in both dollars and
percentages. Percentages are preferable.



E5. Restaurants, hotels, food services, and contract
feeding

Estimates are acceptable, but please do not combine
data for two or more lines.



If the establishment sold merchandise not covered in the
prelisted categories, report the sales of such
merchandise on the “All other merchandise” line and
specify principal lines with their estimated sales or
percent of sales.



Receipts for rentals, storage, repair work, and service
contracts should be reported on the “Nonmerchandise
receipts” line at the end of the listing. Do not include
such receipts with the merchandise sales.



The sum of merchandise lines reported should equal 100
percent (or the amount reported in item 5 if the lines are
reported in dollars).

E3. Wholesalers

Include sales to caterers, contract feeders, and all eating
and drinking establishments.
E6. Governmental bodies
Include sales to the Federal government (including military
post exchanges, General Services Administration (GSA),
U.S. Postal Service, and other agencies), this U.S. territory
government, and Municipal governments.

97201_I

Page 5


File Typeapplication/pdf
AuthorBlynda K Metcalf (CENSUS/EWD FED)
File Modified2017-02-08
File Created2017-02-08

© 2024 OMB.report | Privacy Policy