BE-11 Claim for Ex BE-11 Claim for Exemption

FORM

BE-11 Claim for Not Filing

OMB No. 0608-0053: Approval Expires 11/30/2018

(REV. 01/2018)

2017 ANNUAL SURVEY OF U.S. DIRECT INVESTMENT ABROAD
MANDATORY — CONFIDENTIAL
BE-11 Claim for Not Filing

Reporter ID Number*
*Do not enter Social Security Number in Reporter ID box

Mail reports to:

Bureau of Economic Analysis
Direct Investment Division, BE-69(A)
4600 Silver Hill Road
Washington, DC 20233

Name and address of U.S. business enterprise for which this claim is
filed — If the enterprise received a Form BE-11A but is exempt from filing,
enter below the Reporter name, address, and BEA assigned Identification Number
(Reporter ID) from the preprinted information provided in Part I, 1 , of Form
BE-11A. If a Form BE-11A was not received, enter name and address.

Deliver reports to: Bureau of Economic Analysis
Direct Investment Division, BE-69(A)
4600 Silver Hill Road
Suitland, MD 20746
Fax reports to:

(301) 278-9502

Assistance:

E-mail:
Telephone:
Copies of form:

Name and address of U.S. Reporter

be10/[email protected]
(301) 278-9418
www.bea.gov/dia

Please include your Reporter Identification Number
with all requests.

The BE-11 Claim for Not Filing is to be completed and returned to BEA by May 31, 2018, by all persons, or their agents, who are contacted
by BEA about reporting on this survey and are:
1) Exempt from filing all 2017 BE-11 forms — complete Part I of the form; OR
2) Exempt from filing one or more of the 2017 BE-11B and/or BE-11C forms that they received from BEA — complete Part II of the form.
See Instruction Booklet, Section 1.C., for exemption criteria.

CONTACT INFORMATION
Provide information of person to consult about this report:
Name
0
0990

Street 1

Telephone Number

0
0994

Street 2
0
0997

0992

City

—
— — — - — — — —
Fax Number
0
(— — —) — — — - — — — —
E-mail Address
0

0991

State

Zip

0

(—

Extension

—)

0

0993

0999

NOTE: BEA uses a Secure Messaging System to correspond with you via encrypted message to discuss questions relating to this form. We may use
your e-mail address for survey-related announcements and to inform you about secure messages. When communicating with BEA by e-mail, please do
not include any confidential business or personal information.

CERTIFICATION
The undersigned official certifies that this report has been prepared in accordance with the applicable instructions, is complete, and is substantially
accurate except that, in accordance with instructions Part IV.E of the Instruction Booklet, estimates may have been provided.
Signature of Authorized Official

Date

Telephone Number

—
— — — - — — — —
Fax Number
0
(— — —) — — — - — — — —
0

0996

Name

Title

0
0995

1001

(—

—)

Extension

BASIS OF CLAIM FOR NOT FILING
Mark (X) and complete either Part I or Part II
Part I. Basis of Claim for Not Filing BE-11 Forms
A.

This U.S. person did not own or control, 10 percent or more of the voting securities of an incorporated foreign business enterprise, or an
equivalent interest in an unincorporated foreign business enterprise (including a branch or real estate held for other than personal use) at the
end of its 2017 fiscal year.
But did file the 2016 BE-11, Annual Survey of U.S. Direct Investment Abroad, with this Bureau.

B.

This U.S. person did own or control, directly or indirectly, 10 percent or more of the voting securities of an incorporated
foreign business enterprise, or an equivalent interest in an unincorporated foreign business enterprise (including a branch
or real estate held for other than personal use) at the end of its 2017 fiscal year, but (Mark (X) one) —
1

None of its foreign affiliates are required to be reported on Form BE-11B, BE-11C, or BE-11D because all affiliates are exempt.
You must complete page 3 of this claim for those affiliates for which you received a preprinted form or those
identified as required to file in the eFile system. See Instruction Booklet, Section I.C., for exemption criteria.

2

Is fully consolidated in the BE-11 report for
another U.S. person – Give name and
address of that person and their BEA
Identification Number, if known.

Name
Address – Number and street or P.O. Box
City

State

ZIP Code

BEA Identification
Number
C.

Other – Specify and include reference to section of regulations or instructions on which claim is based.

Part II. Basis of Claim for Not Filing for Foreign Affiliate(s)
A. Did this U.S. reporter have one or more foreign affiliates identified by BEA as required to file a 2017 BE-11B or BE-11C form but no longer
meet one or both of the following two filing requirements at the end of its 2017 fiscal year: 1) the U.S. reporter no longer owns or controls,
directly or indirectly, 10 percent or more of the voting securities of the incorporated foreign business enterprise (or an equivalent interest in an
unincorporated foreign business enterprise), or/and 2) the sales, assets, and net income for this affiliate(s) are all $60 million or less?
1

■

2

■ No

Yes — Please complete page 3 of this Claim form for each of these foreign affiliates.
Do not list foreign affiliates that BEA did not identify to file.

B. Did this U.S. reporter own one or more foreign affiliates identified by BEA as required to file a 2017 BE-11B or BE-11C form but for which ALL
of the following apply: 1) the foreign affiliate is a private fund, AND 2) the private fund foreign affiliate does not own, directly or indirectly through
another business enterprise, an “operating company” – i.e., a business enterprise that is not a private fund or a holding company— in which the
consolidated U.S. reporter owns at least 10 percent of the voting interest, AND 3) If the U.S. reporter owns the private fund indirectly (through one
or more other business enterprises), there are no “operating companies” between the consolidated U.S. reporter and the indirectly-owned foreign
private fund? For more information regarding private funds visit www.bea.gov/privatefunds.
1

■ Yes — Please complete page 3 of this Claim form for each of these foreign affiliates and check the corresponding box.
The U.S. reporter’s investment in the foreign private fund may be required to be reported on Treasury International Capital (TIC)
surveys, review reporting requirements for TIC surveys at www.treasury.gov/tic. Do not list foreign affiliates that BEA did not identify
to file.

2

■

No

MANDATORY — This survey is being conducted under the International Investment and Trade in Services Survey Act (P.L. 94-472, 90 Stat. 2059, 22
U.S.C. 3101–3108, as amended – hereinafter “the Act”), and the filing of reports is mandatory under Section 5(b)(2) of the Act (22 U.S.C. 3104).
CONFIDENTIALITY — The Act provides that your report to this Bureau is CONFIDENTIAL and may be used only for analytical or statistical
purposes. Without your prior written permission, the information filed in your report CANNOT be presented in a manner that allows it to be individually
identified. Your report CANNOT be used for purposes of taxation, investigation, or regulation. Copies retained in your files are immune from legal
process. Per the Cybersecurity Enhancement Act of 2015, your data are protected from cybersecurity risks through security monitoring of the BEA
information systems.
PENALTIES — Whoever fails to report shall be subject to a civil penalty of not less than $2,500, and not more that $25,000, and to injunctive relief
commanding such person to comply, or both. Whoever willfully fails to report shall be fined not more than $10,000 and, if an individual, may be
imprisoned for not more than one year, or both. Any officer, director, employee, or agent of any corporation who knowingly participates in such
violations, upon conviction, may be punished by a like fine, imprisonment, or both (22 U.S.C. 3105). These civil penalties are subject to inflationary
adjustments. Those adjustments are found in 15 C.F.R. 6.4.
Notwithstanding any other provision of the law, no person is required to respond to, nor shall any person be subject to a penalty for failure to comply
with, a collection of information subject to the requirements of the Paperwork Reduction Act, unless that collection of information displays a currently
valid OMB Control Number.
Page 2

FORM BE-11 Claim for Not Filing (REV. 01/2018)

If you are claiming exemption based upon the criteria on page 2, Part I B.1 or Part II, complete the items below for those affiliates for which you
received preprinted forms. Copy the foreign affiliate name and Affiliate ID from the preprinted form or those identified as required to file in the eFile
system and complete the remaining items.
1 Name of foreign affiliate:

a. Percent ownership at close of
fiscal year 2017 — Enter to the
nearest tenth of one percent . . . . . . . . .

___ ___ ___ . ___ %

$ Bil.

Mil.

Thous.

Dols.

Affiliate ID:

b. Total assets — Balance at
close of fiscal year . . . . . . . . . . . . . . . . .

000

■

c. Annual sales or gross operating
revenues, excluding sales taxes. . . . . . .

000

d. Net income (loss) . . . . . . . . . . . . . . . . . .

000

This private fund affiliate meets the exemption criteria stated on
page 2, Part II. B. (Answer to Part II. B has to be ‘Yes’.) DO NOT
complete a.– d.

2 Name of foreign affiliate:

a. Percent ownership at close of
fiscal year 2017 — Enter to the
nearest tenth of one percent . . . . . . . . .

___ ___ ___ . ___ %

$ Bil.

Mil.

Thous.

Dols.

Affiliate ID:

b. Total assets — Balance at
close of fiscal year . . . . . . . . . . . . . . . . .

000

■

c. Annual sales or gross operating
revenues, excluding sales taxes. . . . . . .

000

d. Net income (loss) . . . . . . . . . . . . . . . . . .

000

This private fund affiliate meets the exemption criteria stated on
page 2, Part II. B. (Answer to Part II. B has to be ‘Yes’.) DO NOT
complete a.– d.

3 Name of foreign affiliate:

a. Percent ownership at close of
fiscal year 2017 — Enter to the
nearest tenth of one percent . . . . . . . . .

___ ___ ___ . ___ %

$ Bil.

Mil.

Thous.

Dols.

Affiliate ID:

b. Total assets — Balance at
close of fiscal year . . . . . . . . . . . . . . . . .

000

■

c. Annual sales or gross operating
revenues, excluding sales taxes. . . . . . .

000

d. Net income (loss) . . . . . . . . . . . . . . . . . .

000

This private fund affiliate meets the exemption criteria stated on
page 2, Part II. B. (Answer to Part II. B has to be ‘Yes’.) DO NOT
complete a.– d.

4 Name of foreign affiliate:

a. Percent ownership at close of
fiscal year 2017 — Enter to the
nearest tenth of one percent . . . . . . . . .

___ ___ ___ . ___ %

$ Bil.

Mil.

Thous.

Dols.

Affiliate ID:

b. Total assets — Balance at
close of fiscal year . . . . . . . . . . . . . . . . .

000

■

c. Annual sales or gross operating
revenues, excluding sales taxes. . . . . . .

000

d. Net income (loss) . . . . . . . . . . . . . . . . . .

000

This private fund affiliate meets the exemption criteria stated on
page 2, Part II. B. (Answer to Part II. B has to be ‘Yes’.) DO NOT
complete a.– d.

5 Name of foreign affiliate:

a. Percent ownership at close of
fiscal year 2017 — Enter to the
nearest tenth of one percent . . . . . . . . .

___ ___ ___ . ___ %

$ Bil.
Affiliate ID:

■

This private fund affiliate meets the exemption criteria stated on
page 2, Part II. B. (Answer to Part II. B has to be ‘Yes’.) DO NOT
complete a.– d.

FORM BE-11 Claim for Not Filing (REV. 01/2018)

Mil.

Thous.

Dols.

b. Total assets — Balance at
close of fiscal year . . . . . . . . . . . . . . . . .

000

c. Annual sales or gross operating
revenues, excluding sales taxes. . . . . . .

000

d. Net income (loss) . . . . . . . . . . . . . . . . . .

000
Page 3

If you are claiming exemption based upon the criteria on page 2, B.1 or Part II, complete the items below for those affiliates for which you
received preprinted forms. Copy the affiliate name and Affiliate ID from the preprinted form or those identified as required to file in the
eFile system and complete the remaining items.
6 Name of foreign affiliate:

a. Percent ownership at close of
fiscal year 2017 — Enter to the
nearest tenth of one percent . . . . . . . . .

___ ___ ___ . ___ %

$ Bil.

Mil.

Thous.

Dols.

Affiliate ID:

b. Total assets — Balance at
close of fiscal year . . . . . . . . . . . . . . . . .

000

■

c. Annual sales or gross operating
revenues, excluding sales taxes. . . . . . .

000

d. Net income (loss) . . . . . . . . . . . . . . . . . .

000

This private fund affiliate meets the exemption criteria stated on
page 2, Part II. B. (Answer to Part II. B has to be ‘Yes’.) DO NOT
complete a.– d.

7 Name of foreign affiliate:

a. Percent ownership at close of
fiscal year 2017 — Enter to the
nearest tenth of one percent . . . . . . . . .

___ ___ ___ . ___ %

$ Bil.

Mil.

Thous.

Dols.

Affiliate ID:

b. Total assets — Balance at
close of fiscal year . . . . . . . . . . . . . . . . .

000

■

c. Annual sales or gross operating
revenues, excluding sales taxes. . . . . . .

000

d. Net income (loss) . . . . . . . . . . . . . . . . . .

000

This private fund affiliate meets the exemption criteria stated on
page 2, Part II. B. (Answer to Part II. B has to be ‘Yes’.) DO NOT
complete a.– d.

8 Name of foreign affiliate:

a. Percent ownership at close of
fiscal year 2017 — Enter to the
nearest tenth of one percent . . . . . . . . .

___ ___ ___ . ___ %

$ Bil.

Mil.

Thous.

Dols.

Affiliate ID:

b. Total assets — Balance at
close of fiscal year . . . . . . . . . . . . . . . . .

000

■

c. Annual sales or gross operating
revenues, excluding sales taxes. . . . . . .

000

d. Net income (loss) . . . . . . . . . . . . . . . . . .

000

This private fund affiliate meets the exemption criteria stated on
page 2, Part II. B. (Answer to Part II. B has to be ‘Yes’.) DO NOT
complete a.– d.

9 Name of foreign affiliate:

a. Percent ownership at close of
fiscal year 2017 — Enter to the
nearest tenth of one percent . . . . . . . . .

___ ___ ___ . ___ %

$ Bil.

Mil.

Thous.

Dols.

Affiliate ID:

b. Total assets — Balance at
close of fiscal year . . . . . . . . . . . . . . . . .

000

■

c. Annual sales or gross operating
revenues, excluding sales taxes. . . . . . .

000

d. Net income (loss) . . . . . . . . . . . . . . . . . .

000

This private fund affiliate meets the exemption criteria stated on
page 2, Part II. B. (Answer to Part II. B has to be ‘Yes’.) DO NOT
complete a.– d.

10 Name of foreign affiliate:

a. Percent ownership at close of
fiscal year 2017 — Enter to the
nearest tenth of one percent . . . . . . . . .

___ ___ ___ . ___ %

$ Bil.

Mil.

Thous.

Dols.

Affiliate ID:

b. Total assets — Balance at
close of fiscal year . . . . . . . . . . . . . . . . .

000

■

c. Annual sales or gross operating
revenues, excluding sales taxes. . . . . . .

000

d. Net income (loss) . . . . . . . . . . . . . . . . . .

000

This private fund affiliate meets the exemption criteria stated on
page 2, Part II. B. (Answer to Part II. B has to be ‘Yes’.) DO NOT
complete a.– d.

Additional foreign affiliates should be reported on additional copied sheets.
Page 4

FORM BE-11 Claim for Not Filing (REV. 01/2018)