2 2017 Commodity Flow Survey Paper Questionnaire

12027017

U.S. DEPARTMENT OF COMMERCE
Economics and Statistics Administration

U.S. CENSUS BUREAU
FORM

2017 Commodity Flow Survey

CFS-1000 (2017)
OMB No. 0607-0932: Approval Expires 12/31/2018

(10-25-2016)

DUE DATE:

Respond via Internet:
https://econhelp.census.gov/cfs
OR
Return via Mail:
U.S. Census Bureau
1201 East 10th Street
Jeffersonville, IN 47132-0001
User ID:

Password:

Need help or have questions?
Call: 1-800-772-7851, option "3"
M-F, 8:30 a.m. - 5:00 p.m. ET
YOUR RESPONSE IS REQUIRED BY LAW. Title 13, United States Code (U.S.C.), Sections 8(b), 131, and 193; and Title 49 U.S.C., Section 6302 authorize this
collection. Title 13 United States Code, Sections 224 and 225 require businesses and other organizations that receive this questionnaire to answer the questions
and return the report to the U.S. Census Bureau. By Section 9 of the same law, YOUR CENSUS REPORT IS CONFIDENTIAL. It may be seen only by persons
sworn to uphold the confidentiality of Census Bureau information and may be used only for statistical purposes. Further, copies retained in respondents’ files are
immune from legal process.
This collection has been approved by the Office of Management and Budget (OMB). The eight-digit OMB approval number is 0607-0932 and appears at the upper
right of this page. Without this approval we could not conduct this survey.
We estimate this survey will take an average of 2.5 hours to complete. More information about this estimate and an address where you may write with comments
is at the end of this questionnaire.

INSTRUCTIONS:
0 1 2 3 4 5 6 7 8 9
• Enter numerical digits as illustrated:
• Use blue or black ballpoint pen. Do not use pencil or felt-tip pen.
• Do not put slashes through 0 or 7.
If you prefer to complete the questionnaire online, visit https://econhelp.census.gov/cfs and click the "Survey Log in" button.
Login with your user id and password above.

Item A

VERIFICATION OF NAME AND SHIPPING ADDRESS

Are the name and shipping address listed in the box below the correct name and shipping address from which this
location ships?

Yes, the name and shipping address are correct. (Proceed to Item B)
No, the name and/or shipping address is incorrect. (Enter any corrections below)
Company Name 1

C

Company Name 2

Address

City

State

ZIP Code

-

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Item B

VERIFICATION OF NAME AND MAILING ADDRESS

Are the name and mailing address displayed in the mailing address label on page 1 correct for the remaining
quarterly 2017 Commodity Flow Survey correspondence to be mailed to?
Yes, the name and mailing address are correct. (Proceed to Item C)
No, the name and/or mailing address is incorrect. (Enter any corrections below)
Company Name 1

C

Company Name 2

Attention

Address

City

State

ZIP Code

Item C

OPERATING STATUS

Which of the following best describes this location’s operating status during the week of

?
If the location was sold or acquired, select the "In operation" box and describe these operations changes in Item J – "Remarks".

In operation
MM-DD-YYYY

Temporarily or seasonally inactive
- Proceed to Item G on page 12

Ceased operation - Enter date ceased operation

➤

–

–

- Proceed to Item G on page 12

Item D

TOTAL NUMBER AND VALUE OF OUTBOUND SHIPMENTS

For this survey, it is important to obtain information about the outbound shipments made from this location.
An outbound shipment in this survey is defined as a movement of commodities from the location specified in Item A to
another single location. For shipments traveling to multiple locations, report one shipment for each location.
• Report all outbound shipments originating from the shipping address specified in Item A. Include shipments of all
sizes, by any mode of transportation, shipments sent by parcel, and customer pickups.
• If shipment information is stored in separate files such as by day, by mode of transportation, etc., please gather those
files together before proceeding.
• Estimates are acceptable
Total number of outbound shipments
1. What was the total number of all outbound shipments for this
location the week of

?. . . . . . . . . . . . .
2. What was the total value of shipments for the week listed above, excluding freight charges and excise taxes?

$
3. Did you enter more than 40 shipments in question 1 above?
Yes – Proceed to Item E on page 3
No – PROCEED TO ITEM F AND REPORT ALL OUTBOUND SHIPMENTS ON PAGE 4
Form CFS-1000 (2017)

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Item E

SAMPLING INSTRUCTIONS

In order to avoid asking you for information regarding all of your shipments, we will only ask about a sample of them.
This section will help you identify your sample of shipments that should be reported in Item F.
Using the table below, mark the row that includes the total number of outbound shipments reported in Item D1,
and the corresponding "report every" number.
Number of outbound
shipments reported in Line 1

Report every...

41 - 80

Report every 2nd outbound shipment

81 - 120

Report every 3rd outbound shipment

121 - 160

Report every 4th outbound shipment

161 - 200

Report every 5th outbound shipment

201 - 240

Report every 6th outbound shipment

241 - 280

Report every 7th outbound shipment

281 - 320

Report every 8th outbound shipment

Mark
(X) one

321 - 360

Report every 9th outbound shipment

361 - 400

Report every 10th outbound shipment

401 - 600

Report every 15th outbound shipment

601 - 1200

Report every 20th outbound shipment

1201 - 1800

Report every 30th outbound shipment

1801 - 2400

Report every 40th outbound shipment

2401 - 3000

Report every 50th outbound shipment

3001 - 4800

Report every 60th outbound shipment

4801 - 6400

Report every 80th outbound shipment

6401 - 8000

Report every 100th outbound shipment

8001 - 12000

Report every 150th outbound shipment

12001 - 16000

Report every 200th outbound shipment

More than 16000

Go to https://econhelp.census.gov/cfs
and select "Survey Log in"

Example:
If this location reported 253 shipments in Item D1, it would correspond to the range of 241-280 and every 7th outbound
shipment record would be selected.
This means:
1. The location would count 7 records, starting with the first shipment record of the week that was identified in Item D1,
select that record and report it in Item F.
2. The location would then count another 7 records again from the shipment selected in step 1 and record
that shipment in Item F.
3. The location would repeat this process until it had gone through the full set of shipment records for the week
identified in Item D1.
4. The location would report 36 shipments in Item F. Item F contains 80 lines, so the location would leave lines
37-80 blank.
For further information, refer to the Instruction Guide or visit the business help site at
https://bhs.econ.census.gov/bhs/cfs/form.html

Form CFS-1000 (2017)

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If you prefer to complete the questionnaire online, please go to https://econhelp.census.gov/cfs

Item F

SHIPMENT CHARACTERISTICS

Net
Shipment
Weight
in pounds.
Estimates
acceptable.
(E)

(F)

(G)

SCTG
commodity
code from
accompanying
booklet

1

Commodity Description

1

(D)

Ex.1 123-5

4

26

224,235

4,840

34520

Mechanical machinery

Y

Ex.2

4

26

1,375

50,125

20222

Sulfuric acid

N

(A)

(B)

402H

(H)

Is item in
col (G) a
hazardous
material?
Enter "UN"
or "NA"1
number
(I)

Continue with
column (J) on page 5

(C)

Shipment value
(excluding
freight charges
and excise taxes)
in whole dollars.
Estimates
acceptable.

Is item in col. (G)
Temperature 1, 2
controlled? (Y/N)

Shipment
Date

Day

Your
Shipment
ID
Number

For shipments consisting of more than one commodity, report the code
and description of the commodity that contributed the greatest weight
of the shipment in columns (F) through (I)

Month

Line No.

NOTE: Each line runs across pages 4 and 5. After entering column (I) data on page 4
for any line, continue with column (J) on page 5 for the same line.

➜
1830

➜

1

➜

2

➜

3

➜

4

➜

5

➜

6

➜

7

➜

8

➜

9

➜

10

➜

11

➜

12

➜

13

➜

14

➜

15

➜

16

➜

17

➜

18

➜

19

➜

20

➜

1

2

For shipments consisting of more than one commodity, report the code and description of the commodity that contributed the
greatest weight of the shipment in columns (F) through (I)
Temperature-Controlled (Column H) - A temperature-controlled shipment is defined as a shipment that needs to be, and is transported
in a vehicle, container, or special packaging that regulates, or maintains the required temperature range (e.g. warm, cold, frozen) of the
shipment during all phases of transportation.

Form CFS-1000 (2017)

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If you prefer to complete the questionnaire online, please go to https://econhelp.census.gov/cfs

Mode(s) of
transport to
U.S. destination.

(J)
City

State

ZIP Code

City

Country

(N)

Beijing

China

6

90040

24

Y

Newark

NJ

07105

4

N

Mode of transport codes for columns (K) and (N):

Form CFS-1000 (2017)

7
8
9
0

-

(M)

(L)

CA

4 - Railroad
5 - Inland water
6 - Deep sea

Note: In column (J) enter the U.S. port,
airport, or border crossing of exit.

(K)

Los Angeles

1 - Parcel delivery, courier,
or U.S. Parcel Post
2 - Company-owned truck
3 - For-hire truck

Export mode

Enter all that
apply in
order used.
Use codes
at bottom.

*For customer pick-ups, see below

Foreign Destination
(for export shipments only)
Export? (Y/N)

U.S. Destination or U.S. Exit Port
(Complete for all shipments.)

Pipeline
Air
Other mode
Unknown

*Note: For customer pick-ups only, enter the
customer’s address. If unknown, enter this
location’s shipping address.

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If you prefer to complete the questionnaire online, please go to https://econhelp.census.gov/cfs

Item F

SHIPMENT CHARACTERISTICS - Continued

(B)

Net
Shipment
Weight
in pounds.
Estimates
acceptable.

(D)

(E)

SCTG
commodity
code from
accompanying
booklet
(F)

1

Commodity Description

1

(G)

(H)

Is item in
col (G) a
hazardous
material?
Enter "UN"
or "NA"1
number
(I)

Continue with
column (J) on page 7

(C)

Shipment value
(excluding
freight charges
and excise taxes)
in whole dollars.
Estimates
acceptable.

For shipments consisting of more than one commodity, report the code
and description of the commodity that contributed the greatest weight
of the shipment in columns (F) through (I)

Is item in col. (G)
Temperature 1, 2
controlled? (Y/N)

Shipment
Date

Day

(A)

Your
Shipment
ID
Number

Month

Line No.

NOTE: Each line runs across pages 6 and 7. After entering column (I) data on page 6
for any line, continue with column (J) on page 7 for the same line.

21

➜

22

➜

23

➜

24

➜

25

➜

26

➜

27

➜

28

➜

29

➜

30

➜

31

➜

32

➜

33

➜

34

➜

35

➜

36

➜

37

➜

38

➜

39

➜

40

➜

1

2

For shipments consisting of more than one commodity, report the code and description of the commodity that contributed the
greatest weight of the shipment in columns (F) through (I)
Temperature-Controlled (Column H) - A temperature-controlled shipment is defined as a shipment that needs to be, and is transported
in a vehicle, container, or special packaging that regulates, or maintains the required temperature range (e.g. warm, cold, frozen) of the
shipment during all phases of transportation.

Form CFS-1000 (2017)

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12027074

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If you prefer to complete the questionnaire online, please go to https://econhelp.census.gov/cfs

Mode(s) of
transport to
U.S. destination.

(J)
City

State

ZIP Code

(K)

Mode of transport codes for columns (K) and (N):
1 - Parcel delivery, courier,
or U.S. Parcel Post
2 - Company-owned truck
3 - For-hire truck

Form CFS-1000 (2017)

4 - Railroad
5 - Inland water
6 - Deep sea

7
8
9
0

-

Pipeline
Air
Other mode
Unknown

(L)

Export mode

Enter all that
apply in
order used.
Use codes
at bottom.

*For customer pick-ups, see below

Foreign Destination
(for export shipments only)
Export? (Y/N)

U.S. Destination or U.S. Exit Port
(Complete for all shipments.)

Note: In column (J) enter the U.S. port,
airport, or border crossing of exit.
(M)
City

Country

(N)

*Note: For customer pick-ups only, enter the
customer’s address. If unknown, enter this
location’s shipping address.

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If you prefer to complete the questionnaire online, please go to https://econhelp.census.gov/cfs

Item F

SHIPMENT CHARACTERISTICS - Continued

(B)

Net
Shipment
Weight
in pounds.
Estimates
acceptable.

(D)

(E)

SCTG
commodity
code from
accompanying
booklet
(F)

1

Commodity Description

1

(G)

(H)

Is item in
col (G) a
hazardous
material?
Enter "UN"
or "NA"1
number
(I)

Continue with
column (J) on page 9

(C)

Shipment value
(excluding
freight charges
and excise taxes)
in whole dollars.
Estimates
acceptable.

For shipments consisting of more than one commodity, report the code
and description of the commodity that contributed the greatest weight
of the shipment in columns (F) through (I)

Is item in col. (G)
Temperature 1, 2
controlled? (Y/N)

Shipment
Date

Day

(A)

Your
Shipment
ID
Number

Month

Line No.

NOTE: Each line runs across pages 8 and 9. After entering column (I) data on page 8
for any line, continue with column (J) on page 9 for the same line.

41

➜

42

➜

43

➜

44

➜

45

➜

46

➜

47

➜

48

➜

49

➜

50

➜

51

➜

52

➜

53

➜

54

➜

55

➜

56

➜

57

➜

58

➜

59

➜

60

➜

1

2

For shipments consisting of more than one commodity, report the code and description of the commodity that contributed the
greatest weight of the shipment in columns (F) through (I)
Temperature-Controlled (Column H) - A temperature-controlled shipment is defined as a shipment that needs to be, and is transported
in a vehicle, container, or special packaging that regulates, or maintains the required temperature range (e.g. warm, cold, frozen) of the
shipment during all phases of transportation.

Form CFS-1000 (2017)

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12027090

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If you prefer to complete the questionnaire online, please go to https://econhelp.census.gov/cfs

Mode(s) of
transport to
U.S. destination.

(J)
City

State

ZIP Code

(K)

Mode of transport codes for columns (K) and (N):
1 - Parcel delivery, courier,
or U.S. Parcel Post
2 - Company-owned truck
3 - For-hire truck

Form CFS-1000 (2017)

4 - Railroad
5 - Inland water
6 - Deep sea

7
8
9
0

-

Pipeline
Air
Other mode
Unknown

(L)

Export mode

Enter all that
apply in
order used.
Use codes
at bottom.

*For customer pick-ups, see below

Foreign Destination
(for export shipments only)
Export? (Y/N)

U.S. Destination or U.S. Exit Port
(Complete for all shipments.)

Note: In column (J) enter the U.S. port,
airport, or border crossing of exit.
(M)
City

Country

(N)

*Note: For customer pick-ups only, enter the
customer’s address. If unknown, enter this
location’s shipping address.

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12027108

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If you prefer to complete the questionnaire online, please go to https://econhelp.census.gov/cfs

Item F

SHIPMENT CHARACTERISTICS - Continued

(B)

Net
Shipment
Weight
in pounds.
Estimates
acceptable.

(D)

(E)

SCTG
commodity
code from
accompanying
booklet
(F)

1

Commodity Description

1

(G)

(H)

Is item in
col (G) a
hazardous
material?
Enter "UN"
or "NA"1
number
(I)

Continue with
column (J) on page 11

(C)

Shipment value
(excluding
freight charges
and excise taxes)
in whole dollars.
Estimates
acceptable.

For shipments consisting of more than one commodity, report the code
and description of the commodity that contributed the greatest weight
of the shipment in columns (F) through (I)

Is item in col. (G)
Temperature 1, 2
controlled? (Y/N)

Shipment
Date

Day

(A)

Your
Shipment
ID
Number

Month

Line No.

NOTE: Each line runs across pages 10 and 11. After entering column (I) data on page 10
for any line, continue with column (J) on page 11 for the same line.

61

➜

62

➜

63

➜

64

➜

65

➜

66

➜

67

➜

68

➜

69

➜

70

➜

71

➜

72

➜

73

➜

74

➜

75

➜

76

➜

77

➜

78

➜

79

➜

80

➜

1

2

For shipments consisting of more than one commodity, report the code and description of the commodity that contributed the
greatest weight of the shipment in columns (F) through (I)
Temperature-Controlled (Column H) - A temperature-controlled shipment is defined as a shipment that needs to be, and is transported
in a vehicle, container, or special packaging that regulates, or maintains the required temperature range (e.g. warm, cold, frozen) of the
shipment during all phases of transportation.

Form CFS-1000 (2017)

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12027116

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If you prefer to complete the questionnaire online, please go to https://econhelp.census.gov/cfs

Mode(s) of
transport to
U.S. destination.

(J)
City

State

ZIP Code

(K)

Mode of transport codes for columns (K) and (N):
1 - Parcel delivery, courier,
or U.S. Parcel Post
2 - Company-owned truck
3 - For-hire truck

Form CFS-1000 (2017)

4 - Railroad
5 - Inland water
6 - Deep sea

7
8
9
0

-

Pipeline
Air
Other mode
Unknown

(L)

Export mode

Enter all that
apply in
order used.
Use codes
at bottom.

*For customer pick-ups, see below

Foreign Destination
(for export shipments only)
Export? (Y/N)

U.S. Destination or U.S. Exit Port
(Complete for all shipments.)

Note: In column (J) enter the U.S. port,
airport, or border crossing of exit.
(M)
City

Country

(N)

*Note: For customer pick-ups only, enter the
customer’s address. If unknown, enter this
location’s shipping address.

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If you prefer to complete the questionnaire online, please go to https://econhelp.census.gov/cfs

Item G

VERIFICATION OF PRIMARY INDUSTRY ACTIVITY

Our records indicate that this shipping location’s primary industry is the following:

Is this the correct primary activity?
Yes - (Proceed to Item H)
No C
Describe your industry:

Item H

TIME TO COMPLETE SURVEY

How long did it take to complete this questionnaire?
Include time to read instructions, to gather information, to enter and verify the data.

Hours

Item I

Minutes

CONTACT INFORMATION REGARDING THIS SURVEY

Name - Please print

Area code

Phone Number

–
Area code

Extension

–
Fax Number

–

Item J

Title - Please print

–

REMARKS: Use this space to clarify your responses, if appropriate.

Please return this questionnaire in the enclosed envelope or send it to:
U.S. CENSUS BUREAU 1201 East 10th Street Jeffersonville IN 47132-0001
THANK YOU FOR COMPLETING THIS SURVEY.
BURDEN ESTIMATE STATEMENT: We estimate this survey will take an average of 2.5 hours to complete, 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: ERD Survey Comments 0607-0932, U.S. Census Bureau, 4600 Silver Hill Road, Room ERD-6H128, Washington, DC
20233. You may e-mail comments to [email protected]. Be sure to use "ERD Survey Comments 0607-0932" as the subject.
Form CFS-1000 (2017)

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