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pdfOMB No. 3117‐0016/USITC No. xx‐x‐xxx; Expiration Date: 6/30/2017
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U.S. PRODUCERS’ QUESTIONNAIRE
INVESTIGATION TITLE
This questionnaire must be received by the Commission by DATE
See last page for filing instructions.
The information called for in this questionnaire is for use by the United States International Trade Commission in
connection with its countervailing duty/antidumping investigation(s) concerning #abbrproduct from #ctrysubs (Inv. No.
701/731‐TA‐xxx (Preliminary/Final)). The information requested in the questionnaire is requested under the authority of
the Tariff Act of 1930, title VII. This report is mandatory and failure to reply as directed can result in a subpoena or other
order to compel the submission of records or information in your firm’s possession (19 U.S.C. § 1333(a)).
Name of firm
Address
City
State
Zip Code
Website
Has your firm produced #abbrproduct (as defined on next page) at any time since January 1, #bopyear?
NO
(Sign the certification below and promptly return only this page of the questionnaire to the Commission)
YES
(Complete all parts of the questionnaire, and return the entire questionnaire to the Commission)
Return questionnaire via the U.S. International Trade Commission Drop Box by clicking on the
following link: https://dropbox.usitc.gov/oinv/. (PIN: XXXX)
CERTIFICATION
I certify that the information herein supplied in response to this questionnaire is complete and correct to the best of my
knowledge and belief and understand that the information submitted is subject to audit and verification by the Commission.
By means of this certification I also grant consent for the Commission, and its employees and contract personnel, to use the
information provided in this questionnaire and throughout this proceeding in any other import‐injury proceedings conducted by
the Commission on the same or similar merchandise.
I, the undersigned, acknowledge that information submitted in response to this request for information and throughout this
investigation or other proceeding may be disclosed to and used:
(i) by the Commission, its employees and Offices, and contract personnel (a) for developing or maintaining the records of this or a
related proceeding, or (b) in internal investigations, audits, reviews, and evaluations relating to the programs, personnel, and
operations of the Commission including under 5 U.S.C. Appendix 3; or
(ii) by U.S. government employees and contract personnel, solely for cybersecurity purposes. I understand that all contract
personnel will sign appropriate nondisclosure agreements
Name of Authorized Official Title of Authorized Official
Date
Phone:
Signature
Fax:
Email address
Business Proprietary
U.S. Producers’ Questionnaire ‐ #ABBRPRODUCT
Page 2
PART I.—GENERAL INFORMATION
Background. This proceeding was instituted in response to a petition filed on DATE, by COMPANY
NAME, CITY, STATE. Countervailing/antidumping duties may be assessed on the subject imports as a
result of these proceedings if the Commission makes an affirmative determination of injury, threat, or
material retardation, and if the U.S. Department of Commerce makes an affirmative determination of
subsidization/dumping. Questionnaires and other information pertinent to this proceeding are available
at LINK.
#abbrproduct covered by these investigations is . . . COMMERCE SCOPE LANGAUGE
Reporting of information.‐‐ If information is not readily available from your records, provide carefully
prepared estimates. If your firm is completing more than one questionnaire (i.e., a producer, importer,
and/or purchaser questionnaire), you need not respond to duplicated questions.
Confidentiality.‐‐The commercial and financial data furnished in response to this questionnaire that
reveal the individual operations of your firm will be treated as confidential by the Commission to the
extent that such data are not otherwise available to the public and will not be disclosed except as may
be required by law (see 19 U.S.C. § 1677f). Such confidential information will not be published in a
manner that will reveal the individual operations of your firm; however, general characterizations of
numerical business proprietary information (such as discussion of trends) will be treated as confidential
business information only at the request of the submitter for good cause shown.
Verification.‐‐The information submitted in this questionnaire is subject to audit and verification by the
Commission. To facilitate possible verification of data, please keep all files, worksheets, and supporting
documents used in the preparation of the questionnaire response. Please also retain a copy of the final
document that you submit.
Release of information.‐‐The information provided by your firm in response to this questionnaire, as
well as any other business proprietary information submitted by your firm to the Commission in
connection with this proceeding, may become subject to, and released under, the administrative
protective order provisions of the Tariff Act of 1930 (19 U.S.C. § 1677f) and section 207.7 of the
Commission’s Rules of Practice and Procedure (19 CFR § 207.7). This means that certain lawyers and
other authorized individuals may temporarily be given access to the information for use in connection
with this proceeding or other import‐injury proceedings conducted by the Commission on the same or
similar merchandise; those individuals would be subject to severe penalties if the information were
divulged to unauthorized individuals. [Delete the following in final phase proceedings] In addition, if
your firm is a U.S. producer, the information you provide on your production and imports of
#abbrproduct and your responses to the questions in Part I of the producer questionnaire will be
provided to the U.S. Department of Commerce, upon its request, for use in connection with (and only in
connection with) its requirement pursuant to section 702(c)(4)/732(c)(4) of the Act (19 U.S.C. §
1671a(c)(4)/1673a(c)(4)) to make a determination concerning the extent of industry support for the
petition requesting this proceeding. Any information provided to Commerce will be transmitted under
the confidentiality and release guidelines set forth above. Your response to these questions constitutes
your consent that such information be provided to Commerce under the conditions described above.
Business Proprietary
U.S. Producers’ Questionnaire ‐ #ABBRPRODUCT
I‐1a.
Page 3
OMB statistics.‐‐Please report below the actual number of hours required and the cost to your
firm of completing this questionnaire.
Hours
Dollars
The questions in this questionnaire have been reviewed with market participants to ensure that
issues of concern are adequately addressed and that data requests are sufficient, meaningful,
and as limited as possible. Public reporting burden for this questionnaire is estimated to average
50 hours per response, including the time for reviewing instructions, gathering data, and
completing and reviewing the questionnaire.
We welcome comments regarding the accuracy of this burden estimate, suggestions for
reducing the burden, and any suggestions for improving this questionnaire. Please attach such
comments to your response or send to the Office of Investigations, USITC, 500 E St. SW,
Washington, DC 20436.
I‐1b. TAA information release.‐‐In the event that the U.S. International Trade Commission (USITC)
makes an affirmative final determination in this proceeding, do you consent to the USITC's
release of your contact information (company name, address, contact person, telephone
number, email address) appearing on the front page of this questionnaire to the Departments of
Commerce, Labor, and Agriculture, as applicable, so that your firm and its workers can be made
eligible for benefits under the Trade Adjustment Assistance program?
No
Yes
I‐2.
Establishments covered.‐‐Provide the city, state, zip code, and brief description of each
establishment covered by this questionnaire. If your firm is publicly traded, please specify the
stock exchange and trading symbol in the footnote to the table. Firms operating more than one
establishment should combine the data for all establishments into a single report.
“Establishment”‐‐Each facility of a firm involved in the production of #abbrproduct, including
auxiliary facilities operated in conjunction with (whether or not physically separate from) such
facilities.
Establishments
City, State
Zip (5 digit)
Description
covered1
1
1
2
3
4
5
6
Additional discussion on establishments consolidated in this questionnaire: .
Business Proprietary
U.S. Producers’ Questionnaire ‐ #ABBRPRODUCT
I‐3.
Petition support.‐‐Does your firm support or oppose the petition?
Country
I‐4.
I‐5.
Page 4
Support
Oppose
Take no position
#ctrysubA
#ctrysubB
#ctrysubC
#ctrysubD
Ownership.‐‐Is your firm owned, in whole or in part, by any other firm?
No
Yes‐‐List the following information.
Firm name
Address
Extent of
ownership
(percent)
Related importers/exporters.‐‐Does your firm have any related firms, either domestic or
foreign, that are engaged in importing #abbrproduct from #ctrysubs into the United States or
that are engaged in exporting #abbrproduct from #ctrysubs to the United States?
No
Yes‐‐List the following information.
Firm name
Address
Affiliation
I‐6.
Related producers.‐‐Does your firm have any related firms, either domestic or foreign, that are
engaged in the production of #abbrproduct?
No
Yes‐‐List the following information.
Firm name
Address
Affiliation
Business Proprietary
U.S. Producers’ Questionnaire ‐ #ABBRPRODUCT
Page 5
PART II.‐‐TRADE AND RELATED INFORMATION
Further information on this part of the questionnaire can be obtained from INVESTIGATOR (202‐xxx‐
xxxx, [email protected]). Supply all data requested on a calendar‐year basis.
II‐1. Contact information.‐‐ Please identify the responsible individual and the manner by which
Commission staff may contact that individual regarding the confidential information submitted
in part II.
Name
Title
Email
Telephone
Fax
II‐2. Changes in operations.‐‐Please indicate whether your firm has experienced any of the following
changes in relation to the production of #abbrproduct since January 1, #bopyear.
(check as many as appropriate)
(please describe)
plant openings
plant closings
relocations
expansions
acquisitions
consolidations
prolonged shutdowns or
production curtailments
revised labor agreements
other (e.g., technology)
Business Proprietary
U.S. Producers’ Questionnaire ‐ #ABBRPRODUCT
Page 6
II‐3a. Production using same machinery.‐‐ Please report your firm’s production of products made on
the same equipment and machinery used to produce #abbrproduct, and the combined
production capacity on this shared equipment and machinery in the periods indicated.
“Overall production capacity” or “capacity” – The level of production that your
establishment(s) could reasonably have expected to attain during the specified periods. Assume
normal operating conditions (i.e., using equipment and machinery in place and ready to
operate; normal operating levels (hours per week/weeks per year) and time for downtime,
maintenance, repair, and cleanup).
“Production” – All production in your U.S. establishment(s), including production consumed
internally within your firm and production for another firm under a toll agreement.
Quantity (in #units)
Calendar years
Item
Overall production capacity
Production of:
#abbrproduct1
2
Other products
Total
1
2
2012
2013
January‐#intmonth
2014
2014
2015
0
0
0
0
0
0
0
0
0
0
Data entered for production of #abbrproduct will populate here once reported in question II‐7.
Please identify these products: .
II‐3b. Operating parameters.‐‐The production capacity reported in II‐3a is based on operating hours
per week, weeks per year.
II‐3c. Capacity calculation.‐‐Please describe the methodology used to calculate overall production
capacity reported in II‐3a, and explain any changes in reported capacity.
II‐3d. Production constraints.‐‐Please describe the constraint(s) that set the limit(s) on your firm’s
production capacity.
Business Proprietary
U.S. Producers’ Questionnaire ‐ #ABBRPRODUCT
Page 7
II‐3e. Product shifting.—
(i)
Is your firm able to switch production (capacity) between #abbrproduct and other products
using the same equipment and/or labor?
No
Yes‐‐ (i.e., have produced other products or are able to produce other
products). Please identify other actual or potential products: .
(ii)
Please describe the factors that affect your firm’s ability to shift production capacity
between products (e.g., time, cost, relative price change, etc.), and the degree to which
these factors enhance or constrain such shifts.
Business Proprietary
U.S. Producers’ Questionnaire ‐ #ABBRPRODUCT
II‐4.
Page 8
Tolling.‐‐Since January 1, #bopyear, has your firm been involved in a toll agreement regarding
the production of #abbrproduct?
“Toll agreement”‐‐Agreement between two firms whereby the first firm furnishes the raw
materials and the second firm uses the raw materials to produce a product that it then returns
to the first firm with a charge for processing costs, overhead, etc.
No
Yes‐‐Please describe the toll arrangement(s) and name the firm(s) involved
II‐5.
Foreign trade zones.‐‐
(a)
Firm's FTZ operations.‐‐Does your firm produce #abbrproduct in and/or admit
#abbrproduct into a foreign trade zone (FTZ)?
“Foreign trade zone” is a designated location in the United States where firms utilize
special procedures that allow delayed or reduced customs duty payments on foreign
merchandise. A foreign trade zone must be designed as such pursuant to the rules and
procedures set forth in the Foreign‐Trade Zones Act.
No
Yes‐‐Describe the nature of your firms operations in FTZs and
identify the specific FTZ site(s).
(b)
Other firms' FTZ operations.‐‐To your knowledge, do any firms in the United States
import #abbrproduct into a foreign trade zone (FTZ) for use in distribution of
#abbrproduct and/or the production of downstream articles?
No/Don’t know
Yes‐‐Identify the firms and the FTZs.
II‐6.
Importer.‐‐Since January 1, #bopyear, has your firm imported #abbrproduct?
“Importer” – The person or firm primarily liable for the payment of any duties on the
merchandise, or an authorized agent acting on his behalf. The importer may be the consignee,
or the importer of record.
No
Yes‐‐COMPLETE AND RETURN A U.S. IMPORTERS’ QUESTIONNAIRE
Business Proprietary
U.S. Producers’ Questionnaire ‐ #ABBRPRODUCT
II‐7.
Page 9
Production, shipment and inventory data.‐‐Report your firm’s production capacity, production,
shipments, and inventories related to the production of #abbrproduct in its U.S.
establishment(s) during the specified periods.
“Average production capacity” or “capacity” – The level of production that your
establishment(s) could reasonably have expected to attain during the specified periods. Assume
normal operating conditions (i.e., using equipment and machinery in place and ready to
operate; normal operating levels (hours per week/weeks per year) and time for downtime,
maintenance, repair, and cleanup; and a typical or representative product mix).
“Production” – All production in your U.S. establishment(s), including production consumed
internally within your firm and production for another firm under a toll agreement.
“U.S. commercial shipments” –Shipments made within the United States as a result of an arm’s
length commercial transaction in the ordinary course of business. Report net values (i.e., gross
sales values less all discounts, allowances, rebates, prepaid freight, and the value of returned
goods) in U.S. dollars, f.o.b. your point of shipment.
“Internal consumption” – Product consumed internally by your firm.
“Transfers to related firms” –Shipments made to related domestic firms. Such transactions are
valued at fair market value.
“Related firm” –A firm that your firm solely or jointly owns, manages, or otherwise controls.
Such transactions are valued at fair market value.
“Export shipments” –Shipments to destinations outside the United States, including shipments
to related firms.
“Inventories”— Finished goods inventory, not raw materials or work‐in‐progress.
Note: As requested in Part I of this questionnaire, please keep all supporting documents/records
used in the preparation of the trade data, as Commission staff may contact your firm regarding
questions on the trade data. The Commission may also request that your company submit copies
of the supporting documents/records (such as production and sales schedules, inventory records,
etc.) used to compile these data.
Business Proprietary
U.S. Producers’ Questionnaire ‐ #ABBRPRODUCT
II‐7.
Page 10
Production, shipment and inventory data.‐‐
Quantity (in #units) and value (in $1,000)
Calendar years
Item
2012
2013
January‐#intmonth
2014
1
Average production capacity (quantity) (A)
2014
Beginning‐of‐period inventories (quantity)
(B)
Production (quantity) (C)
U.S. shipments:
Commercial shipments:
Quantity (D)
Value (E)
Internal consumption:
Quantity (F)
2
Value (G)
Transfers to related firms:
Quantity (H)
2
Value (I)
2015
3
Export shipments:
Quantity (J)
Value (K)
4
End‐of‐period inventories (quantity) (L)
1
The production capacity reported is based on operating
hours per week,
weeks per year. Please describe the
methodology used to calculate production capacity, and explain any changes in reported capacity .
2
Internal consumption and transfers to related firms must be valued at fair market value. In the event that your firm
uses a different basis for valuing these transactions, please specify that basis (e.g., cost, cost plus, etc.) and provide value
data using that basis for each of the periods noted above: .
3
Identify your firm’s principal export markets: .
RECONCILIATION OF SHIPMENTS, PRODUCTION, AND INVENTORY.‐‐Generally, the data reported for the end‐of‐
period inventories (i.e., line L) should be equal to the beginning‐of‐period inventories (i.e., line B), plus
production (i.e., line C), less total shipments (i.e., lines D, F, H, and J). Please ensure that any differences are not
due to data entry errors in completing this form, but rather actually reflect your firm’s records; and also provide
any likely explanations for any differences (e.g., theft, loss, damage, record systems issues, etc.) if they exist.
Calendar years
Reconciliation
B + C – D – F – H – J – L = should equal
zero ("0") or provide an explanation.1
1
2012
2013
0
January‐#intmonth
2014
0
2014
0
2015
0
Explanation if the calculated fields above are returning values other than zero (i.e., “0”) but are nonetheless accurate: .
0
Business Proprietary
U.S. Producers’ Questionnaire ‐ #ABBRPRODUCT
II‐8.
Page 11
Channels of distribution.‐‐ Report your firm’s commercial U.S. shipments by channel of
distribution.
Quantity (in #units) and value (in $1,000)
Calendar years
Item
Channels of distribution:
Commercial U.S. shipments:
To distributors (quantity) (M)
To end users (quantity) (N)
2012
2013
January‐#intmonth
2014
2014
2015
Calendar years
Reconciliation
M + N – D = zero ("0"), if not revise.
2012
2013
0
January‐#intmonth
2014
0
2014
0
0
2015
0
Business Proprietary
U.S. Producers’ Questionnaire ‐ #ABBRPRODUCT
II‐9.
Page 12
Employment data.‐‐Report your firm’s employment‐related data related to the production of
#abbrproduct and provide any explanation for any trends in these data.
“Production Related Workers” (PRWs) includes working supervisors and all nonsupervisory
workers (including group leaders and trainees) engaged in fabricating, processing, assembling,
inspecting, receiving, storage, handling, packing, warehousing, shipping, trucking, hauling,
maintenance, repair, janitorial and guard services, product development, auxiliary production
for plant’s own use (e.g., power plant), recordkeeping, and other services closely associated with
the above production operations.
Average number employed may be computed by adding the number of employees, both full
time and part time, for the 12 pay periods ending closest to the 15th of the month and divide
that total by 12. For the January to #intmonth periods, calculate similarly and divide by 3/6/9.
“Hours worked” includes time paid for sick leave, holidays, and vacation time. Include overtime
hours actually worked; do not convert overtime pay to its equivalent in straight time hours.
“Wages paid” –Total wages paid before deductions of any kind (e.g., withholding taxes, old‐age
and unemployment insurance, group insurance, union dues, bonds, etc.). Include wages paid
directly by your firm for overtime, holidays, vacations, and sick leave.
Calendar years
Item
2012
2013
January‐#intmonth
2014
2014
2015
Average number of PRWs
(number)
Hours worked by PRWs
(1,000 hours)
Wages paid to PRWs ($1,000)
Explanation of trends:
II‐10. Related firms.‐‐If your firm reported transfers to related firms in question II‐8, please indicate
the nature of the relationship between your firm and the related firms (e.g., joint venture,
wholly owned subsidiary), whether the transfers were priced at market value or by a non‐
market formula, whether your firm retained marketing rights to all transfers, and whether the
related firms also processed inputs from sources other than your firm.
Business Proprietary
U.S. Producers’ Questionnaire ‐ #ABBRPRODUCT
Page 13
II‐11. Purchases.‐‐Other than direct imports, has your firm otherwise purchased abbrproduct since
January 1, #bopyear?
“Purchase” – A transaction to buy product from a U.S. corporate entity such as another U.S.
producer, a U.S. distributor, or a U.S. firm that has directly imported the product.
“Direct import” –A transaction to buy from a foreign producer where your firm is the importer
of record or consignee.
No
Yes‐‐Report such purchases below and explain the reasons for your firms'
purchases:
(Quantity in #units)
Calendar years
Item
Purchases from U.S.
importers1 of #abbrproduct
from—
#ctrysubA:
2012
2013
January‐#intmonth
2014
2014
2015
#ctrysubB:
#ctrysubC:
Purchases from domestic
producers2
Purchases from other
sources2
1
Please list the name of the importer(s) from which your firm purchased this product. If your firm’s import
suppliers differ by source, please identify the source for each listed supplier: .
2
Please list the name of the producer(s) or U.S. distributor(s) from which your firm purchased this product:
.
II‐12. Other explanations.‐‐If your firm would like to further explain a response to a question in Part II
that did not provide a narrative box, please note the question number and the explanation in
the space provided below. Please also use this space to highlight any issues your firm had in
providing the data in this section, including but not limited to technical issues with the MS Word
questionnaire.
Business Proprietary
U.S. Producers’ Questionnaire ‐ #ABBRPRODUCT
Page 14
PART III.‐‐FINANCIAL INFORMATION
Address questions on this part of the questionnaire to AUDITOR (202‐xxx‐xxxx, [email protected]).
III‐1. Contact information.‐‐ Please identify the responsible individual and the manner by which
Commission staff may contact that individual regarding the confidential information submitted
in part III.
Name
Title
Email
Telephone
Fax
III‐2. Accounting system.‐‐Briefly describe your firm’s financial accounting system.
A.
When does your firm’s fiscal year end (month and day)?
If your firm’s fiscal year changed during the data‐collection period, explain
below:
B.1. Describe the lowest level of operations (e.g., plant, division, company‐wide) for
which financial statements are prepared that include #abbrproduct:
2. Does your firm prepare profit/loss statements for #abbrproduct:
Yes
No
3. How often did your firm (or parent company) prepare financial statements
(including annual reports, 10Ks)? Please check relevant items below.
Audited, unaudited, annual reports, 10Ks, 10 Qs,
Monthly, quarterly, semi‐annually, annually
4. Accounting basis: GAAP, cash, tax, or other comprehensive
basis of accounting (specify)
Note: As requested in Part I of this questionnaire, please keep all supporting documents/records
used in the preparation of the financial data, as Commission staff may contact your firm
regarding questions on the financial data. The Commission may also request that your company
submit copies of the supporting documents/records (financial statements, including internal
profit‐and‐loss statements for the division or product group that includes #abbrproduct, as well as
specific statements and worksheets) used to compile these data.
III‐3.
Cost accounting system.‐‐Briefly describe your firm’s cost accounting system (e.g., standard
cost, job order cost, etc.).
III‐4.
Allocation basis.‐‐Briefly describe your firm’s allocation basis, if any, for COGS, SG&A, and
interest expense and other income and expenses.
Business Proprietary
U.S. Producers’ Questionnaire ‐ #ABBRPRODUCT
III‐5.
Other products.‐‐Please list the products your firm produced in the facilities in which your firm
produced #abbrproduct, and provide the share of net sales accounted for by these products in
your firm’s most recent fiscal year.
Products
III‐6.
Page 15
Share of sales
#abbrproduct
%
%
%
%
%
Does your firm purchase inputs (raw materials, labor, energy, or any services) used in the
production of #abbrproduct from any related suppliers (e.g., inclusive of transactions between
related firms, divisions and/or other components within the same company)?
Yes‐‐Continue to question III‐7.
III‐7.
No‐‐Continue to question III‐9a.
Inputs from related suppliers.‐‐Please identify the inputs used in the production of
#abbrproduct that your firm purchases from related suppliers and that are reflected in table III‐
9a. For “Share of total COGS” please report this information by relevant input on the basis of
your most recently completed fiscal year. For “Input valuation” please describe the basis, as
recorded in your company’s own accounting system, of the purchase cost from the related
supplier; e.g., the related supplier’s actual cost, cost plus, negotiated transfer price to
approximate fair market value.
Input
Related supplier
Share of total COGS
Input valuation as recorded in the firm’s accounting books and records
Business Proprietary
U.S. Producers’ Questionnaire ‐ #ABBRPRODUCT
III‐8.
Page 16
Inputs purchased from related suppliers.‐‐Please confirm that the inputs purchased from
related suppliers, as identified in III‐7, were reported in III‐9a (financial results on #abbrproduct)
in a manner consistent with your firm’s accounting books and records.
Yes
No‐‐In the space below, please report the valuation basis of inputs purchased from related
suppliers as reported in table III‐9a.
Business Proprietary
U.S. Producers’ Questionnaire ‐ #ABBRPRODUCT
Page 17
III‐9a. Operations on #abbrproduct.‐‐Report the revenue and related cost information requested
below on the #abbrproduct operations of your firm’s U.S. establishment(s).1 Do not report
resales of products. Note that internal consumption and transfers to related firms must be
valued at fair market value. Input purchases from related suppliers should be consistent with
and based on information in the firm’s accounting books and records. Provide data for your
firm’s three most recently completed fiscal years, and for the specified interim periods. If your
firm was involved in tolling operations (either as the toller or as the tollee), please contact
AUDITOR at (202) XXX‐XXXX before completing this section of the questionnaire.
Quantity (in #units) and value (in $1,000)
Fiscal years ended‐‐
Item
Net sales quantities:2
Commercial sales (“CS”)
2012
2013
January‐#intmonth
2014
2014
2015
Internal consumption (“IC”)
Transfers to related firms (“Transfers”)
0
0
0
0
0
Internal consumption
Transfers to related firms
0
0
0
0
0
Direct labor
Other factory costs
Total COGS
0
0
0
0
0
Gross profit or (loss)
0
0
0
0
0
Total net sales quantities
Net sales values:2
Commercial sales
Total net sales values
Cost of goods sold (COGS):3
Raw materials
Selling, general, and administrative (SG&A)
expenses:
Selling expenses
General and administrative expenses
0
0
0
0
0
0
0
0
0
0
Total SG&A expenses
Operating income (loss)
Other expenses and income:
Interest expense
All other expense items
All other income items
Net income or (loss) before income taxes
Depreciation/amortization included above
0
0
0
0
0
1 Include only sales (whether domestic or export) and costs related to your U.S. manufacturing operations.
2
Less discounts, returns, allowances, and prepaid freight. The quantities and values should approximate the corresponding
shipment quantities and values reported in Part II of this questionnaire.
3 COGS (whether for domestic or export sales) should include costs associated with CS, IC, and Transfers.
Note ‐‐ The table above contains calculations that will appear when you have entered data in the MS
Word form fields.
Business Proprietary
U.S. Producers’ Questionnaire ‐ #ABBRPRODUCT
Page 18
III‐9b. Financial data reconciliation.‐‐The calculable line items from question III‐9a (i.e., total net sales
quantities and values, total COGS, gross profit (or loss), total SG&A, and net income (or loss))
have been calculated from the data submitted in the other line items. Do the calculated fields
return the correct data according to your firm's financial records ignoring non‐material
differences that may arise due to rounding?
Yes No‐‐If the calculated fields do not show the correct data, please double check the
feeder data for data entry errors and revise.
Also, check signs accorded to the post operating income line items; the two
expense line items should report positive numbers (i.e., expenses are
positive and incomes or reversals are negative‐‐instances of the latter
should be rare in those lines) while the income line item also in most
instances should have its value be a positive number (i.e., income is positive,
expenses or reversals are negative).
If after reviewing and potentially revising the feeder data your firm has
provided, the differences between your records and the calculated fields
persist please identify and discuss the differences in the space below.
III‐10. Nonrecurring items (charges and gains) included in the subject product financial results.‐‐For
each annual and interim period for which financial results are reported in question III‐9a, please
specify all material (significant) nonrecurring items (charges and gains) in the schedule below,
the specific table III‐9a line item where the nonrecurring items are included, a brief description
of the relevant nonrecurring items, and the associated values (in $1,000), as reflected in table
III‐9a; i.e., if an aggregate nonrecurring item has been allocated to table III‐9a, only the allocated
value amount included in table III‐9a should be reported in the schedule below. Note: The
Commission’s objective here is to gather information only on material (significant) nonrecurring
items which impacted the reported financial results of the subject product in table III‐9a.
Fiscal years ended‐‐
2012
2013
January‐#intmonth
2014
2014
2015
Nonrecurring item: In this column please provide a brief
Nonrecurring item: In these columns please report the amount of the relevant
description of each nonrecurring item and indicate the
nonrecurring item reported in table III‐9a.
specific line item in table III‐9a where the nonrecurring item is
classified.
Value ($1,000)
1. , classified as
2. , classified as
3. , classified as
4. , classified as
5. , classified as
6. , classified as
7. , classified as
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III‐11. Classification of identified nonrecurring items (charges and gains) in the accounting books and
records of the company.‐‐If non‐recurring items were reported in table III‐10 above, please
identify where your company recorded these items in your accounting books and records in the
normal course of business; i.e., III‐10 information designates where these items are reported in
table III‐9a.
III‐12. Asset values.‐‐Report the total assets (i.e., both current and long‐term assets) associated with
the production, warehousing, and sale of #abbrproduct. If your firm does not maintain some or
all of the specific asset information necessary to calculate total assets for #abbrproduct in the
normal course of business, please estimate this information based upon a method (such as
production, sales, or costs) that is consistent with your firm’s cost allocations in the previous
question. Provide data as of the end of your firm’s three most recently completed fiscal years.
Note: Total assets should reflect net assets after any accumulated depreciation and allowances
deducted.
Total assets should be allocated to the subject products if these assets are also related to other
products. Please provide a brief explanation if there are any substantial changes in total asset
value during the period; e.g., due to asset write‐offs, revaluation, and major purchases.
Value (in $1,000)
Fiscal years ended‐‐
Item
2012
2013
1
Total assets (net)
1
III‐13.
2014
Describe
Capital expenditures and research and development expenses.‐‐Report your firm’s capital
expenditures and research and development expenses for #abbrproduct. Provide data for your
firm’s three most recently completed fiscal years, and for the specified interim periods.
Value (in $1,000)
Fiscal years ended‐‐
Item
2012
2013
January‐#intmonth
2014
Capital expenditures
Research and development expenses
1
2014
2015
Please indicate the nature, focus, and significance of your firm’s capital expenditures on the subject product.
Business Proprietary
U.S. Producers’ Questionnaire ‐ #ABBRPRODUCT
Page 20
III‐14. Data consistency and reconciliation.‐‐Please indicate whether your firm’s financial data for
questions III‐9a, 12, and 13a are based on a calendar year or on your firm’s fiscal year:
Calendar year
Fiscal year Specify fiscal year
Please note the quantities and values reported in question III‐9a should reconcile with the data
reported in question II‐7 (including export shipments) as long as they are reported on the same
calendar year basis.
Do these data in question III‐9a reconcile with data in question II‐7?
Yes
No
If no, please explain.
III‐15a. Effects of imports on investment.‐‐Since January 1, #bopyear, has your firm experienced any
actual negative effects on its return on investment or the scale of capital investments as a result
of imports of #abbrproduct from #ctrysubs?
No
Yes‐‐My firm has experienced actual negative effects as follows:
(check as many as appropriate)
(please describe)
Cancellation, postponement,
or rejection of expansion
projects
Denial or rejection of
investment proposal
Reduction in the size of
capital investments
Return on specific
investments negatively
impacted
Other
III‐15b. Does your firm’s response differ by country?
No
Yes
If yes, indicate which country and why:
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III‐16a. Effects of imports on growth and development.‐‐Since January 1, #bopyear, has your firm
experienced any actual negative effects on its growth, ability to raise capital, or existing
development and production efforts (including efforts to develop a derivative or more advanced
version of the product) as a result of imports of #abbrproduct from #ctrysubs?
No
Yes‐‐My firm has experienced actual negative effects as follows:
(check as many as appropriate)
(please describe)
Rejection of bank loans
Lowering of credit rating
Problem related to the issue
of stocks or bonds
Ability to service debt
Other
III‐16b. Does your firm’s response differ by country?
No
Yes
If yes, indicate which country and why:
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III‐17a. Anticipated effects of imports.‐‐Does your firm anticipate any negative effects due to imports of
#abbrproduct from #ctrysubs?
No
Yes
If yes, my firm anticipates negative effects as follows:
III‐17b. Does your firm’s response differ by country?
No
Yes
If yes, indicate which country and why:
III‐18. Other explanations.‐‐If your firm would like to further explain a response to a question in Part III
that did not provide a narrative box, please note the question number and the explanation in
the space provided below. Please also use this space to highlight any issues your firm had in
providing the data in this section, including but not limited to technical issues with the MS Word
questionnaire.
Business Proprietary
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Page 23
PART IV.‐‐ PRICING AND MARKET FACTORS
Further information on this part of the questionnaire can be obtained from Economist (202‐xxx‐xxxx,
[email protected]).
IV‐1. Contact information.‐‐Please identify the individual that Commission staff may contact
regarding the confidential information submitted in part IV.
Name
Title
Email
Telephone
Fax
PRICE DATA
IV‐2. This question requests quarterly quantity and value data for your firm’s commercial shipments
to unrelated U.S. customers since January 1, #bopyear of the following products produced by
your firm.
Product 1.‐‐DEFINE
Product 2.‐‐DEFINE
Product 3.‐‐DEFINE
Product 4.‐‐DEFINE
Please note that values should be f.o.b., U.S. point of shipment and should not include U.S.‐inland
transportation costs. Values should reflect the final net amount paid to your firm (i.e., should be net
of all deductions for discounts or rebates).
During January #bopyear‐#intmonth #termyear, did your firm produce and sell to unrelated U.S.
customers any of the above listed products (or any products that were competitive with these
products)?
Yes.‐‐Please complete the following pricing data table(s) as appropriate.
No.‐‐Skip to question IV‐3.
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U.S. Producers’ Questionnaire ‐ #ABBRPRODUCT
IV‐2.
Page 24
Price data.‐‐Report below the quarterly price data1 for pricing products2 produced and sold by
your firm.
Report data in actual #units and actual dollars (not 1,000s).
(Quantity in #units, value in dollars)
Product 1
Product 2
Product 3
Quantity
Value
Quantity
Value Quantity
Value
Product 4
Period of shipment
Quantity
Value
2012:
January‐March
April‐June
July‐September
October‐December
2013:
January‐March
April‐June
July‐September
October‐December
2014:
January‐March
April‐June
July‐September
October‐December
2015:
January‐March
April‐June
July‐September
1
Net values (i.e., gross sales values less all discounts, allowances, rebates, prepaid freight, and the value of returned
goods), f.o.b. your firm’s U.S. point of shipment.
2
Pricing product definitions are provided on the first page of Part IV.
Note.‐‐If your firm’s product does not exactly meet the product specifications but is competitive with the specified product,
provide a description of your firm’s product. Also, please explain any anomalies in your firm’s reported pricing data.
Product 1:
Product 2:
Product 3:
Product 4:
Pricing data methodology.—Please describe the method and the kinds of documents/records
that were used to compile your price data.
Note: As requested in Part I of this questionnaire, please keep all supporting documents/records used in
the preparation of the price data, as Commission staff may contact your firm regarding
questions on the price data. The Commission may also request that your company submit copies
of the supporting documents/records (such as sales journal, invoices, etc.) used to compile these
data.
Business Proprietary
U.S. Producers’ Questionnaire ‐ #ABBRPRODUCT
IV‐3.
Page 25
Price setting.‐‐ How does your firm determine the prices that it charges for sales of
#abbrproduct (check all that apply)? If your firm issues price lists, please submit sample pages
of a recent list.
Transaction
by
transaction
Contracts
IV‐4.
Set
price
lists
Other
If other, describe
Discount policy.‐‐ Please indicate and describe your firm’s discount policies (check all that
apply).
Quantity
discounts
Annual
total
volume
discounts
IV‐5.
(a)
Describe
What are your firm’s typical sales terms for its U.S.‐produced #abbrproduct?
(b)
IV‐6.
Other
Pricing terms.‐‐
Net 30
days
No
discount
policy
Net 60
days
2/10 net
30 days
Other
Other (specify)
On what basis are your firm’s prices of domestic #abbrproduct usually quoted (check
one)?
Delivered
F.o.b.
If f.o.b., specify point
Contract versus spot.‐‐Approximately what share of your firm’s sales of its U.S.‐produced
#abbrproduct in #termyear was on a (1) long‐term contract basis, (2) annual contract basis, (3)
short‐term contract basis, and (4) spot sales basis?
Type of sale
Short‐term
Long‐term
Annual
Total
contracts
contracts
Spot sales
contracts
(should
(multiple
(multiple
(for a single
(multiple
sum to
deliveries for
deliveries for
delivery)
deliveries for 12
100.0%)
less than 12
more than 12
months)
months)
months)
Share of
#termyear
%
%
%
% 0.0 %
sales
Business Proprietary
U.S. Producers’ Questionnaire ‐ #ABBRPRODUCT
IV‐7.
Page 26
Contract provisions.‐‐Please fill out the table regarding your firm’s typical sales contracts for
U.S.‐produced #abbrproduct (or check “not applicable” if your firm does not sell on a long‐term,
short‐term and/or annual contract basis).
Item
Short‐term contracts
(multiple deliveries
for less than 12
months)
Annual contracts
(multiple
deliveries for 12
months)
Long‐term contracts
(multiple deliveries for
more than 12 months)
Average contract
duration
No. of
days
365
Price renegotiation
(during contract
period)
Yes
No
Quantity
Price
Both
Yes
No
Typical sales
contract provisions
Fixed quantity
and/or price
Meet or release
provision
Not applicable
IV‐8.
Lead times.‐‐What is your firm’s share of sales from inventory and produced to order and what
is the typical lead time between a customer’s order and the date of delivery for your firm’s sales
of its U.S.‐produced #abbrproduct?
Share of
#termyear
Source
sales
Lead time (days)
From inventory
%
Produced to order
%
Total (should sum to 100.0%)
0.0 %
Business Proprietary
U.S. Producers’ Questionnaire ‐ #ABBRPRODUCT
IV‐9.
Page 27
Shipping information.‐‐
(a)
(b)
(c)
What is the approximate percentage of the total delivered cost of U.S.‐produced
#abbrproduct that is accounted for by U.S. inland transportation costs? percent
Who generally arranges the transportation to your firm’s customers’ locations?
Your firm Purchaser (check one)
Indicate the approximate percentage of your firm’s sales of #abbrproduct that are
delivered the following distances from its production facility.
Distance from production facility
Share
Within 100 miles
%
101 to 1,000 miles
%
Over 1,000 miles
%
Total (should sum to 100.0%)
0.0 %
IV‐10. Geographical shipments.‐‐ In which U.S. geographic market area(s) has your firm sold its U.S.‐
produced #abbrproduct since January 1, #bopyear (check all that apply)?
Geographic area
√ if applicable
Northeast.–CT, ME, MA, NH, NJ, NY, PA, RI, and VT.
Midwest.–IL, IN, IA, KS, MI, MN, MO, NE, ND, OH, SD, and WI.
Southeast.–AL, DE, DC, FL, GA, KY, MD, MS, NC, SC, TN, VA, and WV.
Central Southwest.–AR, LA, OK, and TX.
Mountains.–AZ, CO, ID, MT, NV, NM, UT, and WY.
Pacific Coast.–CA, OR, and WA.
Other.–All other markets in the United States not previously listed,
including AK, HI, PR, and VI.
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Page 28
IV‐11. End uses.‐‐List the end uses of the #abbrproduct that your firm manufactures. For each end‐use
product, what percentage of the total cost is accounted for by #abbrproduct and other inputs?
Share of total cost of end use product
accounted for by
Total
(should sum to
100.0% across)
End use product
#abbrproduct
Other inputs
%
%
0.0 %
%
%
0.0 %
%
%
0.0 %
IV‐12. Substitutes.‐‐ Can other products be substituted for #abbrproduct?
No
Yes‐‐Please fill out the table.
End use in which this
substitute is used
Substitute
Have changes in the price of this substitute
affected the price for #abbrproduct?
No Yes
Explanation
1.
2.
3.
IV‐13. Demand trends.‐‐ Indicate how demand within the United States and outside of the United
States (if known) for #abbrproduct has changed since January 1, #bopyear. Explain any trends
and describe the principal factors that have affected these changes in demand.
Market
Overall
No
Overall
increase change decrease
Fluctuate
with no
clear trend
Explanation and factors
Within
the United
States
Outside
the United
States
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IV‐14. Product changes.‐‐Have there been any significant changes in the product range, product mix,
or marketing of #abbrproduct since January 1, #bopyear?
No
Yes
If yes, please describe and quantify if possible.
IV‐15. Conditions of competition.‐‐
(a) Is the #abbrproduct market subject to business cycles (other than general economy‐wide
conditions) and/or other conditions of competition distinctive to #abbrproduct? If yes,
describe.
Check all that apply.
Please describe.
No
Skip to question IV‐16.
Yes‐Business cycles (e.g.
seasonal business)
Yes‐Other distinctive
conditions of competition
(b) If yes, have there been any changes in the business cycles or conditions of competition for
#abbrproduct since January 1, #bopyear?
No
Yes
If yes, describe.
IV‐16. Supply constraints.‐‐Has your firm refused, declined, or been unable to supply #abbrproduct
since January 1, #bopyear (examples include placing customers on allocation or “controlled
order entry,” declining to accept new customers or renew existing customers, delivering less
than the quantity promised, been unable to meet timely shipment commitments, etc.)?
No
Yes
If yes, please describe.
IV‐17. Raw materials.‐‐How have #abbrproduct raw materials prices changed since January 1,
#bopyear?
Fluctuate
Overall
No
Overall
with no
increase change decrease clear trend
Explain, noting how raw material price changes
have affected your firm’s selling prices for
#abbrproduct.
Business Proprietary
U.S. Producers’ Questionnaire ‐ #ABBRPRODUCT
Page 30
IV‐18. Interchangeability.‐‐Is #abbrproduct produced in the United States and in other countries
interchangeable (i.e., can they physically be used in the same applications)?
Please indicate A, F, S, N, or 0 in the table below:
A = the products from a specified country‐pair are always interchangeable
F = the products are frequently interchangeable
S = the products are sometimes interchangeable
N = the products are never interchangeable
0 = no familiarity with products from a specified country‐pair
Country‐pair
#ctrysubA
#ctrysubB
#ctrysubC
Other countries
United States
#ctrysubA
#ctrysubB
#ctrysubC
For any country‐pair producing #abbrproduct that is sometimes or never interchangeable,
identify the country‐pair and explain the factors that limit or preclude interchangeable use:
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Page 31
IV‐19. Factors other than price.‐‐Are differences other than price (e.g., quality, availability,
transportation network, product range, technical support, etc.) between #abbrproduct
produced in the United States and in other countries a significant factor in your firm’s sales of
the products?
Please indicate A, F, S, N, or 0 in the table below:
A = such differences are always significant
F = such differences are frequently significant
S = such differences are sometimes significant
N = such differences are never significant
0 = no familiarity with products from a specified country‐pair
Country‐pair
#ctrysubA
#ctrysubB
#ctrysubC
Other countries
United States
#ctrysubA
#ctrysubB
#ctrysubC
For any country‐pair for which factors other than price always or frequently are a significant
factor in your firm’s sales of #abbrproduct, identify the country‐pair and report the
advantages or disadvantages imparted by such factors:
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Page 32
IV‐20. Customer identification.‐‐List the names and contact information for your firm’s 10 largest U.S.
customers for #abbrproduct since January 1, #bopyear. Indicate the share of the quantity of
your firm’s total shipments of #abbrproduct that each of these customers accounted for in
#termyear.
FOR FINAL INVESTIGATIONS DELETE CONTACT PERSON, EMAIL, AND TELEPHONE
Customer’s name
Contact person
Email
Telephone
City
State
Share of
#termyear
sales (%)
1
2
3
4
5
6
7
8
9
10
Business Proprietary
U.S. Producers’ Questionnaire ‐ #ABBRPRODUCT
Page 33
IV‐21. Competition from imports
(a)
Lost revenue.‐‐Since January 1, #bopyear: To avoid losing sales to competitors selling
#abbrproduct from #ctrysubs, did your firm:
No
Yes
Reduce prices
Roll back announced price increases
(b)
Lost sales.‐‐Since January 1, #bopyear: Did your firm lose sales of #abbrproduct to
imports of this product from #ctrysubs?
No
Yes
(c)
PRELIM ONLY‐ DELETE this question in FINALS. The submission of lost sales/lost
revenue allegations is to be completed only by NON‐PETITIONERS.
If your firm indicated “yes” to any of the above, your firm can provide the Commission
with additional information by downloading and completing the lost sales/lost revenues
worksheet at http://usitc.gov/trade_remedy/question.htm. Note that the Commission
may contact the firms named to verify the allegations reported.
Is your firm submitting the lost sales/lost revenues worksheet?
No—Please explain.
Yes—Please complete the worksheet and submit via the Commission dropbox.
https://dropbox.usitc.gov/oinv/. (PIN: XXXX)
IV‐22. Other explanations.‐‐If your firm would like to further explain a response to a question in Part
IV that did not provide a narrative response box, please note the question number and the
explanation in the space provided below. Please also use this space to highlight any issues your
firm had in providing the data in this section, including but not limited to technical issues with
the MS Word questionnaire.
Business Proprietary
U.S. Producers’ Questionnaire ‐ #ABBRPRODUCT
Page 34
HOW TO FILE YOUR QUESTIONNAIRE RESPONSE
This questionnaire is available as a “fillable” form in MS Word format on the
Commission’s website at: LINK
Please do not attempt to modify the format or permissions of the questionnaire
document. Please submit the completed questionnaire using one of the methods noted
below. If your firm is unable to complete the MS Word questionnaire or cannot use one
of the electronic methods of submission, please contact the Commission for further
instructions.
• Upload via Secure Drop Box.—Upload the MS Word questionnaire along with a scanned copy of the
signed certification page (page 1) through the Commission’s secure upload facility:
Web address: https://dropbox.usitc.gov/oinv/
Pin: XXXX
• E‐mail.—E‐mail the MS Word questionnaire to [email protected]; include a scanned copy of the signed
certification page (page 1). Submitters are strongly encouraged to encrypt nonpublic documents that are
electronically transmitted to the Commission to protect your sensitive information from unauthorized
disclosure. The USITC secure drop‐box system and the Electronic Document Information System (EDIS)
use Federal Information Processing Standards (FIPS) 140‐2 cryptographic algorithms to encrypt data in
transit. Submitting your nonpublic documents by a means that does not use these encryption algorithms
(such as by email) may subject your firm’s nonpublic information to unauthorized disclosure during
transmission. If you choose a non‐encrypted method of electronic transmission, the Commission warns
you that the risk of such possible unauthorized disclosure is assumed by you and not by the Commission.
If your firm does not produce this product, please fill out page 1, print, sign, and submit a scanned copy
to the Commission.
Parties to this proceeding.—If your firm is a party to this proceeding, it is required to serve a copy of the
completed questionnaire on parties to the proceeding that are subject to administrative protective
order (see 19 CFR § 207.7). A list of such parties may be obtained from the Commission’s Secretary (202‐
205‐1803). A certificate of service must accompany the completed questionnaire you submit (see 19 CFR
§ 207.7). Service of the questionnaire must be made in paper form.
File Type | application/pdf |
File Title | Microsoft Word - US Producer Questionnaire.dot |
Author | nathanael.comly |
File Modified | 2015-12-16 |
File Created | 2015-12-16 |