BE-10 Claim for No BE-10 Claim for Not Filing

FORM

BE-10 Claim for Not Filing

(REV. 12/2014)

OMB No. 0608-0049: Approval Expires 11/30/2017

2014 BENCHMARK SURVEY OF U.S. DIRECT INVESTMENT ABROAD
MANDATORY — CONFIDENTIAL
BE-10 Claim for Not Filing
Reporter ID Number
Mail reports to:

U.S. Department of Commerce
Bureau of Economic Analysis, BE-69(A)
Washington, DC 20230

Deliver reports to: U.S. Department of Commerce

Bureau of Economic Analysis, BE-69(A)

Shipping and Receiving, Section M-100

1441 L Street, NW

Washington, DC 20005
Fax reports to:

(202) 606-5312

Assistance:

E-mail:
Telephone:
Copies of form:

Name and address of U.S. business enterprise for which this claim
is filed — If the enterprise received a Form BE-10A 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-10A. If a Form BE-10A was not received, enter name and address.
Name and address of U.S. Reporter

be10/[email protected]
(202) 606-5566
www.bea.gov/dia

Please include your BEA Identification Number
with all requests.

A BE-10, Benchmark Survey of U.S. Direct Investment Abroad — 2014,
is required from any U.S. person that had a foreign affiliate — that is,
that had direct or indirect ownership or control of at least 10 percent of
the voting stock of an incorporated foreign business enterprise or an
equivalent interest in an unincorporated foreign business enterprise — at
any time during its 2014 fiscal year. (The U.S. person’s 2014 fiscal year is
defined to be the person’s financial reporting year that has an ending date
in calendar year 2014.)

It also requires that persons, or their agents, who are contacted by
BEA about reporting in this survey, either by sending them report
forms or by written inquiry, must respond in writing. They may
respond by:
• filing the properly completed BE-10 report by May 29, or June 30,
2015, as required;
• completing and returning the “BE-10 Claim for Not Filing” by May
29, 2015; or

Section 801.8 of 15 CFR, Chapter VIII , requires that all persons subject
to the reporting requirements of the BE-10 survey respond, whether or
not they are contacted by BEA.

• certifying in writing, by May 29, 2015, to the fact that the person
had no direct investment within the purview of the reporting
requirements of the BE-10 survey.

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

0

Street 1
0991

Telephone Number

0

0994

Street 2
0992
0993

0

(—

— —) — — — - — — — —

(—

— —) — — — - — — — —

Extension

Fax Number

0

City

0

0997

State

Zip

0

E-mail Address
0999

0

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 the information contained in this claim is correct and complete to the best of his/her knowledge.
Signature of Authorized Official

Date

Telephone Number
0996

Name
0995

0

Title
1001

—
— — — - — — — —
Fax Number
1
(— — —) — — — - — — — —
1

(—

—)

Extension

BE-10 Claim for Not Filing
BASIS OF CLAIM FOR NOT FILING — Mark (X) and complete either A or B
A.

B.

This U.S. person did not own or control, directly and/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 any time during its 2014 fiscal year.
1

1

But did file the 2013 BE-11, Annual Survey of U.S. Direct Investment Abroad with this Bureau.

1

2

And did not file a 2013 BE-11, Annual Survey of U.S. Direct Investment Abroad report with this Bureau.

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) during its 2014 fiscal year, but (Mark (X) one) –
1

1

The owners are citizens of a foreign country who (a) are residing in the U.S. as a result of official employment by a foreign government
(including the immediate family of such persons), or (b) have been and expect to be residing in the U.S. for less than one year.

1

2

Is fully consolidated in the BE-10 report of
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
1

3

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

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.
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.
Remarks

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FORM BE-10 Claim for Not Filing (REV. 12/2014)