SM-4417B-A Monthly Retail Trade Report

Attachment 9

OMB No. 0607-0717: Approval Expires 6/30/2020

U.S. DEPARTMENT OF COMMERCE
Economics and Statistics Administration

U.S. CENSUS BUREAU

MONTHLY RETAIL TRADE REPORT

FORM

SM-4417B-A

(05-01-2017)

Due Date

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Title 13 United States Code (U.S.C.),
Sections 131 and 182, authorizes the
Census Bureau to conduct this collection
and to request your assistance. The U.S.
Census Bureau is required by Section 9
of the same law to keep your information
confidential and can use your responses
only to produce statistics. The Census
Bureau is not permitted to publicly release
your responses in a way that could identify
your business, organization, or institution.
Per the Federal Cybersecurity Enhancement
Act of 2015, your data are protected from
cybersecurity risks through screening of the
systems that transmit your data.
This collection has been approved by the
Office of Management and Budget (OMB).
The eight-digit OMB approval number is
0607-0717 and appears at the upper right of
this page. Without this approval, we could
not conduct this survey.

(Please correct any errors in name, address, and ZIP Code.)

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GENERAL INSTRUCTIONS
• Any significant change in this firm's operations should be noted in 5
• For establishments sold or acquired during the month, report data only for the period the establishment was operated by this firm
• Estimates are acceptable if book figures are not available
• Enter "0" where applicable
INCLUDE
• Data for auxiliary facilities primarily engaged in supporting services
to this firm's establishment(s) such as warehouses, garages, central
administrative offices, and repair services
• Leased departments and concessions operated in other establishments

EXCLUDE
• Leased departments and concessions operated by other firms in this
firm's establishments
• Sales taxes and finance charges
• Data for establishments operated by other firms, such as franchises

44119014

ANNOUNCEMENTS AND SPECIAL INSTRUCTIONS

We estimate this survey will take an average of 7 minutes to complete. More information about this estimate and an address where you may write
with comments is on the back of this form.

1

FEDERAL EMPLOYER IDENTIFICATION (EIN)
Has this firm acquired any new EINs for its retail operation(s) since last month?
Yes - List here and continue with

2

. Report additional EIN(s) in

5

EIN (9 digits)

. . . . . . . . . . .

No

2

NUMBER OF RETAIL ESTABLISHMENTS

Number

How many retail establishments did this firm operate? . . . . . . . . . . . . . . . . . . . . . . . . .
The remainder of this report refers to the establishments reported here.
CONTINUE ON PAGE 2

Attachment 9

Form SM-4417B-A
3

Page 2

(05-01-2017)

SALES, RECEIPTS, OR REVENUE
INCLUDE

EXCLUDE

• Cash and credit sales of merchandise whether or not payment was
received
• E-commerce sales if not submitted on a separate monthly retail report
• Wholesale sales and services revenue made by retail establishments
covered by this report
• Value of trade-ins taken as part payment for other merchandise

• Commissions from vending machine operators and from sales of
government lottery tickets
• Nonoperating receipts (such as interest income, income from
investments, and receipts from the rental or sale of real estate)
• Refunds and allowances for returned goods
• The actual value of rebates and discounts granted to the purchaser,
even if granted as an increase in trade-in allowance

A. What type of reporting period do this month's sales represent?
Calendar month reporting period - Go to

3

C

4-week reporting period

5-week reporting period
Ending Date
Month Day

B. If not a calendar month reporting period, what is the ending date for the period you are reporting sales?
Dollars
C. What were the total sales in
D. Do the sales reported in
Book Figure

4

3

. . . . . . . . . . . . . . . . . . . . . .

C represent book figures or estimates?
Estimate

VALUE OF INVENTORIES
INCLUDE

EXCLUDE

• The cost value of all merchandise for the end of the month
• Merchandise owned by this firm but held by others for consignment
• Merchandise under contract for sale
• Merchandise if title has passed to you, including merchandise in transit
• Inventory held in Foreign Trade Zones or in bond warehouses in the U.S.

• Items such as fixtures, equipment, and supplies not held for resale
• Merchandise owned by others such as those held on consignment
• Merchandise of leased departments and concessions operated by
other firms in this retail establishment

A. What was the value of merchandise inventories, regardless of where held, owned as of the end of the month?
1. Merchandise inventories in retail stores
Include leased departments and concessions operated by this firm in other
establishments. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2. Merchandise inventories in warehouses, offices, or in transit for distribution to retail
stores . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Dollars

3. Total inventories (if applicable, before Last-in, First-out (LIFO) adjustment) . . . . . .
Month

44119022

5

Day

B. Inventories were reported as of what date? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
REMARKS - Please use this space to explain any significant month-to-month changes, to clarify responses, or indicate where data were
estimated.

CONTACT INFORMATION
Name of person to contact regarding this report
Area code
Telephone

Number

-

Title
Extension

Area code
Fax

Number

-

DEFINITIONS OF E-COMMERCE SALES, AUXILIARY ESTABLISHMENTS, LEASED DEPARTMENTS AND CONCESSIONS
• E-commerce is the sale of goods and services where the buyer places an order, or the price and terms of the sale are negotiated, over an Internet, mobile device (M-Commerce),
extranet, EDI network, electronic mail, or other comparable online system. Payment may or may not be made online.
• Auxiliary Establishments are facilities primarily engaged in furnishing supporting services (such as warehouses, garages and central administrative offices) to this firm's
establishments.
• Leased Departments and Concessions are separate businesses that lease space on the premises of another business.
We estimate this survey will take an average of 7 minutes 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 voluntary collection of information, including
suggestions for reducing this burden, to: EID Survey Comments 0607-0717, U.S. Census Bureau, 4600 Silver Hill Road, Room EID-8K170, Washington, DC 20233. You may email comments
to [email protected]. Be sure to use "EID Survey Comments 0607-0717" as the subject.