Week 4 questionnai Week 4 questionnaire

Small Business Pulse Survey

Welcome to the Small Business Pulse Survey

The U.S. Census Bureau is requesting your assistance in understanding the impact of the COVID-19 (coronavirus) outbreak on your business. Your response is especially important right now as it helps policy makers, government officials, and businesses like yours understand the impacts of the Coronavirus. Please complete this short 16 question survey; it will take approximately 5 minutes.

This survey asks about the experience of your business over the last week, but also about the experience of your business since the start of the COVID-19 pandemic. The White House declared a national emergency because of the COVID-19 pandemic on March 13, 2020.

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C. Electronic Census Bureau Surveys or Censuses

Under federal law, we protect the confidentiality of the data we collect. When you respond to a survey or census via the Internet, you may have to provide us personally identifiable information (PII) or business identifiable information (BII). For each survey and census, we provide an explanation to respondents about the confidentiality of the data and the laws that protect the data (e.g., Title 13, United States Code Section 9 (a)) protect against unauthorized disclosure under penalty of $250,000 and up to 5 years in prison, or both.

When you respond to surveys or censuses over the Internet that collect identifiable information, Tier 2 technology is used. Personally identifiable information or business identifiable information collected in the course of a survey or census is not used to customize your online experience.

Once you access an online survey or census, we automatically collect information about how long it took you to complete the survey or census, which questions you answered, and how many times you logged into the survey or census. In addition, we collect data on navigation of the survey or census, which includes mouse clicks and any data entered onto the survey or census, whether or not the survey or census is completed and submitted. These data are used in aggregate to assess the usability of the survey or census, or for other authorized statistical purposes. They are protected under the same confidentiality procedures as response data.

All web data submissions are encrypted to strengthen further the protection of the information we collect online. Per the Federal Cybersecurity Enhancement Act of 2015, your data are protected from cybersecurity risks through screening of the systems that transmit your data.

Questions concerning this policy may be addressed to: ask.census.gov, attn: Policy Coordination Office.

BURDEN STATEMENT

We estimate this survey will take an average of 5 minutes to complete, including the time for reviewing and answering questions, searching existing data sources, and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of collection of information, including suggestions for reducing this burden, to:

EID Survey Comments 0607-1014

U.S. Census Bureau

4600 Silver Hill Road

Room EID-7K154

Washington, DC 20233

You may email comments to [email protected], use "EID Survey Comments 0607-1014" as the subject.

1. Overall, how has this business been affected by the COVID-19 pandemic?

Select only one:

• Large negative effect

• Moderate negative effect

• Little or no effect

• Moderate positive effect

• Large positive effect

2. In the last week, did this business experience a change in operating revenues/sales/receipts, not including any financial assistance or loans?

Select only one:

• Yes, increased

• Yes, decreased

• No

3. In the last month, what were the total operating revenues/sales/receipts for this business, not including any financial assistance or loans?

Select only one:

• $0 - $500

• $501 - $2,500

• $2,501 - $5,000

• $5,001 - $15,000

• $15,001 - $50,000

• $50,001 - $125,000

• $125,001 - $200,000

• $200,001 - $500,000

• $500,001 or more

• Don’t know

4. In the last week, did this business temporarily close any of its locations for at least one day?

Select only one:

• Yes

• No

5. In the last week, did this business have a change in the number of paid employees?

Select only one:

• Yes, increased

• Yes, decreased

• No

6. In the last week, did this business have a change in the total number of hours worked by paid employees?

Select only one:

• Yes, increased

• Yes, decreased

• No

7. In the last week, did this business have disruptions in its supply chain?

Select only one:

• Yes

• No

8. In the last week, did this business shift to the production of other goods or services?

Select only one:

• Yes

• No

9. In the last week, did any of this business’s locations adopt pickup/carry-out/delivery as their only means of providing goods and services to their customers?

Select only one:

• Yes

• No

10. How would you describe the current availability of cash on hand for this business, including any financial assistance or loans? Currently, cash on hand will cover:

Select only one:

• 1-7 days of business operations

• 1-2 weeks of business operations

• 3-4 weeks of business operations

• 1-2 months of business operations

• 3 or more months of business operations

• No cash available for business operations

• Don’t know

11. The White House declared a national emergency because of the COVID-19 pandemic on March 13, 2020. Since then, has this business missed any loan payments? Loan payments that have been forgiven or postponed should not be considered to be missed.

Select only one:

• Yes

• No

12. Since March 13, 2020, has this business missed any other scheduled payments, not including loans? Examples of other scheduled payments include rent, utilities, and payroll. Scheduled payments that have been forgiven or postponed should not be considered to be missed.

Select only one:

• Yes

• No

13. Since March 13, 2020, has this business requested financial assistance from any of the following sources?

Select all that apply:

• Paycheck Protection Program (PPP)

• Economic Injury Disaster Loans (EIDL)

• SBA Loan Forgiveness

• Other Federal programs

• State or local government programs

• Banks

• Self

• Family or friends

• Other sources

• This business has not requested financial assistance from any source since March 13, 2020

14. Since March 13, 2020, has this business received financial assistance from any of these programs from the Federal government?

Select all that apply:

• Paycheck Protection Program (PPP)

• Economic Injury Disaster Loans (EIDL)

• SBA Loan Forgiveness

• Other Federal Programs

• This business has not received financial assistance from any Federal program since March 13, 2020

15. In your opinion, how much time do you think will pass before this business returns to its normal level of operations relative to one year ago?

Select only one:

• 1 month or less

• 2-3 months

• 4-6 months

• More than 6 months

• I do not believe this business will return to its normal level of operations relative to one year ago

• There has been little or no effect on this business’s normal level of operations relative to one year ago

16. What is this business 9-digit Employer Identification number (EIN) used on its latest Internal Revenue Service 941 Employer's Federal Quarterly Tax Return?

Text box for 9 digit numeric EIN