Adequacy Purchaser Questionnaire

OMB No. 3117—0016/USITC No. 16-5-xxx; Expiration Date: 6/30/2020
(No response is required if currently valid OMB control number is not displayed)

ADEQUACY PHASE U.S. PURCHASERS’ QUESTIONNAIRE
INVESTIGATION TITLE
This questionnaire must be received by the Commission by no later than Date
The information called for in this questionnaire is for use by the United States International Trade Commission in
connection with its review of the countervailing and antidumping duty order(s) concerning #abbrproduct from #ctrysubs
(Inv. No. 701-TA-xxx and 731-TA-xxx (Second/Third Review). The information requested in the questionnaire is
requested under the authority of the Tariff Act of 1930, title VII. This report is mandatory (19 U.S.C. § 1333(a)). Further
information on this questionnaire can be obtained from Economist (phone: 202-205-XXXX; fax: 202-205-2340; e-mail:
[email protected]).
Name of firm
Address
City

State

Zip Code

Website
Has your firm purchased #abbrproduct from ANY source (domestic or foreign) 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 and return the 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/. (Investigation: Adequacy Phase Reviews, PIN:
REVIEWS)
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 submitting 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
Signature

Title of Authorized Official
Phone:

Date
Email address

Business Proprietary
U.S. Purchasers’ Questionnaire – #abbrproduct

Page 2

Please respond to the following questions related to market conditions for #abbrproduct. In your
responses, significant changes in the U.S. market or the market in #ctrysubs, if any, could include:
(a) technology; production methods; or development efforts to produce the product;
(b) ability to increase production (including the shift of production facilities used for other
products and the use, cost, or availability of major inputs into production) that affected the
availability of the product;
(c) factors related to the ability to shift supply of the product among different national markets
(including barriers to importation in foreign markets or changes in market demand abroad) that
affected its availability;
(d) changes in the end uses and applications;
(e) the existence and availability of substitute products for the product;
(f) level of competition among the product produced in the United States, produced in
#ctrysubs, and from other countries; and
(g) changes in the business cycles for the product.
1. Past changes—Have there been any significant changes in the supply and demand conditions for
#abbrproduct that have occurred in the United States or in the market for #abbrproduct in #ctrysubs
since January 1, #bopyear?
No

Yes--Discuss factors.

2. Anticipated changes—Do you anticipate any significant changes in the supply and demand
conditions for #abbrproduct in the United States or in the market for #abbrproduct in #ctrysubs
within a reasonably foreseeable time?
No

Yes--Discuss factors.

Business Proprietary
U.S. Purchasers’ Questionnaire – #abbrproduct

Page 3

OMB INFORMATION
3. OMB statistics.--Please report the actual number of hours required and the cost to your firm of
completing this survey.
Hours

Dollars

The questions in this survey 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 survey is estimated to average 4 hours per response,
including the time for reviewing instructions, gathering data, and completing and reviewing the
survey.
We welcome comments regarding the accuracy of this burden estimate, suggestions for reducing
the burden, and any suggestions for improving this survey. Please attach such comments to your
response or send to the Office of Investigations, USITC, 500 E St. SW, Washington, DC 20436.

HOW TO FILE YOUR SURVEY RESPONSE
Please do not attempt to modify the format or permissions of the survey document.
Please submit the completed survey using one of the methods noted below. If your firm
is unable to complete the MS Word survey 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 survey along with a scanned copy of the signed
certification page (page 1) through the Commission’s secure upload facility:
o
o
o

Web address: https://dropbox.usitc.gov/oinv/
Enter Investigation: Select “Adequacy Phase Reviews” in the drop down menu
Pin: REVIEWS

• E-mail.—E-mail the MS Word survey 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 did not purchase this product, please fill out page 1, print, sign, and submit a scanned copy
to the Commission.