QFR-201(MG) Quarterly Financial Report

OMB No. 0607-0432: Approval Expires 10/31/2021
FORM QFR-201(MG)
(09-26-2019)

U.S. DEPARTMENT OF COMMERCE
U.S. CENSUS BUREAU

NOTICE – YOUR RESPONSE IS REQUIRED BY LAW. Title 13 United States Code (U.S.C.), Section 91, authorizes this collection and
requires your response. 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 0607-0432 and appears at the upper right of this page. Without this approval, we
could not conduct this survey. We estimate this survey will take 1.2 hours to complete. More information about this estimate and an address
where you may write with comments is in the instructions that accompany this form.

QUARTERLY FINANCIAL
REPORT

MANUFACTURING
Please read the accompanying instructions
before answering the questions.
NEED HELP?
Use Secure Messaging Center at Internet
Website:
econhelp.census.gov/qfr/contactus
Call 1 (800) 272–4250 between
8 a.m. and 5 p.m. Eastern time
Monday through Friday
Note – Audited figures are not required.
Estimates are acceptable for line items where
actual data are not available.
Submit VIA Internet Reporting at:
econhelp.census.gov/qfr
or Mail to: U.S. CENSUS BUREAU
1201 East 10th Street
Jeffersonville, IN 47132-0001
or FAX to: 1 (800) 447–4613
INTERNET REPORTING — You may complete this survey online at:

econhelp.census.gov/qfr

Username:

Use your firm’s unique username and original password.

Password:

1 Person to contact regarding this report – Print or type
●
011

012

Name and title
Area code

013

Telephone

(

Extension

Number

014

–

)

e-mail address
Area code
Fax

(

Number

–

)

ITEMS 2 THROUGH 7 REFER TO THE CORPORATION NAMED IN THE ADDRESS BOX
Month

2 a. Annual closing date of this corporation
●

Day

021

b. Federal Employer Identification Number (FEIN)

–

022

3 Corporation status – Mark "X" only ONE box. Insert discontinued or merged date if corporation is no longer operating.
●
Month
a. Active

b. Discontinued

Day

Year

Month
c. Merged

034

Day

Year

035

4 Is this corporation owned more than 50 percent by another corporation? (Mark "X" only ONE box.)
●
a. No
043

Name

b. Yes

– Provide the name, FEIN, and address assigned to this corporation below.
044

045

FEIN

Address

–
5 Does this corporation own more than 50 percent of any other corporation – Mark "X" only ONE box.
●
a. Yes

STOP! Read Consolidation Rules page 2.

b. No

– Proceed to page 2.

6 What is the total number of domestic and foreign corporations directly or indirectly (all tiers) owned
●
more than 50 percent by this corporation?
7
● a. After reviewing the Consolidation Rules on page 2, how many corporations are consolidated in this report?
b. How many corporations are not consolidated in this report?

Number
061
071
072

READ "RULES FOR CONSOLIDATION" ON PAGE 2 AND THE ACCOMPANYING INSTRUCTIONS

CONTINUE ON PAGE 2

PLEASE KEEP A COPY OF THIS FORM FOR YOUR RECORDS
BEFORE COMPLETING THIS REPORT, READ THE CONSOLIDATION RULES LOCATED BELOW
AND THE ACCOMPANYING INSTRUCTIONS.
REPORT ALL DOLLAR FIGURES IN THOUSANDS. AUDITED FIGURES ARE NOT REQUIRED.
ESTIMATES ARE ACCEPTABLE FOR LINE ITEMS WHERE ACTUAL DATA ARE NOT AVAILABLE.

8
●

Schedule A – Statement of Income and Retained
Earnings for your 3-MONTH PERIOD (inclusive)

401 FROM: Month

Year 402 TO: Month

Day

Day

Year

AMOUNT
(in thousands)
101

A Sales, receipts, and operating revenues (net of returns and allowances, and excise and sales taxes) . . . . . . . . . . . . . . . . . . . .
102

B Depreciation, depletion, and amortization of property, plant, and equipment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
103

C All other operating costs and expenses — Include cost of goods sold (net of purchase discounts), selling,
general and administrative expenses. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
104

D Income (loss) from operations — 8 line A less the sum of lines B and C . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
105

E Interest expense . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
110

1

F Nonoperating income and expenses — Include interest income, equity and dividend income, etc. . . . . . . . . . . . . . . . . . . . . .
111

G Income (loss) before income taxes — Sum of 8 lines D and F less line E . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
H Provision for current and deferred domestic income taxes on 8 line G (accrue payable in 10 lines C and G)

2

114

. . . . . . . . . . . . . . .
115

I

Net income (loss) for quarter — Sum of 8 line G less line H

J

CENSUS USE ONLY — REB

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
119

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
120

K Cash dividends charged to retained earnings this quarter — Include 1120S cash distributions.

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

CENSUS USE ONLY — ADJ

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

M CENSUS USE ONLY — REE

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

L

122
123

9
●

Schedule B1 – Balance Sheet – Assets

403 Month

Balance Sheet date as of

Day

Year

AMOUNT
(in thousands)
201

A 1. Cash and demand deposits in the U.S. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
202

2. Time deposits in the U.S. — Include negotiable certificates of deposit. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
210

B Other short-term financial investments — Include marketable and government securities, commercial paper, etc.
3

C Trade accounts and trade notes receivable (less allowance for doubtful accounts).
D Inventories

3

213

. . . . . . . . . . . . . . . . . . . . . . . . . . . . .
214

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
3

E All other current assets — Include prepaid expenses and income taxes receivable.

215

. . . . . . . . . . . . . . . . . . . . . . . . . . . . .
216

1. Property, plant, and equipment — Include construction in progress. . . . . . . . . . . . . . . . . . . . . . .

F

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

$

217

2. Land and mineral rights. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

218

3. Accumulated depreciation, depletion, and amortization . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
219

4. Net property, plant, and equipment — Sum of 9 lines F-1 and F-2 less line F-3

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

G All other noncurrent assets — Include long-term investments, intangibles, etc. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
H TOTAL ASSETS
Sum of 9 lines A-1 through E, F-4, and G (must equal 10 line I)

10
●

222
223

Schedule B2 – Balance Sheet – Liabilities and Stockholders’ Equity
301

A 1. Short-term loans (original maturity of one year or less) from banks — Include overdrafts

. . . . . . . . . . . . . . . . . . . . . . . .
304

2. Other short-term loans (original maturity of one year or less) — Include commercial paper. . . . . . . . . . . . . . . . . . . . . . . .
306

B Trade accounts and trade notes payable . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
309

C Domestic income taxes accrued, prior and current years, net of payments — Include overpayments.

. . . . . . . . . . . . . . . . . . .
310

D Current portion of long-term debt — Classify noncurrent portion in 10 line F. . . . . . . . . . . . . . .
E All other current liabilities — Include accrued expenses and excise, sales, and payroll taxes.

3

{

1. Loans from banks . . . .
313

2. Other long-term loans

. .
315

. . . . . . . . . . . . . . . . . . . . . . . .
316

F Long-term debt due in more than one year — Classify current portion in 10 line D.

. . . . . . . . . .

{

1. Loans from banks . . . .
319

2. Other long-term loans

. .
320

G All other noncurrent liabilities — Include deferred income taxes and minority stockholders’ interest. . . . . . . . . . . . . . . . . . . . .
326

H 1. Capital stock and other capital (less treasury stock) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

$

322

2. Retained earnings at end of quarter

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

3. Stockholders’ equity — Sum of 10 lines H-1 and H-2

327

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
328

I

TOTAL LIABILITIES AND STOCKHOLDERS’ EQUITY
Sum of 10 lines A-1 through G and H-3 (must equal 9 line H above)

CONSOLIDATION RULES: This is a domestic-only consolidation. Nonconsolidated subsidiaries must be reported using either
the equity or cost method of accounting. Fully consolidate the operations of every majority-owned domestic subsidiary (including majorityowned subsidiaries of these subsidiaries) that are taxable under the U.S. Internal Revenue Code. Consolidated subsidiaries should
include 1120S corporations.
EXCEPTION: Do not fully consolidate domestic subsidiaries that are primarily engaged in foreign operations, banking, finance,
or insurance (as defined in the North American Industry Classification System (NAICS) Sector 52, United States, 2007).
Do not fully consolidate foreign subsidiaries or foreign operations. Nonconsolidated subsidiaries must be reported using
the equity method or cost method of accounting.
Equity method of accounting – Report net equity earnings (losses) of all nonconsolidated domestic and foreign operations on 8
line F of the Income Statement. Report the investment on 9 line G on the Balance Sheet. For purposes of this report, domestic
operations refer to operations that are within the 50 United States and the District of Columbia. Commonwealths such as Puerto Rico
and territories such as the Virgin Islands are not considered domestic.
2

Attach a list and explain, on a separate sheet, the principal debits and credits reflected during the quarter.
Attach a brief explanation on a separate sheet if tax provision is not shown (e.g., "net operating loss," "1120S," etc.).

3

Progress payments and billings from U.S. Government and others should not be deducted from 10
9 lines C, D, and E; but included in 10 line E.

1

IMPORTANT: IN ALL CORRESPONDENCE WITH US, PLEASE REFER TO THE 10-DIGIT USERNAME LOCATED ON THE FRONT OF THIS FORM.
FORM QFR-201(MG) (09-26-2019)

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