Small Business Pulse Survey Phase 6 Draft
June 23, 2021
Welcome to the Small Business Pulse Survey
The U.S. Census Bureau is requesting your assistance in understanding the effect of changing business conditions due to the Coronavirus pandemic on your business. Your response is especially important right now as it helps policy makers, government officials, and businesses like yours understand these effects. Please complete this short 20 question survey; it will take approximately 5 minutes.
For the completion of this survey, please provide data for: XXXX [Name of company]
Q1. Is XX-XXXXXXX the Employer Identification Number (EIN) used on this business’s latest
Internal Revenue Service Form 941, Employer's Federal Quarterly Tax Return?
• Yes
• No
If no, please provide EIN:
Q2. Overall, how has this business been affected by the Coronavirus pandemic?
• Large
negative effect
• Moderate negative effect
•
Little or no effect
• Moderate positive effect
•
Large positive effect
Q3. In the last month, what were the total operating revenues/sales/receipts for this business, not including any financial assistance or loans?
• $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
Q4. In the last week, did this business have a change in operating revenues/sales/receipts, not including any financial assistance or loans?
• Yes,
increased
• Yes, decreased
• No change
Q5. In the last week, did this business do any of the following?
• Open a
previously closed location
• Temporarily close a location
•
Permanently close a location
• None of the above
Q6. In the last week, did this business have a change in the number of paid employees?
• Yes,
increased
• Yes, decreased
• No change
Q7. In the last week, did this business have a change in the total number of hours worked by paid employees?
• Yes, increased
• Yes, decreased
• No change
Q8. In the last week, did this business require employees to have proof of COVID-19 vaccination before physically coming to work?
• Yes
• No
• Not applicable, this business did not have employees physically coming to work in the last week.
Q9. In the last week, did this business have difficulties hiring paid employees?
• Yes
• No
• Not applicable
Q10. In the last week, did this business have any of the following?
•
Domestic supplier delays
• Foreign supplier
delays
• Difficulty locating alternative domestic
suppliers
• Difficulty locating alternative foreign
suppliers
• Production delays at this business
•
Delays in delivery/shipping to customers
• None of the
above
Q11. The White House declared a national emergency because of the Coronavirus pandemic on March 13, 2020.
Comparing now to what was normal before March 13, 2020, has the number of paid employees at this business changed?
Large increase in number of paid employees
Moderate increase in number of paid employees
Little or no change in number of paid employees
Moderate decrease in number of paid employees
Large decrease
in number of paid employees
Q12. Comparing now to what was normal before March 13, 2020, how has the number of hours
paid employees
worked from home changed?
Large increase in number of hours worked from home
Moderate increase in number of hours worked from home
Little or no change in number of hours worked from home
Moderate decrease in number of hours worked from home
Large decrease
in number of hours worked from home
Q13. Comparing now to what was normal before March 13, 2020, how has demand for this business’s goods or services changed?
Large increase in demand
Moderate increase in demand
Little or no change in demand
Moderate decrease in demand
Large decrease
in demand
Q14. Comparing now to what was normal before March 13, 2020, how have the prices this business pays for goods and services changed?
• Large increase in prices
• Moderate increase in prices
• Little or no change in prices
• Moderate decrease in prices
• Large decrease in prices
Q15. On December 27, 2020, the Consolidated Appropriations Act 2021 was enacted providing a second round of Coronavirus pandemic relief. Recently the American Rescue Plan Act of 2021 was enacted providing further Coronavirus pandemic relief.
Since December 27, 2020, has this business received financial assistance from any of the following sources?
•
Paycheck Protection Program (PPP)
• Paycheck Protection
Program (PPP) loan forgiveness
• Economic Injury Disaster Loans (EIDL)
• Restaurant Revitalization Fund
• Shuttered Venue Operators Grants
• Child Care Stabilization Fund
• Other Federal
programs
• Other sources
• This business has not
received financial assistance from any source since December 27,
2020.
Q16. In the next 6 months, do you think this business will have business travel expenditures for air, rail, car rental, or lodging?
• Yes
• No
• Not applicable, this business does not usually have business travel expenditures
Q17. In the next 6 months, do you think this business will have revenues from exports (revenues from selling products or services internationally)?
• Yes
• No
• Not applicable, this business does not usually have revenues from exports
Q18. In the next 6 months, do you think this business will need to do any of the following?
• Obtain financial assistance or additional capital
• Identify new supply chain options
• Develop online sales or websites
• Increase marketing or sales
• Identify and hire new employees
• Make a capital expenditure
• Cancel or postpone a planned capital expenditure
• Identify potential markets for exporting products or services
• Permanently close this business
• None of the above
Q19. In your opinion, how much time do you think will pass before this business returns to its normal level of operations?
• 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.
• This business
has permanently closed.
• There has been little or no
effect on this business's normal level of operations.
•
This business has returned to its normal level of operations
Q20. Please describe any changes this business has made to its operations due to the Coronavirus pandemic that you expect to keep.
(1000 characters)
Would you like to provide any information about your responses to these questions or this business's experiences during the Coronavirus pandemic?
Remarks (500 characters)
OMB Number
This collection has been approved by the Office of Management and Budget (OMB). The eight-digit OMB approval number is 0607-1014 and appears in the top right corner of each reporting screen. Without this approval, we could not conduct this survey.
Authority and Confidentiality
Title 13, United States Code, Sections 131 and 182, authorizes the U.S. Census Bureau to conduct this collection and to request your voluntary assistance. The Census Bureau is required by Section 9 of the same law to keep your information confidential and 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.
Burden Estimate Statement
We estimate the Small Business Pulse Survey will take an average of 5 minutes to complete. Factors such as company size, complexity and activity will affect your actual time to complete the survey. This estimate includes the time to review instructions, search existing data sources, gather and maintain the data needed, and complete and review the survey.
Send comments regarding this burden estimate or any other aspect of this 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-6K081
Washington, DC 20233
You may email comments to [email protected]. Be sure to use “EID Survey Comments 0607-1014” as the subject.
File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
Author | Kathryn Bonney (CENSUS/EMD FED) |
File Modified | 0000-00-00 |
File Created | 2021-07-02 |