Small Business Pul Small Business Pulse Survey

Small Business Pulse Survey

SBPS Phase 6 Questionnaire 6.23.2021

Small Business Pulse Survey

OMB: 0607-1014

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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:

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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)

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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)


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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.


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File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
AuthorKathryn Bonney (CENSUS/EMD FED)
File Modified0000-00-00
File Created2021-07-02

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