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2021 Annual Survey of Manufactures (ASM)
MA-10000 - Annual Survey of Manufactures
Location Information
DEFINITION OF ESTABLISHMENT
The reporting unit for this questionnaire is an establishment. An establishment is generally a single physical location where business is conducted
or where services or industrial operations are performed.
MAILING ADDRESS
ATTN
City, town, village, etc.
AF
Number and Street
Store/Plant
State
ZIP Code
Select State or Territory
PHYSICAL LOCATION
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Name 2
T
Name 1
99999-9999
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Please update the physical location if needed.
(P.O. Box and rural route addresses are not physical locations.)
Number and Street
City, town, village, etc.
State
Select State or Territory
ZIP Code
99999-9999
For Census Bureau Use Only
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CFN
2021_MA-10000_su.pdf
1
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2021 Annual Survey of Manufactures (ASM)
MA-10000 - Annual Survey of Manufactures
Legal Boundary and Municipality
EIN:
Store / Plant:
CFN:
LEGAL BOUNDARY AND MUNICIPALITY
Is this establishment physically located inside the legal boundaries of the city, town, village, etc.?
Yes
No
Do not know
Town or township
Other
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Do not know
AF
City, village, or borough
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In what type of municipality is this establishment physically located?
T
No legal boundaries
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2021 Annual Survey of Manufactures (ASM)
MA-10000 - Annual Survey of Manufactures
Item 1: Employer Identification Number
EIN:
Store / Plant:
CFN:
ITEM 1: EMPLOYER IDENTIFICATION NUMBER
Is the Employer Identification Number (EIN) used on this establishment's latest Internal Revenue Service Form 941, Employer’s Federal Quarterly Tax
Return?
Yes
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AF
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No
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2021 Annual Survey of Manufactures (ASM)
MA-10000 - Annual Survey of Manufactures
Item 1: Employer Identification Number - Enter/Update EIN
EIN:
Store / Plant:
CFN:
ITEM 1: EMPLOYER IDENTIFICATION NUMBER - ENTER / UPDATE EIN
What is this establishment’s 9-digit Employer Identification Number (EIN) used on its latest Internal Revenue Service Form 941, Employer’s Federal
Quarterly Tax Return?
EIN
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AF
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T
99-9999999
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2021 Annual Survey of Manufactures (ASM)
MA-10000 - Annual Survey of Manufactures
Item 2A: Ownership or Control
EIN:
Store / Plant:
CFN:
ITEM 2A: OWNERSHIP OR CONTROL
Is your company owned or controlled by another domestic company?
Yes
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AF
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No
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2021 Annual Survey of Manufactures (ASM)
MA-10000 - Annual Survey of Manufactures
Item 2B: Ownership or Control - Voting Stock Validation
EIN:
Store / Plant:
CFN:
ITEM 2B: OWNERSHIP OR CONTROL - VOTING STOCK VALIDATION
Does another domestic company own more than 50 percent of the voting stock of your company?
Yes
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AF
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No
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2021 Annual Survey of Manufactures (ASM)
MA-10000 - Annual Survey of Manufactures
Item 2C: Ownership or Control - Management and Policy
EIN:
Store / Plant:
CFN:
ITEM 2C: OWNERSHIP OR CONTROL - MANAGEMENT AND POLICY
Does another domestic company have the power to control the management and policies of your company?
Yes
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AF
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No
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2021 Annual Survey of Manufactures (ASM)
MA-10000 - Annual Survey of Manufactures
Item 2D: Ownership or Control - Percent of Voting Stock Held
EIN:
Store / Plant:
CFN:
ITEM 2D: OWNERSHIP OR CONTROL - PERCENT OF VOTING STOCK HELD
What percent of voting stock was held by the owning or controlling company?
Less than 50%
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AF
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50%
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2021 Annual Survey of Manufactures (ASM)
MA-10000 - Annual Survey of Manufactures
Item 2E: Ownership or Control - Company Information
,
EIN:
Store / Plant:
CFN:
ITEM 2E: OWNERSHIP OR CONTROL - COMPANY INFORMATION
Home office address (Number and
street)
City, town, village, etc.
AF
Name of owning or controlling company
State
ZIP Code
Select State or Territory
EIN
99999-9999
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99-9999999
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What is the name, address, and 9-digit Employer Identification Number (EIN) of the owning or controlling company?
9
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MA-10000 - Annual Survey of Manufactures
Item 3: Operational Status
,
EIN:
Store / Plant:
CFN:
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2021 Annual Survey of Manufactures (ASM)
ITEM 3: OPERATIONAL STATUS
In operation
Under construction, development, or exploration
Ceased operation
AF
Temporarily or seasonally inactive
Sold or leased to another operator
CEASED OPERATION OR SOLD OR LEASED INFORMATION
If this establishment ceased operation or was sold or leased to another operator, what was the date?
MMDDYYYY
MMDDYYYY
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If this establishment was sold or leased to another operator, what is the name, address, and 9-digit Employer Identification Number (EIN) of this
establishment's new owner or operator?
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Which of the following best describes this establishment's operational status at the end of 2021?
Name of new owner/operator
Mailing Address (Number and Street,
P.O. Box, etc.)
State
Select State or Territory
EIN
99-9999999
2021_MA-10000_su.pdf
ZIP Code
99999-9999
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City, town, village, etc.
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MA-10000 - Annual Survey of Manufactures
Item 4: Months in Operation
EIN:
Store / Plant:
CFN:
ITEM 4: MONTHS IN OPERATION
Check
if
None
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2021
AF
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What was the number of months in operation during 2021?
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2021 Annual Survey of Manufactures (ASM)
MA-10000 - Annual Survey of Manufactures
Consolidating Data for Multiple Locations
EIN:
Store / Plant:
CFN:
CONSOLIDATING DATA FOR MULTIPLE LOCATIONS
If multiple physical locations (establishments) operate under EIN , report on a consolidated basis (sum the total of each location and combine) for:
Item 5: Sales, Shipments, Receipts, or Revenue
Item 7: Employment, Annual Payroll, and First Quarter Payroll
Item 22: Detail of Sales, Shipments, Receipts, or Revenue
AF
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Other Item Questions should be reported individually for just this location.
At the end of the Survey, after Remarks, Item 32: Number of Establishments will ask for the number of locations operated under this EIN. Please
provide information for each establishment individually.
Name, Store/Plant, Address, Kind of Business
Number of Employees; Annual Payroll; First Quarter Payroll; Sales, Shipments, Receipts, or Revenue
12
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2021 Annual Survey of Manufactures (ASM)
MA-10000 - Annual Survey of Manufactures
General Reporting Guidelines
,
EIN:
Store / Plant:
CFN:
T
GENERAL REPORTING GUIDELINES
Reporting Period:
Responses should cover calendar year 2021.
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If your fiscal year covers at least 10 months of calendar year 2021, you may report by fiscal year on all items EXCEPT payroll.
Prior Year Data:
AF
Calendar year figures for payroll may be available from:
IRS Form 941 (Employer’s Quarterly Federal Tax Return)
IRS Form 944 (Employer’s Annual Federal Tax Return)
If you report by fiscal year, indicate the exact dates of the fiscal year on the submission certification screen.
Where available, your establishment's Prior Year data is prelisted in the
2020 column.
Check these figures and make any necessary corrections as needed.
If 2020 Inventories figures are not prelisted, report these figures in the appropriate sections as
instructed.
How to Report Dollar Figures:
Dollar figures should be rounded to thousands of dollars.
EXAMPLE - DO NOT ENTER DATA
Check
if
None
$
EXAMPLE - if a dollar figure is $2,036,355.25, report 2036:
EXAMPLE - if a dollar figure is "0" (or less than $500.00), check the None box:
How to Report Percents:
Percents should be rounded to whole percents.
2021
2036
,000.00
EXAMPLE - DO NOT ENTER DATA
Check
if
None
X
2021
$
,000.00
EXAMPLE - DO NOT ENTER DATA
2021
39
EXAMPLE - if figure is 38.76% of total sales, report 39:
2021_MA-10000_su.pdf
%
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Providing Estimates:
If book figures are not available, estimates are acceptable.
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2021 Annual Survey of Manufactures (ASM)
MA-10000 - Annual Survey of Manufactures
Item 5: Sales, Shipments, Receipts, or Revenues
,
EIN:
Store / Plant:
CFN:
ITEM 5: SALES, SHIPMENTS, RECEIPTS, OR REVENUE More
Include:
All products physically shipped from this
establishment during 2021
establishment during 2021
Exclude:
Freight charges
Excise taxes
AF
Products donated and physically shipped from this
Check
if
None
2021
$
,000.00
2020
$
,000.00
B. What percent of the $,000.00 reported in Item 5, line A
was for goods that were ordered or whose movement was
controlled or coordinated over electronic networks?
(Report whole percent.)
Include:
Electronic Data Interchange (EDI)
E-mail
Internet
Extranet
Other online systems
Check
if
None
2021
2020
%
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%
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D
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E-shipments are online orders accepted for manufactured
products from customers. These include shipments to
other domestic plants of your own company for further
manufacture, assembly, or fabrication. The price and terms
of sale for these shipments are negotiated over an online
system. Payment may or may not be made online.
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A. What was the total value of products shipped and other
receipts for this establishment?
(Report detail in Item 22.)
14
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AF
D
R
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MA-10000 - Annual Survey of Manufactures
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2021 Annual Survey of Manufactures (ASM)
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2021 Annual Survey of Manufactures (ASM)
MA-10000 - Annual Survey of Manufactures
Item 7: Employment, Payroll, and Fringe Benefits
,
EIN:
Store / Plant:
CFN:
Include:
Full- and part-time employees working at this establishment whose payroll was reported on Internal Revenue Service Form 941, Employer's
Quarterly Federal Tax Return, and filed under the Employer Identification Number (EIN)
All persons on paid sick leave, paid holidays, and paid vacation during the year at this establishment
AF
Exclude:
Full- or part-time leased employees whose payroll was filed under an employee leasing company's EIN (Report values in Item 16, line C1.)
Temporary staffing obtained from a staffing service (Report values in Item 16, line C1.)
Purchased professional and technical services (Report values in Item 16, line C9.)
Subcontractors and their employees (Report cost of contract work in Item 16, line A3.)
Fishermen, agricultural employees, members of the Armed Forces, and pensioners carried on your active rolls
A. TOTAL EMPLOYMENT AND PAYROLL
For all employees at this establishment, what was the
D
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1. Total number of employees for pay period including
March 12?
Check
if
None
2. Total annual payroll (before deductions)?
3. Total first quarter payroll (January - March)?
2021 Number
2020 Number
2021
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ITEM 7: EMPLOYMENT, PAYROLL, AND FRINGE BENEFITS More
2020
$
,000.00
$
,000.00
$
,000.00
$
,000.00
B. PRODUCTION WORKER EMPLOYMENT AND PAYROLL
Check
if
None
2021 Number
a. March 12 (Q1)?
b. June 12 (Q2)?
c. September 12 (Q3)?
d. December 12 (Q4)?
2020 Number
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1. Production Worker Employment More
What was the number of production workers at this establishment (direct labor including first-line supervisors) for the pay period
including:
2. Production Worker Annual Payroll (before deductions) More
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MA-10000 - Annual Survey of Manufactures
2. Production Worker Annual Payroll (before deductions) More
For production workers at this establishment, what was the
Exclude: Employer-paid annual cost for fringe benefits reported in lines E1 through E3.
Check
if
None
2021
2020
$
Annual payroll (before deductions)?
,000.00
$
,000.00
3. Production Worker Quarterly Payroll
For production workers at this establishment, what was the
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2021 Annual Survey of Manufactures (ASM)
Exclude: Employer-paid annual cost for fringe benefits reported in lines E1 through E3.
2021
T
Check
if
None
$
,000.00
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AF
a. First quarter payroll (January - March)?
C. NON-PRODUCTION EMPLOYMENT AND PAYROLL
For non-production employees at this establishment, what was the
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1. Number of employees for the pay period including
March 12?
Check
if
None
2. Annual payroll (before deductions)?
3. First quarter payroll (January - March)?
2021 Number
2020 Number
2021
2020
$
,000.00
$
,000.00
$
,000.00
D. HOURS WORKED
Exclude:
Hours paid for vacations, holidays, or sick leave
unless an employee elects to work during their
vacation period. Report only actual hours worked
by such employee. Overtime hours should be
reported as actual hours worked and not as
straight-time equivalent hours.
Check
if
None
2021 Hours
2020 Hours
,000
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,000
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What was the annual number of hours worked by the
production workers at this establishment (direct
labor including first-line supervisors) reported in
line B1?
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E. EMPLOYER-PAID ANNUAL COST FOR FRINGE BENEFITS More
What were the employer's annual costs at this establishment for:
1. Health Insurance? - Insurance premiums on hospitals,
medical plans, and single-service plans such as dental,
vision, and prescription drug plans
Check
if
None
2021
$
2020
,000.00
$
,000.00
2. Retirement Plans?
$
AF
b. Defined contribution plans - Plans that define
the employer contributions to a separate account
provided for each employee. The employee
"benefit" at retirement depends on the amount
contributed and the results of the account's activity.
,000.00
Examples:
Profit sharing plans
Money purchases (e.g., 401k, 403b)
Stock bonus plans (e.g., ESOPs)
$
,000.00
,000.00
$
,000.00
$
,000.00
$
,000.00
$
,000.00
$
,000.00
3. Payroll taxes, employer-paid insurance premiums,
and other employer-paid benefits?
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Include:
Legally-required fringe benefits (e.g., Social
Security, workers compensation insurance, state
disability insurance programs, long- and short- term
disability, unemployment tax, and Medicare)
Life insurance benefits
"Quality of life” benefits (e.g., childcare assistance,
adoption assistance, subsidized commuting, longterm care insurance, flexible workplace, employerprovided home PC, etc.)
Employer contributions to pre-tax benefit accounts
(e.g., health savings account)
Education assistance
Stock options
Other benefits not specified above (e.g., job-related
travel accident insurance, education assistance,
wellness programs, fitness centers, employee
assistance programs, etc.)
Exclude:
Disbursements from trusts or funds to satisfy health
insurance claims
4. TOTAL (Add lines E1 through E3.)
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$
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a. Defined benefit pension plans (qualified and
nonqualified) - Plans that specify the benefit to be
paid to employees upon retirement, generally either
a specific amount or a percentage of compensation.
Employer contributions are based on actuarial
computations that include employee's compensation
and years of service and are not allocated to specific
accounts maintained for employees.
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2021 Annual Survey of Manufactures (ASM)
MA-10000 - Annual Survey of Manufactures
Item 9: Value of Inventories
,
EIN:
Store / Plant:
CFN:
ITEM 9: VALUE OF INVENTORIES More
What was the value of inventories owned by this establishment as of December 31 before Last-In, First-Out (LIFO) adjustment (if any) for:
Check
if
None
AF
Check
if
None
A. Finished goods (final output of this
establishment, but still within ownership)?
B. Work-in-process (goods that have been
substantially transformed in the
manufacturing process, but are not yet the
final output of the establishment)?
TOTAL (Add lines A through C.)
End of 2020
,000.00
$
,000.00
$
,000.00
$
,000.00
$
,000.00
$
,000.00
,000.00
$
,000.00
$
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C. Materials, supplies, fuels, etc. (goods that are
raw inputs to the manufacturing process and
will be substantially altered to produce this
establishment’s output)?
End of 2021
$
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Report inventories at cost or market using generally accepted accounting practices, and report all inventories owned by this establishment regardless
of where the inventories are held. If this establishment is part of a multiple-establishment company, assign to each establishment those inventories
that the establishment is responsible for as if it owned them.
19
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Item 10: Inventories by Valuation Method
,
EIN:
Store / Plant:
CFN:
ITEM 10: INVENTORIES BY VALUATION METHOD More
T
Of the $,000.00 reported in Item 9 as the total value of inventories owned by this establishment as of December 31, 2021, and the $,000.00
reported in Item 9 as the total value of inventories owned by this establishment as of December 31, 2020, how much is subject to the following
valuation methods:
AF
Check
if
None
Check
if
None
End of 2021
End of 2020
$
,000.00
$
,000.00
$
,000.00
$
,000.00
$
,000.00
$
,000.00
$
,000.00
$
,000.00
$
,000.00
$
,000.00
$
,000.00
$
,000.00
TOTAL Non-LIFO and LIFO valuation methods
(Add TOTAL of lines A1 through A4 and B.)
$
,000.00
$
,000.00
C. What is the amount of LIFO reserve (if any)?
(If the value of reserve is negative, use "-".)
$
,000.00
$
,000.00
1. First-In, First-Out (FIFO)?
2. Average Cost?
3. Standard Cost?
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4. Other non-LIFO valuation method(s)?
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A. Non-LIFO (Last-In, First-Out) valuation methods
Describe
TOTAL (Add lines A1 through A4.)
B. LIFO valuation method (gross LIFO amount)?
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Item 13: Capital Expenditures
,
EIN:
Store / Plant:
CFN:
AF
Include:
Dollar value of capital expenditures
Buildings, structures, and equipment used directly or indirectly by this establishment to produce the goods and services reported in Item 5, line
A and Item 22
What were the capital expenditures for new and used depreciable assets in 2021 for:
A. New and used buildings and other structures?
Exclude:
The value of land on which structures stand
Check
if
None
2021
2020
$
,000.00
$
,000.00
$
,000.00
$
,000.00
$
,000.00
$
,000.00
$
,000.00
$
,000.00
$
,000.00
$
,000.00
B. New and used machinery and equipment?
1. Automobiles, trucks, etc. for highway use?
3. All other expenditures for machinery and
equipment?
TOTAL (Add lines A and B1 through B3.)
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2. Computers and peripheral data processing
equipment?
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ITEM 13: CAPITAL EXPENDITURES More
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Item 14: Rental Payments
,
EIN:
Store / Plant:
CFN:
ITEM 14: RENTAL PAYMENTS More
Exclude:
Capital leases (leases with a contract to own at the end of the lease)
At this establishment, what were the payments for:
AF
A. Rental or lease of buildings and other structures?
Include:
Job-site trailers
Land on which the buildings and other structures
stand
Check
if
None
2021
2020
,000.00
$
,000.00
$
,000.00
$
,000.00
$
,000.00
$
,000.00
B. Rental or lease of machinery and equipment?
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Include:
Production, loading, and transportation machinery
and equipment
Construction equipment
Tools
Office equipment
Furniture
Vehicles
Exclude:
Computer time-sharing charges for machinery and
equipment rentals from computer service companies
where the computer is not on site at the
establishment
TOTAL (Add lines A and B.)
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$
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Include:
Operating leases
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2021 Annual Survey of Manufactures (ASM)
MA-10000 - Annual Survey of Manufactures
Item 16: Selected Expenses
,
EIN:
Store / Plant:
CFN:
ITEM 16: SELECTED EXPENSES More
1. Materials, parts, containers, packaging, supplies, etc.
used for manufacturing processes, repairs, services
Include:
AF
for others, or other operating supplies?
Cost of production-related materials purchased
by this establishment for other companies
(contractors).
Exclude:
Non-production-related expenses that were paid
to other companies (contractors) by this
establishment. (Report these expenses on the
next screen in Item 16, line C.)
3. Work done for you by others on your materials (work
contracted to others)? (Report on line A1 the cost of
production-related materials purchased by this
establishment for other companies (contractors).)
4. Purchased fuels consumed for heat, power, or the
generation of electricity? (Report on line B2 the
quantity of electricity generated (Gross less
generating station use).)
5. Purchased electricity? (Report comparable quantity
on line B1.)
TOTAL (Add lines A1 through A5.)
2021
2020
$
,000.00
$
,000.00
$
,000.00
$
,000.00
$
,000.00
$
,000.00
$
,000.00
$
,000.00
$
,000.00
$
,000.00
$
,000.00
$
,000.00
B. For this establishment, what was the quantity of:
1. Purchased electricity? (Quantity comparable to cost
reported in line A5)
2021 Kilowatt Hours
2. Generated electricity (gross less generating station
use)? (Quantity comparable to cost reported in line
A4)
2021_MA-10000_su.pdf
2020 Kilowatt Hours
,000
,000
,000
,000
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D
R
2. Products bought and sold without further processing?
(Report sales in Item 5, line A and in Wholesaling
Services product codes in Item 22.)
Check
if
None
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A. For this establishment, what were the production-related costs in 2021 for:
23
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MA-10000 - Annual Survey of Manufactures
3. Electricity sold or transferred to other
establishments? (Also include quantity on lines B1
and/or B2.)
AF
D
R
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,000
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,000
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2021 Annual Survey of Manufactures (ASM)
24
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2021 Annual Survey of Manufactures (ASM)
MA-10000 - Annual Survey of Manufactures
Item 16: Selected Expenses - Continued
,
EIN:
Store / Plant:
CFN:
T
ITEM 16: SELECTED EXPENSES
C. What were the other operating expenses paid by this establishment in 2021 for:
AF
1. Temporary staff and leased employees? (Professional
Employer Organizations and staffing agencies for
personnel)
Include:
All charges for payroll, benefits, and services
Check
if
None
2021
2020
,000.00
$
,000.00
$
,000.00
$
,000.00
$
,000.00
$
,000.00
2. Expensed equipment? (Expensed computer
hardware and other equipment)
D
R
Include:
Copiers
Fax machines
Telephones
Shop and lab equipment
CPUs
Monitors
Laptops
Tablets
Exclude:
Packaged software (Report on line C3.)
Leased and rented equipment (Report in Item
14, line B.)
3. Expensed purchases of software? (Purchases of
prepackaged, custom-coded or vendor-customized
software)
Include:
Software developed or customized by others
Web-design services and purchases
Licensing agreements
Upgrades of software
Maintenance fees related to software upgrades
and alterations
Exclude:
Costs associated with computer software
developed within your own company
Capitalized computer software costs
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$
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Include:
Expenses normally considered as non-production-related costs purchased from other companies
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MA-10000 - Annual Survey of Manufactures
4. Purchased communication services?
Include:
Telephone, cellular, and fax services
Computer-related communications (e.g.,
Internet, connectivity, online)
Other wired and wireless communication
services
Credit card transaction fees
$
,000.00
$
,000.00
5. Data processing and other purchased computer
services?
T
AF
Exclude:
Services provided by other establishments of
this company (such as a separate central data
processing unit)
Expensed integrated systems (Report in line
C4.)
Repair and maintenance of computer equipment
(Report on line C6.)
Payroll processing and credit card transaction
fees (Report payroll processing fees on line C9
and credit card transaction fees on line C4.)
Expenses for telecommunication services (e.g.,
Internet, connectivity, telephone) (Report on
line C4.)
,000.00
$
,000.00
$
,000.00
$
,000.00
D
R
$
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Include:
Computer facilities management services
Computer input preparation
Data storage
Computer time rental
Optical scanning services
Other computer-related advice and services,
including training
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2021 Annual Survey of Manufactures (ASM)
6. Purchased repairs and maintenance to buildings
and/or machinery and equipment?
Exclude:
Extensive "repairs" or reconstruction that is
capitalized. Report these as a capital
expenditure in Item 13.
Costs of materials, parts, and supplies directly
incurred by this establishment using its own
work force to perform repairs and maintenance
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Include:
Repairs for painting, roof repairs, replacing
parts, over-hauling of equipment, and other
repairs chargeable as current operating costs
Cost of repair and maintenance of any leased
property if this establishment assumes the cost
26
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2021 Annual Survey of Manufactures (ASM)
MA-10000 - Annual Survey of Manufactures
7. Water, sewer, refuse removal, and other non-electric
utility payments?
(Report electric utility payments on line A5. If the
costs of these utilities are included in a lease or rental
payment, report in Item 14, line A.)
Include:
Cost of hazardous waste removal or treatment
T
$
AF
8. Purchased advertising and promotional services?
,000.00
$
,000.00
Include:
Marketing and public relations services
Exclude:
Salaries paid to employees of this establishment
for advertising work
,000.00
$
,000.00
$
,000.00
$
,000.00
$
,000.00
$
,000.00
9. Purchased professional and technical services?
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Include:
Management consulting
Accounting
Auditing
Bookkeeping
Legal
Actuarial
Payroll processing
Architectural
Engineering
Other professional services (i.e. janitorial,
security, or landscape services)
Exclude:
Salaries paid to your own employees for these
services (Report in Item 7.)
10. Governmental taxes and licensing fees? (Payments
to government agencies for taxes and licenses)
Include:
Business and property taxes
Exclude:
Income taxes
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$
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Exclude:
Cost of refuse removal services if included in
rental payments
Machinery or equipment reported as a capital
expenditure in Item 13
Cost of salaries paid to employees of this
establishment whose work involves refuse
removal and/or hazardous waste removal or
treatment
27
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MA-10000 - Annual Survey of Manufactures
11. All other operating expenses not reported
elsewhere?
Exclude:
Purchases of merchandise for resale
Non-operating expenses
Other expenses reported in Items 7, 13, 14,
and 16
$
,000.00
$
,000.00
$
,000.00
$
,000.00
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2021 Annual Survey of Manufactures (ASM)
Describe
AF
D
R
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TOTAL (Add lines 1 through 11.)
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2021 Annual Survey of Manufactures (ASM)
MA-10000 - Annual Survey of Manufactures
Item 17: Principal Business or Activity
,
EIN:
Store / Plant:
CFN:
ITEM 17: PRINCIPAL BUSINESS OR ACTIVITY
T
Which ONE of the following best describes this establishment's principal kind of business or activity in 2021?
D
R
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AF
If none of the provided selections seem appropriate or selection options are not provided, provide a specific description to search for an appropriate
business activity.
Select only ONE.
29
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2021 Annual Survey of Manufactures (ASM)
MA-10000 - Annual Survey of Manufactures
Item 22: Detail of Sales, Shipments, Receipts, or Revenue
,
EIN:
Store / Plant:
CFN:
ITEM 22: DETAIL OF SALES, SHIPMENTS, RECEIPTS, OR REVENUE
T
Of the $,000.00 of Sales, Shipments, Receipts, or Revenue reported in Item 5, what was the value of each product or service?
General – Please do not combine product lines. If the information is not directly available from your records, reasonable estimates are
acceptable.
AF
Manufacturing of Products – Report the value of the products shipped and services performed at the net selling value, free on board (FOB) plant to
the customer, after discounts and allowances.
Include:
Products made elsewhere by others from materials supplied by this establishment. Report these products on the specific lines as if they were
made in this establishment.
Products transferred to other establishments within your company. These products should be assigned the full economic value (market value);
i.e., include all direct costs of production and a reasonable proportion of all other costs and profits.
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Exclude:
Wholesale products (previously Resales), which include products that are bought from other establishments or transferred from other
establishments of your company and then sold without further manufacture, processing, or assembly by this establishment. Report
Wholesale products in any relevant prelisted product code, click the "Add Product Not Listed" button and search for an existing Wholesale
product, or use the section for "Add product not listed above (you can only add one at a time)."
Products made from materials owned by others (i.e., the customer). Report your commission or contract receipts in the appropriate
Contract Manufacturing product line(s).
Freight charged
Excise taxes
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The manufactured products and services listed below are generally made in your industry. If you make products or have revenue from sources not
listed, click the “Add Product Not Listed” button and search for an existing product, or use the section for “Add product not listed above (you can only
add one at a time).”
30
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2021 Annual Survey of Manufactures (ASM)
MA-10000 - Annual Survey of Manufactures
Item 28: Industrial Robots and Robotic Equipment
,
EIN:
Store / Plant:
CFN:
AF
INDUSTRIAL ROBOTIC EQUIPMENT
Industrial robotic equipment (or industrial robots) are automatically controlled, reprogrammable, and multipurpose machines used in the
industrial automated operations.
Industrial robots may be mobile, incorporated into stand-alone stations, or integrated into a production line.
An industrial robot may be part of a robotic cell (or work cell) or incorporated into another piece of equipment.
Industrial robots are commonly used in operations such as welding, material handling, machine tending, dispensing, cleanroom, and pick and
place.
REPORTING INDUSTRIAL ROBOTIC EQUIPMENT
Estimates are acceptable.
In (A), report capital expenditures for new and used industrial robotic equipment for this establishment. Include other one-time costs, including
software and installation.
In (B) and (C), report the number of industrial robots in operation at this establishment and purchased for this establishment.
For robots purchased as part of a work cell or other integrated robotic equipment, it may not be possible to report the expenditures on only the
robots. In this case, report the expenditures on the integrated robotic equipment.
Exclude:
Automated guided vehicles (AGVs)
Driverless forklifts
Automated storage and retrieval systems
CNC machining equipment
A. What were the capital expenditures for new and used
industrial robotic equipment, including software,
installation, and other one-time costs?
B. What was the number of industrial robots IN OPERATION
at this plant? Refer to instructions above for definitions.
If you are unable to provide the number of industrial robots
IN OPERATION, please explain:
Check
if
None
2021
$
2021 Number
2021_MA-10000_su.pdf
2020
,000.00
$
2020 Number
,000.00
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D
R
Examples of operations industrial robotic equipment can perform may include:
Palletizing
Pick and place
Machine tending
Machine handling
Dispensing
Welding
Packing/repacking
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T
ITEM 28: INDUSTRIAL ROBOTS AND ROBOTIC EQUIPMENT
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AF
D
R
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T
C. What was the number of industrial robots PURCHASED for
this plant? Refer to instructions above for definitions.
If you are unable to provide the number of industrial robots
PURCHASED, please explain:
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MA-10000 - Annual Survey of Manufactures
Item 31: Remarks
,
EIN:
Store / Plant:
CFN:
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2021 Annual Survey of Manufactures (ASM)
ITEM 31: REMARKS (Optional - Enter remarks only if necessary)
AF
D
R
You have 1000 characters remaining
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T
Please use this space only for any explanations that may be essential in understanding your reported data. (Maximum length is 1,000 characters.)
33
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MA-10000 - Annual Survey of Manufactures
Item 32: Number of Establishments
,
EIN:
Store / Plant:
CFN:
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ITEM 32: NUMBER OF ESTABLISHMENTS
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R
AF
How many establishments operated under EIN at the end of 2021?
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T
2021
34
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MA-10000 - Annual Survey of Manufactures
Item 32: Establishment Information
ITEM 32: ESTABLISHMENT INFORMATION
CFN
Name
Store/Plant
City, town, village, etc.
AF
Number and Street
State
ZIP Code
Select State or Territory
99999-9999
Describe kind of business at this location
D
R
For employees that worked at more than one location, report the employment and payroll data for employees at the ONE location
where they spent most of their working time.
2021
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Secondary Name
What was the number of employees for pay period including March 12?
2021
What was the annual payroll?
$
What was the first quarter payroll (January - March 2021)?
$
What were the sales, shipments, receipts, or revenue?
$
2021
,000.00
2021
,000.00
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,000.00
35
| File Type | application/pdf |
| File Modified | 2021-08-30 |
| File Created | 2021-01-04 |