BLS 230 B Form

Bureau of Labor Statistics
U.S. Import I Export Price Information

U.S. Department of Labor
0MB No. 1220·0025

The �,\: ot �!>:,r statistks, its -em.pbye-i:.s, 2;-�r.b, .,n,3- �rtr.er �:Heti:,1 :i�i:�s. wiH �: � ir.te.rm. ,-ti:r, you prov� r�r sti,thli::ii purp,:,.s:.s ordy .sri4 wiH f'-eU �
in'torm,!or, in conri!!=ftiCe to ct•.c tQ.b u�rt permitt:O by In,. In ,-::=rd,na: with tf'R Cor,M!!ntisl tntcrmatQn ?rot:alon ult S:t:itistal Erttc:i=I\C)' � (44 U.S.C, 3$71) :ind
oU,-u •pplie.011 ,.,d:ar1I t1w1, your rupo-""' ...,111 not ba a,ICkPn4 ln 1C,,.tirl,os1, rOffl'I w,�t yoi.r ,nf0ffll10 eon.uf'lt, Pu tl'-1 l'1C1tr1I Cyl>tl'HC11Nty en.tl1M:1l"l1.l"tt .4rou;l'I cybc�i:ci.nt'y .s::n:CJ'Urg or lnlri:.m.ith:d data.
Pi.li: n:p-:rt� bi.ricu, 1 220·002S, l Mu, Av, Ne,
W:�;l◊n, DC 20212. T� OMS e◊r,trcl number !or t??'$ volunbry $U:rvcy t$ 1220·0025. With�t: cu�.r:tty v.,tid num.�r SIS wo\,dd r.:t � :bl: b �v:t thi$ swv:y.

Quole No:

Schedule:

SCG: __________

TSUSA / Sched B:

MuttipleHtt:

Item Description

If off.cycle, mark
monlh(s) priced:

-----

(Number of OuotesReprueMed)

JAIi

FEB

MAR APR MAY JUH

Price related to size of order:
Price related to class of buyer/seller:

JUL

AUG SEP

OCT HOV

DEC

------------------------

D Market Sale

□
D
□
D

Intra-Co Transfer

Market-Based
Cost-Based

Other
Unknown

Price, Duty and Discounts
Date:

Currency of Price:

Price:

Unit Priced:

Price Basis:

Country imported from/counlry of destination:___________

Imports only Duty:$ _____
(If Included In CIF prlee)

Discounts
Type:
Amount: _____

Already deducted?
Amount Currency: ________

%:

Type: _____________Already deducted?
Amount:
Comments:

BLS-230

Amount Currency:

%:

-----------