Report forms for the 2007 Ecomomic Census Covering the Manufacturing Sector

Source: FRESHLY ASSEMBLED; layout IN SYNC as of 05-Feb-2007 08:35:26
Item: Questionnaire MA-10000 - 2007 ANNUAL SURVEY OF MANUFACTURES :
Media: PAPER / LETTER (8 1/2 X 11)
Status: UNLOCKED (DRAFT)
User: PARKE343
EMR: EQCPRD / 6.05.16.13.33.55
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Date: 05-Feb-2007 08:35:21

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2007 ANNUAL SURVEY OF MANUFACTURES

U.S. DEPARTMENT OF COMMERCE
Economics and Statistics Administration

U.S. CENSUS BUREAU
FORM

MA-10000

OMB No. : Approval Expires

(DRAFT)

DUE DATE
FEBRUARY 12, 2008
Mail your completed form to:
U.S. CENSUS BUREAU
1201 East 10th Street
Jeffersonville, IN 47134-0001
Please read the accompanying
information sheet(s) before
answering the questions.
Need help or have questions
about filling out this form?
Visit www.census.gov/econhelp
Call 1-800-233-6136, between
8:00 a.m. and 6:00 p.m., Eastern
time, Monday through Friday.
- OR Write to the address above.
Include your 11-digit Census File
Number (CFN) printed in the
mailing address.

(Please correct any errors in this mailing address.)

YOUR RESPONSE IS REQUIRED BY LAW. Title 13, United States Code, requires businesses and other organizations
that receive this questionnaire to answer the questions and return the report to the U.S. Census Bureau. By the same
law, YOUR CENSUS REPORT IS CONFIDENTIAL. It may be seen only by persons sworn to uphold the confidentiality
of Census Bureau information and may be used only for statistical purposes. Further, copies retained in respondents'
files are immune from legal process.
• Use blue or black ballpoint pen. • Please center numbers in their respective boxes.
• Do not use pencil or felt-tip pen. • Do not put slashes through 0 or 7.
• Place an "X" inside the box.
• Complete only the unshaded portion of each item.

Examples:

0 1 2 3 4 5 6 7 8 9

The reporting unit for this form is an establishment. An establishment is generally a single physical location
where business is conducted or where services or industrial operations are performed. For further clarification, see
information sheet(s).
EMPLOYER IDENTIFICATION NUMBER
Is the Employer Identification Number (EIN) shown in the mailing address the same as the one used for this
establishment on its latest 2007 Internal Revenue Service Form 941, Employer's Quarterly Federal Tax Return?
Yes - Go to

0021

2

2

No - Enter current EIN (9 digits)

0022

-

0025

PHYSICAL LOCATION
A. Is this establishment's physical location the same as shown in the mailing address?
(P.O. Box and rural route addresses are not physical locations.)
0031

0032

Yes - Go to line B
No - Enter
physical
location

0035

Number and street

0036

City, town, village, etc.

0037

State

0038

ZIP Code

B. Is this establishment physically located inside the legal boundaries of the city, town, village, etc.?
(Mark "X" only ONE box.)
0041

Yes

0042

No

0043

No legal boundaries

0044

Do not know

C. In what type of municipality is this establishment physically located? (Mark "X" only ONE box.)
0046

City, village, or borough

PENALTY FOR FAILURE TO REPORT

USCENSUSBUREAU

0047

Town or township

0048

Other

0024

Do not know

CONTINUE ON PAGE 2

10000016

1

Form MA-10000
3

Page 2

(DRAFT)

OPERATIONAL STATUS
Which of the following best describes this establishment's operational status at the end of 2007?
(Mark "X" only ONE box.)
0011

In operation

0016

Under construction, development, or exploration

0013

Temporarily or seasonally inactive

0014

Ceased operation - Give date at right

0015

0018

Month

Day

Year

Sold or leased to another operator - Give date at right AND
enter name and address of new owner or operator and
Employer Identification Number (EIN) below
6030

Name of new owner or operator

0061 EIN

(9 digits)

6031

Mailing address (Number and street, P.O. Box, etc.)

6032

City, town, village, etc.

6033

State

6034 ZIP

Code

4

Mark "X" 2007
if None Number

MONTHS IN OPERATION
Number of months in operation during 2007 (If none, mark "X" and go to 30 .) . . . . . . . . . . . .

HOW TO
REPORT
DOLLAR
FIGURES

Mark "X"
if None $ Bil.

If a figure is $1,025,628.79:

Report

If a value is "0" (or less than $500.00):

Report

2007
Mil.

Thou.

1 0 2 6

SALES, SHIPMENTS, RECEIPTS, OR REVENUE
Mark "X"
if None $ Bil.

A. Total value of products shipped and other receipts
(Report detail in 22 .) . . . . . . . . . . . . . . . . . .

2007
Mil.

2006
Thou.

$ Thou.

0100

B. Value of products exported (This is a breakout of the
value reported on line A.)
Report the value of products shipped for export. Include
shipments to customers in the Panama Canal Zone, the
Commonwealth of Puerto Rico, and U.S. possessions,
as well as the value of products shipped to exporters
or other wholesalers for export. Also, include the value
of products sold to the U.S. Government to be shipped
to foreign governments. Exclude products shipped for
further manufacture, assembly, or fabrication in the
United States. . . . . . . . . . . . . . . . . . . . . .
C. Shipments to other domestic plants of your company for
further assembly, fabrication, or manufacture

0130

10000024

5

Dollar figures should be rounded to
thousands of dollars.

0002

1. Is this the only establishment of this firm?
0907

Yes - Go to

0908

No - Go to line C2

6

2. Market value of products shipped to other domestic
plants of your company for further assembly,
fabrication, or manufacture (This is a breakout of the
value reported on line A.) . . . . . . . . . . . . . .

0905

CONTINUE ON PAGE 3

Form MA-10000

Page 3

(DRAFT)

If not shown, please enter your 11-digit Census File
Number (CFN) from the mailing address.
6

E-SHIPMENTS
A. Did this plant use any electronic network to control or coordinate the flow of any of the shipments of goods reported
in 5 , line A? Or, were the orders for any of the shipments reported in 5 , line A received over an electronic network?
Electronic networks include:
• Electronic Data Interchange (EDI)
• E-mail
• Internet
0181

Yes - Go to line B

• Extranet
• Other online systems
No - Go to

0182

7

B. Percent of total reported in , line A that were ordered, or whose movement was
controlled or coordinated over electronic networks (Report whole percents. Estimates
are acceptable.) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

2007
Percent

5

%

%

EMPLOYMENT AND PAYROLL
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) shown in the mailing address or corrected in 1 .
Exclude:
• Full- or part-time leased employees whose payroll was filed under an employee leasing company's EIN.
• Temporary staffing obtained from a staffing service.
For further clarification, see information sheet(s).
A. Number of employees

Mark "X"
if None

1. Number of production workers for pay periods including:
a. March 12 . . . . . . . . . . . . . . . . . . . . . . .

0325

b. June 12 . . . . . . . . . . . . . . . . . . . . . . . .

0324

c. September 12 . . . . . . . . . . . . . . . . . . . . .

0344

d. December 12

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

0347

2. Add lines A1a through A1d . . . . . . . . . . . . . . .

0329

3. Average annual production workers (Divide line 2 by 4 omit fractions.) . . . . . . . . . . . . . . . . . . . . . .

0335

4. All other employees for pay period including March 12 . . .

0336

5. TOTAL (Add lines A3 and A4) . . . . . . . . . . . . . . .

0337

B. Payroll before deductions (Exclude employer's cost for
fringe benefits.)

Mark "X"
if None $ Bil.

1. Annual payroll
a. Production workers . . . . . . . . . . . . . . .

0304

b. All other employees . . . . . . . . . . . . . . .

0305

c. TOTAL (Add lines B1a and B1b) . . . . . . . . .

0300

2. First quarter payroll (January-March 2007) . . . . . .

0310

Mark "X"
if None

C. Number of hours worked by production workers (Annual hours
worked by production workers reported on lines A1a through
A1d.) . . . . . . . . . . . . . . . . . . . . . . . . . . . .
CONTINUE WITH

7

2007
Number

2007
Mil.

Thou.

2006
Number

2006
$ Thou.

10000032

7

0109

2006
Percent

2007
Hours

2006
Hours

Thou.

Thou.

0200

ON PAGE 4
CONTINUE ON PAGE 4

Form MA-10000
7

Page 4

(DRAFT)

EMPLOYMENT AND PAYROLL - Continued
D. Employer's cost for fringe benefits - Employer's cost for
legally required programs and programs not required
by law.
1. Health insurance - Insurance premiums on
hospitals, medical plans, and single service plans
such as dental, vision, and prescription drug plans.
Include premium equivalents for self-insured plans
and fees paid to third party administrators (TPAs). Do
not include employee contributions. . . . . . . . . .

Mark "X"
if None $ Bil.

2007
Mil.

2006
$ Thou.

Thou.

0333

2. Pension plans
a. Defined benefit pension plans - Costs for both
qualified and unqualified defined pension plans.
Pension 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 the employee's
compensation and years of service and are not
allocated to specific accounts maintained for
employees. . . . . . . . . . . . . . . . . . . .

0335

b. Defined contribution plans - Costs under
defined contribution plans. Pension 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. Examples include profit sharing
plans, money purchase (e.g., 401k, 403b) and stock
bonus plans (e.g., ESOPs) . . . . . . . . . . . .

0337

3. Other - Other fringe benefits (e.g., Social Security,
workers' compensation insurance, unemployment
tax, state disability insurance programs, life insurance
benefits, Medicare) . . . . . . . . . . . . . . . . .

0339

4. TOTAL (Add lines D1 through D3) . . . . . . . . . .

0220

8

Not Applicable.

9

VALUE OF INVENTORIES
A. Did this establishment own inventories, regardless of where held, at the end of 2007 and/or 2006?
Yes - Go to line B

0489

No - Go to 13

B. Report inventories owned by this
establishment as of December
31 before Last-in, First-out (LIFO)
adjustment (if any)

Mark "X"
if None $ Bil.

End of 2007
Mil.
Thou.

Mark "X"
if None $ Bil.

1. Finished goods . . . . . . . . .

0461

0471

2. Work-in-process . . . . . . . . .

0463

0473

3. Materials, supplies, fuels, etc.. . .

0462

0472

4. Total inventories (Add lines B1
through B3) . . . . . . . . . . .

0460

0470

5. LIFO reserve (if any) . . . . . . .

0466

0476

6. Total inventories after LIFO
adjustment (Line B4 minus line
B5) . . . . . . . . . . . . . . .

0490

0492

End of 2006
Mil.
Thou.

10000040

0488

CONTINUE ON PAGE 5

Form MA-10000

Page 5

(DRAFT)

If not shown, please enter your 11-digit Census File
Number (CFN) from the mailing address.
10 INVENTORIES BY VALUATION METHOD
Report how much of the inventory reported
in 9 , line B4 is subject to the following
valuation methods.

Mark "X"
if None $ Bil.

End of 2007
Mil.
Thou.

Mark "X"
if None $ Bil.

A. LIFO valuation method before
adjustment . . . . . . . . . . . . .

0465

0475

B. First-in, First-out (FIFO)

. . . . . . .

0498

0496

C. Average cost . . . . . . . . . . . .

0502

0500

D. Standard cost . . . . . . . . . . . .

0506

0504

0487

0485

0510

0508

End of 2006
Mil.
Thou.

E. Other valuation method - Specify
method
0895

F. TOTAL (Add lines A through E. Total
should equal 9 , line B4.) . . . . . .

11 INVENTORIES OUTSIDE OF THE UNITED STATES
A. Of the total inventories reported in
the District of Columbia?
0256

Yes - Go to line B

0257

No - Go to 13

9

, line B4 were any stored or en route OUTSIDE the 50 U.S. states and

B. Report the total value of these
inventories (Do not report
inventory held in Foreign Trade
Zones or in bond warehouses in the
U.S.) . . . . . . . . . . . . . . . .

Mark "X"
if None $ Bil.
0261

End of 2007
Mil.
Thou.

Mark "X"
if None $ Bil.

End of 2006
Mil.
Thou.

0260

10000057

12 Not Applicable.

CONTINUE ON PAGE 6

Form MA-10000

Page 6

(DRAFT)

13 ASSETS, CAPITAL EXPENDITURES, RETIREMENTS, AND DEPRECIATION
(Refer to the instructions on how to report leasing arrangements.)

Mark "X"
if None $ Bil.

Report the dollar value of assets, capital expenditures, and depreciation
A. Gross value of depreciable assets (acquisition costs) at the beginning of the
year . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

2007
Mil.

Thou.

0500

B. Capital expenditures for new and used depreciable assets in 2007
1. Capital expenditures for new and used buildings and other structures
(Exclude land.) . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

0525

2. Capital expenditures for new and used machinery and equipment . . . . .

0530

3. TOTAL (Add lines B1 and B2) . . . . . . . . . . . . . . . . . . . . . .

0520

C. Gross value of depreciable assets sold, retired, scrapped, destroyed, etc. . . .

0510

D. Gross value of depreciable assets at the end of 2007 (Add lines A and B3
minus C) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

0505

E. Depreciation charges . . . . . . . . . . . . . . . . . . . . . . . . . . . .

0540

F. Breakdown of expenditures for new and used machinery and equipment by
type (Reported on line B2.)
1. Automobiles, trucks, etc., for highway use . . . . . . . . . . . . . . . .

0522

2. Computers and peripheral data processing equipment

. . . . . . . . . .

0523

3. All other expenditures for machinery and equipment . . . . . . . . . . .

0524

4. TOTAL (Add lines F1 through F3) . . . . . . . . . . . . . . . . . . . .

0529

14 RENTAL PAYMENTS
(Exclude capital leases (leases with a contract to own at the
end of the lease).)

Mark "X"
if None $ Bil.

A. Rental or lease of buildings, job-site trailers, and other
structures (Include land.) . . . . . . . . . . . . . . . .

0551

B. Rental or lease of construction equipment and tools,
machinery, office equipment, furniture, and vehicles . . .

0552

C. TOTAL (Add lines A and B) . . . . . . . . . . . . . .

0550

2007
Mil.

Thou.

10000065

15 Not Applicable.

CONTINUE ON PAGE 7

Form MA-10000

Page 7

(DRAFT)

If not shown, please enter your 11-digit Census File
Number (CFN) from the mailing address.
16 SELECTED EXPENSES
Mark "X"
if None $ Bil.

A. Selected production related costs
1. Cost of materials, parts, containers, packaging, etc.
used (Report detail in 17 .) . . . . . . . . . . . . . .
2. Cost of products bought and sold as such without
further processing (Report sales in 22 .) . . . . . . .
3. Cost of purchased fuels consumed for heat, power, or
the generation of electricity . . . . . . . . . . . . .
4. Cost of purchased electricity (Report quantity on line
B1.) . . . . . . . . . . . . . . . . . . . . . . . .
5. Cost of work done for you by others on your
materials . . . . . . . . . . . . . . . . . . . . .

2007
Mil.

Thou.

2006
$ Thou.

0421

0426

0430

0425

0424

6. TOTAL (Add lines A1 through A5) . . . . . . . . . . 0420

Mark "X"
if None

B. Quantity of Electricity

CONTINUE WITH

16

Bil.

Mil.

Thou.

2006
Kilowatthours
Thou.

0436

0437

0438

ON PAGE 8

10000073

1. Purchased electricity (Quantity comparable to cost
reported on line A4.) . . . . . . . . . . . . . . . .
2. Generated electricity (Gross less generating station
use.) . . . . . . . . . . . . . . . . . . . . . . . .
3. Electricity sold or transferred to other establishments
(Include on lines B1 or B2.) . . . . . . . . . . . . .

2007
Kilowatthours

CONTINUE ON PAGE 8

Form MA-10000

Page 8

(DRAFT)

16 SELECTED EXPENSES - Continued
Mark "X"
if None $ Bil.

C. Other operating expenses paid by this establishment
1.

Temporary staff and leased employee expense
- Total costs paid to Professional Employer
Organizations (PEOs) and staffing agencies for
personnel. (Include all charges for payroll, benefits
and services.) . . . . . . . . . . . . . . . . . . .

2.

Expensed equipment - Expensed computer hardware
and other equipment (e.g., copiers, fax machines,
telephones, shop and lab equipment, CPUs,
monitors). (Report packaged software on line C3.) . . 0403
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; and
maintenance fees related to software upgrades and
alterations.) . . . . . . . . . . . . . . . . . . . . 0188

3.

Thou.

0176

4.

Data processing and other purchased computer
services (Include computer facilities management
services, computer input preparation, data
storage, computer time rental, optical scanning
services, and other computer-related advice and
services, including training. Exclude expensed
integrated systems, repair and maintenance
of computer equipment, payroll processing
and credit card transaction fees, and expenses
for telecommunication services (e.g., Internet,
connectivity, telephone).) . . . . . . . . . . . . .

0198

5.

Purchased communication services - Telephone,
cellular, and fax services; computer-related
communications (e.g., Internet, connectivity, online)
and other wired and wireless communication
services. . . . . . . . . . . . . . . . . . . . . .

0427

6.

Purchased repairs and maintenance to buildings and/
or machinery and equipment (Exclude materials,
parts, and supplies used for repairs and maintenance
performed by this firm's employees.) . . . . . . . .

0401

7.

Water, sewer, refuse removal, and other utility
payments (Include the costs of hazardous waste
removal.) . . . . . . . . . . . . . . . . . . . . .

0407

8.

Purchased advertising and promotional services
(Include marketing and public relations services.) . .

0409

Purchased professional and technical services
(Include management consulting, accounting,
auditing, bookkeeping, legal, actuarial, payroll
processing, architectural, engineering, and other
professional services. Exclude salaries paid to your
own employees for these services.) . . . . . . . . . 0216

10. Governmental taxes and license fees - Payments to
government agencies for taxes and licenses. (Include
business and property taxes. Exclude income taxes.)

0405

10000081

9.

2007
Mil.

11. All other operating expenses - All other operating
expenses not reported elsewhere. (Exclude purchases
of merchandise for resale and nonoperating
expenses.) - Specify
0417

0415

12. TOTAL (Add lines C1 through C11) . . . . . . . . . 0422