WS Form 45 WS Resource Values Survey

OMB Control No. 0579-XXXX

1.
SELLER/DEALER

SURVEY FOR COLLECTING PRICES FOR MIS RESOURCES PROTECTED
2.
3.
4.
5.
6.
CONTACT INFO
RESOURCE (Product)
PRICE
UOM
DATE

7.
COMMENTS

INSTRUCTIONS FOR GATHERING PRICES FOR MIS RESOURCES PROTECTED
1. While canvassing for prices on www, advertisements or other sources, enter the Seller/Dealer name and Contact Info in columns 1 & 2, respectively. Enter the name of the resource / product
you will be requesting pricing etc. about in column 3.
2. Call or e-mail the respondent and ask for a price quote on the resource / product for a specific UOM (Unit of Measure: each, per 100, feet, yards, square foot, pounds, tons, etc.)
3. Enter UOM and price in columns 4 & 5, respectively
4. Enter date in column 6 as mm/dd/yy.
5. Enter any comments needed in column 7.
According
to the(2007)
Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless it displays a valid OMB control number. The valid OMB control number for this information collection is 0579-XXXX. The time
WS
FORM XXX
required to complete this information collection is estimated to average .053 minutes/hours per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and
reviewing the collection of information.

WS FORM 45 (2007)