SA-48T Service Annual Survey

OMB No. 0607-0422: Approval Expires XX/XX/2012

2009 Annual Services Report
Service Annual Survey

U.S. DEPARTMENT OF COMMERCE
Economics and Statistics Administration

U.S. CENSUS BUREAU

FORM

SA-48T

REPORT DUE

Any questions call 1–800–772–7851
M–F, 8:30 a.m. to 5:00 p.m. EST.

or

Please correct any error in the name, address, or ZIP Code.

Visit our web site:
www.census.gov/econhelp/sas
Internet Reporting
To complete this report online go to: www.census.gov/econhelp/sas
Click on "Census Taker" and use your username and password to login.

Username:
Password:

YOUR RESPONSE IS REQUIRED BY LAW
Title 13, U.S. Code, requires businesses and other organizations that receive this questionnaire to answer the
questions and return the report to the Census Bureau.

YOUR RESPONSE IS CONFIDENTIAL BY LAW
Title 13, U.S. Code, requires that your response may be seen only by persons sworn to uphold the confidentiality of Census
Bureau information and may be used only for statistical purposes. The law also provides that copies retained in your files are
immune from legal process.

YOUR RESPONSE IS IMPORTANT
The services industries account for nearly 70 percent of all economic activity. We conduct this survey to obtain timely,
comprehensive and consistent measures needed by policy-makers, businesses, and the public to accurately assess domestic
economic performance.

FORM asr_a_09 (4-9-2009)

USCENSUSBUREAU

Annual Services Report
•
•

This report should be completed and returned on or before the due date in the preaddressed envelope provided.
If filing within the required time frame will cause an undue burden and you would like an extension, or if you have any questions, please write to:
U.S. CENSUS BUREAU
1201 East 10th Street
Jeffersonville, IN 47132-0001
or call a Census Bureau Representative at 1–800–772–7851, weekdays from 8:30 a.m. to 5:00 p.m., Eastern Standard Time.

1 Report Coverage

Does the above coverage describe this firm’s business activity?
0001

1
2

Yes – Go to 2
No – Specify the firm’s business activity and complete the report where applicable beginning with 2 .
0002

2 Report Periods
What periods of time will this data represent?
• Report data for the 2009 and 2008 calendar years if possible.
• For locations that were sold or acquired during the year, only report for the periods that this firm operated the locations.
2009
Month

Day

2008
Year

Month

0007
0006

1

2009 and 2008 calendar years – Go to 3

2

Other than calendar year – Enter the periods
this report will cover. . . . . . . . . . . . . . . . . . . . . .
(e.g., fiscal years, periods with less than a full calendar
year).

FORM asr_b1_09 (7-21-2009)

From

From

0008

To

To

Day

Year

3 Operating Revenue
Report the total operating revenue for this firm’s locations defined in 1 for the following categories.
• Enter "0" where applicable.
• Estimates are acceptable.
Exclude:
• Transfers made within the company.

2009 Operating Revenue
Bil.
Mil.
Thou.
Dol.

1. TOTAL OPERATING REVENUE . . . . . . . . . . . . . .

4 Not Applicable

FORM asr_c1_09 (4-208-2009)

1800

$

2008 Operating Revenue
Bil.
Mil.
Thou.
Dol.

$

5 Operating Expenses
Report operating expenses for this firm’s locations as defined in 1 for the following categories.
• Enter "0" where applicable.
• Estimates are acceptable.
Exclude:
• Transfers made within the company
• Capitalized expenses
• Interest
• Bad debt
• Impairment
• Income tax

Personnel Costs
1. Gross annual payroll – Total annual Medicare salaries
and wages for all employees as reported on your firm’s
IRS Form 941, Employer’s Quarterly Federal Tax Return,
line 5(c) for the four quarters that correspond to the
survey period or IRS Form 944 Employer’s Annual
Federal Tax Return, line 4(c). . . . . . . . . . . . . . . . .

2009 Operating Expenses
Mark "X"
Bil.
Mil.
Thou.
Dol.
if None
1821

$

2. Employer’s cost for fringe benefits – Employer’s cost for
legally required programs and programs not required by law.
Include insurance premiums for hospital plans, medical
plans, and single service plans (e.g., dental, vision,
prescription drugs); premium equivalents for self-insured
plans and fees paid to third-party administrators (TPAs);
defined benefit pension plans; defined contribution plans
(e.g., profit sharing, 401K and stock option plans); and
Mark "X"
other fringe benefits (e.g., Social Security, workers’
if None
compensation insurance, unemployment tax, state disability
insurance programs, life insurance benefits, Medicare).
$
Exclude employee contributions. . . . . . . . . . . . . . . 1822
3. 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. . . . . . . . . .

Mark "X"
if None
1823

$

2008 Operating Expenses
Mark "X"
Bil.
Mil.
Thou.
Dol.
if None

$

Mark "X"
if None

$
Mark "X"
if None

$

Expensed Materials, Parts and Supplies
(not for resale)
4. Expensed equipment – Expensed computer hardware
and other equipment (e.g., copiers, fax machines,
telephones, shop and lab equipment, CPUs and monitors).
Report packaged software in line 6. Report leased and
rented equipment in line 8. . . . . . . . . . . . . . . . . .
5. Expensed purchases of other materials, parts, and
supplies – Materials and supplies used in providing
services to others; materials and parts used in repairs;
office and janitorial supplies; small tools; containers and
other packaging materials. Report the cost of motor
fuels in line 11. . . . . . . . . . . . . . . . . . . . . . . . .

Mark "X"
if None
1824

$

Mark "X"
if None

Mark "X"
if None

$

Mark "X"
if None

$

$

6. Expensed purchases of software – Purchases of prepackaged, custom coded, or vendor customized software.
Mark "X"
Include software developed or customized by others,
web-design services and purchases, licensing agreements, if None
upgrades of software; and maintenance fees related to
$
software upgrades and alterations. . . . . . . . . . . . . . 1826

Mark "X"
if None

Mark "X"
7. Purchased electricity and fuels (except motor fuels) – If if None

Mark "X"
if None

1825

Expensed Purchased Services

the cost of electricity and heating fuels (e.g., natural gas,
propane, oil, coal) are included in lease or rental
payments, report in line 8 . . . . . . . . . . . . . . . . . .

1827

$

8. Lease and rental payments – For land, buildings, offices,
structures, machinery, equipment, and other tangible items. Mark "X"
Include lease and rental of transportation equipment with- if None
out operators; and penalties incurred for broken leases.
Exclude capital and financing lease agreements and
$
licensing/leasing of software. . . . . . . . . . . . . . . . . 1828
FORM asr_484_g3_09 (5-20-2009)

$

$

Mark "X"
if None

$

5 Operating Expenses
Report operating expenses for this firm’s locations as defined in 1 for the following categories.
• Enter "0" where applicable.
• Estimates are acceptable.
Exclude:
• Transfers made within the company
• Capitalized expenses
• Interest
• Bad debt
• Impairment
• Income tax

Expensed Purchased Services – (Continued)
2009 Operating Expenses
9. Purchased freight transportation – Contract payments
Mark "X"
Bil.
Mil.
Thou.
Dol.
to railroads, airlines, waterborne, and other motor
if None
carriers. Report the cost of leased and rented
transportation equipment without operators in line 8.
$
Report travel expenses in line 16. . . . . . . . . . . . . . 5097

10. Purchased repair and maintenance – Expensed repair
and maintenance services to motor vehicles, vessels,
aircraft and other transportation equipment; machinery,
equipment, and computer hardware; integral parts of
Mark "X"
building (e.g., elevators, heating systems, etc.) Exclude if None
materials, parts and supplies used for repairs and
maintenance performed by this firm’s employees. Report
$
janitorial and grounds maintenance services in line 16. . 1829
Mark "X"
if None
11. Purchased fuels for transportation equipment –
Gasoline and fuels purchased for trucks, truck-tractors,
and other motor vehicles. . . . . . . . . . . . . . . . . . . 5098

Other Operating Expenses

1830

5099

FORM asr_484_g4_09 (7-21-2009)

$
Mark "X"
if None

$

$

16. All other operating expenses – All other operating
expenses not reported above, unless specifically
Mark "X"
excluded in the general instructions at the top of the
if None
page. Include office postage and package delivery.
Exclude purchases of merchandise for resale and
$
nonoperating expenses. . . . . . . . . . . . . . . . . . . . 1899

6 Not Applicable

$

$

Mark "X"
15. Governmental taxes and license fees – Payments to
if None
government agencies for taxes and licenses. Include
business and property taxes. Exclude income taxes,
$
and sales and excise taxes collected from customers. . . 1832

1900

$

Mark "X"
if None

14. Depreciation and amortization charges – Include
depreciation charges taken against tangible assets
owned and used by your firm, tangible assets and
Mark "X"
improvements owned by your firm within leaseholds,
if None
tangible assets obtained through capital lease
agreements, and amortization charges against intangible
$
assets (e.g., patents, copyrights). Exclude impairment. . 1831

17. TOTAL OPERATING EXPENSES – Sum of lines 1–16. . .

Mark "X"
if None

$

Mark "X"
if None

13. Cost of insurance – Premiums for bonding and
insurance not included in line 2. . . . . . . . . . . . . . .

$

Mark "X"
if None

Mark "X"
if None

12. Purchased advertising and promotional services –
Include marketing and public relations services. . . . . .

2008 Operating Expenses
Bil.
Mil.
Thou.
Dol.

Mark "X"
if None

$

Mark "X"
if None

$
Mark "X"
if None

$

Mark "X"
if None

$

$

11 Change in Structure
Did you have an Employer Identification Number (EIN) change in 2009 or 2008?
0015
0013

Yes – Enter the new EIN. . . . . . . . . . . . . .
No – Continue

1
2

EIN

–

Month

Was there a change in ownership or control?
1

Yes – Provide the date of the change and the firm’s information. . . . . . . . . . . . . . . . . . . . .
(for multiple mergers, provide each firm’s information as an attachment to this report)

2

No – Go to 12

0016

0017

Year

0018

Name of company acquired or merged with

Street address

City, State, ZIP Code

0019
EIN

–

Specify the nature of this change here
0035

12 Remarks –

Please provide an explanation for any inconsistent or incomplete data that would aid in understanding this report.
For any separate correspondence pertaining to this report, please include the identification number shown in the
address label area at the top of the first page.

0027

13 Certification – This report is substantially accurate and has been prepared in accordance with the instructions.
0020 Name of person completing this report – Please print

0024 Title

0025 Date

0021 Address (Street address, City, State, ZIP Code)

0022 Telephone number
Area code

Number

Return Completed form to:
U.S. CENSUS BUREAU
1201 East 10th Street
Jeffersonville, IN 47132-0001
or fax to: 1–800–447–4613

0023 Fax number
Extension

Area code

0026 E-mail address

Number

Public reporting burden for this collection of information is estimated to average
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. Send comments regarding this burden estimate or any other aspect of this collection of
information, including suggestions for reducing this burden, to: Paperwork Project 0607-0422, U.S. Census Bureau, 4600
Silver Hill Road, AMSD-3K138, Washington, DC 20233. You may e-mail comments to Paperwork@census.gov; use
"Paperwork Project 0607-0422" as the subject. Please include form name and number in all correspondence. Respondents
are not required to respond to any information collection unless it displays a valid approval number from the Office of
Management and Budget. This 8-digit number appears in the top right corner on the front of this form.

To see aggregate industry results of previous Service Annual Surveys, go to the following website: www.census.gov/services/index.html
FORM asr_z1_09 (5-20-2009)