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Attachment 1
Page 1 of 8
OMB No. : Approval Expires
BUSINESS AND PROFESSIONAL
CLASSIFICATION REPORT
Economics and Statistics Administration
U.S. CENSUS BUREAU
FORM
SQ-CLASS(00) (DRAFT)
Due Date
DRAFT
Need help or have questions?
Call 1-800-253-1882
(8:30 a.m. - 5:00 p.m. ET, M-F)
or
Visit econhelp.census.gov/sqclass
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.
(Please correct any error in name, address, and ZIP code)
Return via Internet:
econhelp.census.gov/sqclass
User ID:
Return via Mail:
U.S. Census Bureau
1201 East 10th Street
Jeffersonville, IN 47132-0001
Return via Fax:
1-800-447-4613
Password:
INSTRUCTIONS - This report covers this firm's locations in the United States that report payroll under the Federal
Employer Identification Number (EIN) printed above.
If this EIN has changed, complete this form for the locations that previously used it to report payroll. If all the locations have
been closed or sold, base your answers on the last two months of operation. Use the space in 12 to explain these or any other
special instructions.
1
Which of the following best describes this firm's primary business?
10050011
See attached instruction sheet.
Retail Trade
Administrative and Support and Waste Management
and Remediation Services
Wholesale Distributor (i.e., distributor, jobber,
importer, exporter)
Accommodation and Food Services
Manufacturers' sales branch or sales office (selling
goods manufactured, refined, or mined in the
United States by this firm, this firm's parent
company, or subsidiary)
Finance and Insurance Services
Agent, broker, or electronic market (buying and
selling on a commission basis)
Health Care and Social Assistance Services
Transportation and Warehousing Services
Other Services
Real Estate and Rental and Leasing Services
Manufacturing
Professional, Scientific, and Technical Services
Utilities
Arts, Entertainment, and Recreation Services
Other Area of Business (such as Agriculture, Fishing,
Mining, Construction, Forestry, etc.) - Specify
PENALTY FOR FAILURE TO REPORT
Information and Data Processing Services
CONTINUE ON PAGE 2
Attachment 1
Page 2 of 8
Form SQ-CLASS(00)(DRAFT)
2
Page 2
What is this firm's primary business activity?
Be specific.
For example:
• For retail book stores, specify the following: general
bookstore, college bookstore, or specialty bookstore.
• Enter "fast food restaurant" rather than "restaurant."
• Enter "custom computer programming" rather than
"computer services."
• For computer stores, specify one or more of the
following: end use, for resale, custom assembly,
used, value added reseller.
3
What are this firm's principal lines of merchandise
sold, services provided, or products manufactured,
and on average, what percent of total monthly
revenues are from each of these lines?
For example, restaurants that sell only food and alcoholic
beverages should report in the following manner -
Principal product and
service lines
% of total
revenues
• Food . . . . . . . . . . . . . . . . . . . . . . . . . 69%
1
• Alcoholic beverages consumed on the premises
. . . . 31%
2
3
Total . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
100%
4 Does this firm have revenues from e-commerce?
028
E-commerce includes sales, receipts, and contributions
from any transaction completed over an Internet,
extranet, EDI network, electronic mail, or other online
system. Transactions are agreements between buyers
and sellers to transfer ownership of, or rights to use,
goods or services. Payment for these goods and
services may or may not be made online.
5
• Estimates are acceptable.
• Include revenues from e-commerce.
10050029
2
Yes - On average, what
percent of total monthly
revenues are e-commerce
revenues?
029
%
No
What was this firm's total operating revenue for the months
specified?
See additional instructions on attached
instruction sheet.
6
1
Month
Mil.
006
007
008
009
Thou.
Dol.
Cents
$
$
a. Is this firm operated on a not-for-profit basis?
031
1
Yes - Go to
6b
2
No - Go to
7
b. Was all or part of the income of this firm or organization exempt from
Federal income taxes under section 501 of the Internal Revenue Code?
032
1
Yes
2
No
CONTINUE ON PAGE 3
Form SQ-CLASS(00)(DRAFT)
Attachment 1
Page 3 of 8
Page 3
INSTRUCTIONS - If this firm operates as a Wholesale Distributor or a Manufacturer's Sales Branch - Go to
If this firm operates in Retail Trade - Go to 8 .
If this firm operates in Other Areas of Business - Go to 9 .
7
• Estimates are acceptable.
• Include goods owned regardless of where held.
• Exclude goods not for sale (such as
fixtures, equipment, and supplies) and
goods owned by others and held on
consignment.
a.
Dol.
Date of inventory
Month
Year
017
Store or display showroom (selling from a fixed
or permanent location with physical displays of
priced merchandise and/or from a counter)
023
024
020
Warehouse or office (including
telephone/fax/Internet orders or direct
business-to-business selling by a sales
representative)
Home shopping via television
Direct selling to the general public
(selling in a face-to-face manner
away from a fixed location, such
as house-to-house, party plan, or
temporary kiosk sales)
021
Mail-order
025
Vending machines
022
E-commerce
042
Other - Specify
b.
As a general business practice, does this firm sell to household consumers and individual users?
1
2
c.
Yes
On average, what percent of total monthly sales are to household
consumers and individual users? . . . . . . . . . . . . . . . . . . . .
018
%
No
Does this firm sell to retailers/wholesalers for resale?
026
1
Yes
2
No
On average, what percent of total monthly sales were for resale? . . .
030
%
Does this firm primarily sell nonconsumer durable goods (such as: industrial machinery,
farm equipment, construction machinery, heavy trucks, and tractors)?
d.
027
10050037
Thou.
016
What is this firm's primary method of selling?
Mark (X) one box only.
019
9
.
What were this firm's inventories at the end of the latest month
printed in 5 or the latest period available? Specify date of inventory.
Mil.
8
7
1
Yes
2
No
Is this firm owned or controlled by another company?
A firm is owned or controlled if another domestic company owns more than 50 percent of the voting stock of that firm,
or if another domestic company has the power to direct or cause the direction of the management or policies of that
firm. Do not list as a controlling company, the company for which you operate a franchise.
1
2
Yes - Enter the name, mailing
address, and EIN of the owning or
controlling company.
010
No
EIN
CONTINUE ON PAGE 4
Attachment 1
Page 4 of 8
Form SQ-CLASS(00)(DRAFT)
Page 4
10 Does this firm own or control any other company that operates under a different EIN?
A company is owned or controlled if another domestic firm owns
more than 50 percent of the voting stock of that company, or if
another domestic firm has the power to direct or cause the direction
of the management or policies of that company.
1
2
012
Yes - Enter the name, mailing address, and EIN of the owned
or controlled company. If more than one company and more
space is required, continue in 12 or on another sheet of
paper, using the same format as above.
-
EIN
No
11 How many locations report payroll under the EIN printed on the front of this form?
Is the physical location the same as the mailing address printed on the front
One location
of this form?
Street Address
Yes -Go to
12
No -Enter street address, city, state
and ZIP code and then go to 12
City
More than one location
State
ZIP Code
Number
014
What is the number of locations? . . . . . . . . . . .
Provide the following information for each of these
locations. If more space is required, continue in 12 or on
another sheet of paper, using the same format as below.
Name and physical location
(Street address, city, state, and ZIP code)
Primary Business Activity
at this location
12 Are there any remarks that help clarify your responses?
13 CONTACT INFORMATION
10050045
Name of person to contact regarding this report (Please print)
Address (Number and street)
Title
City
State
ZIP Code
Area code
Telephone
Number
-
Extension
Area code
Fax
E-mail address
PLEASE RETURN THE COMPLETED FORM IN THE ENCLOSED ENVELOPE.
IF YOU PREFER, YOU MAY FAX THE COMPLETED FORM TO 1-800-447-4613.
Number
-
Attachment 1
Page 5 of 8
INSTRUCTIONS FOR COMPLETING SELECTED ITEMS
QUESTION 1 – Primary Area of Business
To properly classify this firm’s primary area of business, use
the following definitions in completing 1 .
Retail Trade
This category includes establishments engaged in retailing
merchandise, generally without transformation, and
rendering services incidental to the sale of merchandise.
The retailing process is the final step in the distribution of
merchandise; retailers are therefore organized to sell
merchandise in small quantities to the general public.
Examples include:
• New and used car dealers
• Household appliance stores
• Computer/software stores
• Beer/wine/liquor stores
• Supermarkets and other grocery (except
convenience) stores
• Gasoline stations with convenience stores
• Electronic shopping and mail-order houses
• Building materials stores
• Gift/novelty/souvenir stores
• Sporting goods stores
• Women’s clothing stores
Wholesale Distributor
This category includes establishments that are primarily
engaged in buying and selling products on their own
account (take title to goods), generally without
transformation, and rendering services incidental to the sale
of merchandise. Wholesale distributors are organized to sell
(a) goods for resale (i.e., goods sold to other wholesalers or
retailers) and (b) capital or durable nonconsumer goods.
Examples include:
• Cash-and-carry wholesalers
• Exporters or importers
• Farm product assemblers
• Industrial distributors
• Petroleum bulk plants and terminals not operated by
petroleum refining companies
• Retailer cooperative warehouses
• Terminal and country grain elevators
• Voluntary group wholesalers
• Wholesaler cooperative associations
• Wholesale merchants, jobbers, or distributors
Manufacturers’ Sales Branch or Sales Office
This category includes establishments that primarily sell
goods manufactured, refined, or mined in the United
States by this firm, this firm’s parent company, or
subsidiaries.
A manufacturers’ sales branch normally carries stock or
merchandise for delivery to customers while a sales office
does not.
Agent, Broker, or Electronic Market
This category includes establishments that primarily sell or
buy goods for others (do not take title to goods).
Examples include:
• Auction companies
• Commission merchants
• Import or export agents
• Manufacturers’ agents
• Merchandise brokers
• Purchasing agents
• Selling agents
• Electronic Market (business to business)
Transportation and Warehousing Services
This category includes industries providing transportation of
passengers and cargo, warehousing and storage for goods,
scenic and sightseeing transportation, and support activities
related to modes of transportation.
Examples include:
• Air transportation
• Rail transportation
• Water transportation
• Truck transportation
• Transit and ground
passenger transportation
• Pipeline transportation
Real Estate and Rental and Leasing Services
This category includes establishments primarily engaged
in renting, leasing, or otherwise allowing the use of
tangible or intangible assets, and establishments providing
related services.
Examples include:
• Real estate services
• Rental and leasing services
• Lessors of nonfinancial intangible
assets (except copyrighted works)
Professional, Scientific, and Technical Services
This category includes establishments that specialize in
performing professional, scientific, and technical activities
for others.
Examples include:
• Legal services
• Accounting, tax preparation, bookkeeping,
and payroll services
• Architectural, engineering, and related services
• Specialized design services
• Computer system design and related services
• Management, scientific, and technical consulting services
• Scientific research and development services
Note: A branch store that sells to household consumers
and individual users is classified in retail trade. If this
applies, indicate this in 12 .
FORM SQ-CLASS(00) (5-7-2013)
• Scenic and sightseeing
transportation
• Support activities for
transportation
• Postal services
• Couriers and messengers
• Warehousing and storage
CONTINUE ON REVERSE SIDE
Attachment 1
Page 6 of 8
INSTRUCTIONS FOR COMPLETING SELECTED ITEMS – Continued
Arts, Entertainment, and Recreation Services
This category includes a wide range of establishments
that operate facilities or provide services to meet varied
cultural, entertainment, and recreational interests of their
patrons. This category includes (1) establishments that
are involved in producing, promoting, or participating in
live performances, events, or exhibits intended for public
viewing; (2) establishments that preserve and exhibit
objects and sites of historical, cultural, or educational
interest; and (3) establishments that operate facilities or
provide services that enable patrons to participate in
recreational activities or pursue amusement, hobby, and
leisure time interests.
Examples include:
• Performing arts
• Spectator sports, and related industries
• Museums, historical sites, and similar institutions
• Amusement, gambling, and recreation industries
Administrative and Support and Waste
Management and Remediation Services
This category includes establishments performing routine
support activities for the day-to-day operations of other
organizations. Activities performed include: hiring and
placing of personnel; document preparation and similar
clerical services; solicitation; and collection.
Examples include:
• Office administrative services
• Facilities support services
• Employee services
• Business support services
• Travel arrangement and reservation services
• Investigation and security services
• Services to buildings and dwellings
• Other support services
• Waste collection
• Waste treatment and disposal
• Remediation and other waste management services
Accommodation and Food Services
This category includes establishments providing
customers with lodging and/or preparing meals, snacks,
and beverages for immediate consumption. This category
includes both accommodation and food services
establishments because the two activities are often
combined at the same establishment.
Examples include:
Examples include:
• Publishing industries including software
• Motion picture and sound recording industries
• Broadcasting and telecommunications
• Information services and data processing services
Health Care and Social Assistance Services
This category includes establishments providing health care and
social assistance for individuals. The services provided by
establishments in this category are delivered by trained
professionals. All industries in this category share this
commonality of process, namely, labor inputs of health
practitioners or social workers with the requisite expertise.
Examples include:
• Ambulatory health care services
• Hospitals
• Nursing and residential care facilities
• Social assistance
Utilities
This category includes establishments engaged in the
provision of the following utility services: electric power,
natural gas, steam supply, water supply, and sewage
removal.
Examples include:
• Electric power generation, transmission, and distribution
• Natural gas distribution
• Steam supply provision and/or distribution
• Sewer systems and sewer treatment facilities
Other Services
This category includes establishments in service industries
not specified in the previous categories.
Examples include:
• Educational services
• Repair and maintenance
• Personal and laundry services
• Religious, grant making, civic, professional, and similar
organizations
The definition of operating revenue varies by industry.
Supplement the instructions in 5 with those below, as
applicable.
All Areas of Business
Include cash and credit revenues.
Finance and Insurance Services
This category includes establishments primarily engaged
in financial transactions (transactions involving the
creation, liquidation, or change in ownership of financial
assets) and/or in facilitating financial transactions.
FORM SQ-CLASS(00) (5-7-2013)
This category includes establishments engaged in the
following processes: (1) producing and distributing
information and cultural products; (2) providing the means
to transmit or distribute these products as well as data or
communications; and (3) processing data.
QUESTION 5 – Operating Revenue
• Full-service restaurants
• Limited-service restaurants
• Drinking places (alcoholic beverages)
• Hotels and motels
• Snack and nonalcoholic beverage bars
• Food service contractors
Examples include:
• Monetary authorities – Central Bank
• Credit intermediation and related activities
• Securities, commodity contracts,
and other financial investments
• Insurance carriers and related activities
• Funds, trusts, and other financial vehicles
Information and Data Processing Services
Include excise taxes (such as those on gasoline, liquor,
and tobacco) levied on the manufacturer and included in
the cost of goods purchased by this firm.
Exclude sales taxes and other taxes collected directly
from customers or clients and paid directly to a local, state,
or federal tax agency.
CONTINUE ON NEXT PAGE
Page 2
Attachment 1
Page 7 of 8
INSTRUCTIONS FOR COMPLETING SELECTED ITEMS – Continued
Retail Trade
Accommodation and Food Services
Include freight, delivery, and other transportation costs.
Include receipts from guest rooms or unit rentals for all
establishments owned by this firm.
Include parts and supplies used in repair work and other
services.
Include sales of meals, alcoholic beverages, and other
merchandise.
Include charges for dealer preparation, warranty charges,
and delivery costs.
Include site rental and equipment usage fees.
Exclude receipts from customers for tag and title fees,
licenses, etc. forwarded to State or local licensing
agencies.
Exclude rents and receipts from departments or
concessions that are operated by others in locations
covered by this report.
Exclude non-operating income such as commissions from
lottery ticket sales, commissions from vending machine
operators, and income from interest, dividends, and the
rental of real estate.
Wholesale Distributor
Include sales of products that are shipped on this firm’s
orders directly to customers.
Include sales of goods imported to the United States by
your company.
Include gross value of sales made on a commission basis
(not actual commissions).
Include receipts from freight, installations, rentals,
maintenance, repairs, alterations, storage, and other such
services.
Include excise taxes (such as those on gasoline, liquor,
and tobacco) that are levied on the manufacturer and
included in the cost of products purchased by this firm.
Exclude foreign sales of products that never enter the
United States.
Exclude foreign sales of products that are not owned by
establishments in the United States.
Exclude taxes (sales, excise, and other) collected directly
from customers and paid directly to a local, state, or
federal tax agency.
Exclude non-operating receipts (such as interest income,
income from investments, and receipts from the rental or
sale of real estate).
Exclude commissions or fees for goods that never entered
the United States.
Exclude finance charges.
Agent, Broker, or Electronic Market
Include total commissions, fees, sales, and operating
revenue.
Include receipts from freight, installations, rentals,
maintenance, repairs, alterations, storage, and other such
services.
Include excise taxes (such as those on gasoline, liquor,
and tobacco) that are levied on the manufacturer and
included in the cost of products purchased by this firm.
Include receipts from valet, laundry, parking, and other
guest services provided by this firm.
Exclude civic and social organizations, amusement and
recreation parks, theaters, and other recreation or
entertainment facilities providing food and beverage
services.
Other Services
Instructions for Taxable Firms
Include amounts received for work subcontracted to
others.
Include locations that were sold or acquired during the
year only report for the periods that this firm operated the
locations.
Include revenue from services performed by domestic
locations of foreign parent firms, subsidiaries, branches,
etc.
Include revenue for maintenance and repair services,
delivery services, and installation.
Include revenue from beauty services and sales of
merchandise, Also include rents from operators of leased
stations or chairs.
Exclude rents from and revenue of separately operated
departments, concessions, etc., which are leased to others.
Exclude commissions from vending machine operators.
Instructions for Tax-Exempt Firms
Include program service revenue for services provided in
the applicable period, whether or not payment was
received in the applicable period.
Include gross revenues of merchandise minus returns and
allowances.
Include revenues from interest, dividends, gross rents
(including display space rentals and share of receipts from
departments operated by other companies), royalties, and
other investments.
Include gross contributions, gifts, and grants (whether or
not restricted for use in operations).
Include commissions earned from the revenues of
merchandise owned by others (including commissions
from vending machine operators).
Include gross revenues from fundraising activities.
Exclude gross receipts of departments or concessions
operated by other companies.
Exclude amounts transferred to operating funds from
capital or reserve funds.
Exclude non-operating receipts (such as interest income,
income from investments, and receipts from the rental or
sale of real estate).
Exclude taxes (sales, excise, and other) collected directly
from customers and paid directly to a local, state or federal
tax agency.
Exclude commissions or fees for goods that never entered
the United States.
Exclude finance charges.
Page 3
FORM SQ-CLASS(00) (5-7-2013)
Attachment 1
Page 8 of 8
INSTRUCTIONS FOR COMPLETING SELECTED ITEMS – Continued
NOTICE – Public reporting burden for this collection of information is estimated to average 13 minutes 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 0607-0189, U.S. Census Bureau, 4600 Silver Hill Road, AMSD-3K138, Washington, DC
20233-1500. You may e-mail comments to Paperwork@census.gov; use "Paperwork Project 0607-0189" as the
subject. 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 the questionnaire.
FORM SQ-CLASS(00) (5-7-2013)
Page 4
File Type | application/pdf |
Author | shirl002 |
File Modified | 2013-05-09 |
File Created | 2013-05-09 |