2014 Form

Welcome to the 2014 Annual Survey of Entrepreneurs
DO NOT use this worksheet to respond to the survey, it is intended to assist you with gathering and preparing your data
prior to reporting online. Please view the online report for specific instructions.
Return to https://econhelp.census.gov/ase when you are ready to report online.
CONTACT INFORMATION
Please enter the first and last name of the person who is filling out this survey. We request a telephone number so we
can contact you if there is a question.
Contact Name:
Phone:
NUMBER OF OWNERS
In 2014, how many people owned this business?
• Do not combine two or more owners to create one
• Count spouses and partners as separate owners
1 person – Skip to 10 percent or more ownership
2-4 people – Skip to 10 percent or more ownership
5-10 people – Skip to 10 percent or more ownership
11 or more people
Business is owned by a parent company, estate, trust, or other entity
Don’t know
GOVERNMENT OR TRIBAL ENTITY OWNERSHIP
In 2014, was this business owned by a government or tribal entity?
Yes
No
10 PERCENT or MORE OWNERSHIP
In 2014, did any one person own 10% or more of this business?
Yes
No
PERCENT OWNERSHIP
For the person(s) owning the largest percentage(s) in this business in 2014, please list the percentage owned by each
person and his or her name.
• Do not report percentages owned by parent companies, estates, trusts, or other entities
• If more than 4 people owned this business equally, select any 4 people
• Round percentages to whole numbers. For example, report 1/3 ownership as 33.0%.

Owner 1:
Owner 2:
Owner 3:
Owner 4:

Percentage Owned
(Estimates are
acceptable)

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Name

1

OWNER 1
INITIAL ACQUISITION
How did Owner 1 initially acquire ownership of this business? Select all that apply.
Founded or started
Purchased
Inherited
Received transfer of ownership or gift
INITIAL ACQUISITION YEAR
In what year did Owner 1 acquire ownership of this business?
Year
Don’t Know
_________
JOB FUNCTION(S)
In 2014, which of the following were Owner 1’s function(s) in this business? Select all that apply.
Managing day-to-day operations
Providing services and/or producing goods
Financial control with the authority to sign loans, leases, and contracts
None of these functions
AVERAGE NUMBER OF HOURS WORKED
In 2014, what was the average number of hours per week that Owner 1 spent managing or working in this business?
None
40 hours
Less than 20 hours
41-59 hours
20-39 hours
60 hours or more
PRIMARY INCOME SOURCE
In 2014, did this business provide Owner 1’s primary source of personal income?
Yes
No
PRIOR BUSINESS OWNERSHIP
Prior to establishing, purchasing, or acquiring this business, had Owner 1 ever owned a business?
Yes
No
EDUCATION
What was the highest degree or level of school Owner 1 completed prior to establishing, purchasing, or acquiring this
business? Select ONE box only.
Less than high school graduate
High school graduate - Diploma or GED
Technical, trade, or vocational school
Some college, but no degree
Associate Degree
Bachelor’s Degree
Master’s, Doctorate, or Professional Degree

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2

SEX
What is the sex of Owner 1?
Male
Female
AGE
What was the age of Owner 1 as of December 31, 2014?
Under 25
45-54
25-34
55-64
35-44
65 or over
US CITIZENSHIP
Was Owner 1 born a citizen of the United States?
Yes
No
ETHNICITY
Is Owner 1 of Hispanic, Latino, or Spanish origin?
No, not of Hispanic, Latino, or Spanish origin
Yes, Mexican, Mexican American, Chicano
Yes, Puerto Rican
Yes, Cuban
Yes, another Hispanic, Latino, or Spanish origin - please enter origin below. For example, Argentinean,
Colombian, Dominican, Nicaraguan, Salvadoran, Spaniard, and so on. C
___________________________________________________________________________
RACE
What is Owner 1’s race? NOTE: For this survey, Hispanic origins are not races. Select all that apply.
White
Black or African American
American Indian or Alaska Native - please enter name of enrolled or principal tribe below C
___________________________________________________________________________
Japanese
Native Hawaiian
Asian Indian
Chinese
Korean
Guamanian or Chamorro
Filipino
Vietnamese
Samoan
Other Asian- please enter race below. For example, Hmong, Laotian, Thai, Pakistani, Cambodian, and so on. C
__________________________________________________________________________
Other Pacific Islander - please enter race below. For example, Fijian, Tongan, and so on. C
__________________________________________________________________________
Some other race - please enter race below. C
__________________________________________________________________________

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3

MILITARY SERVICE
Has Owner 1 ever served in any branch of the U.S. Armed Forces, including the Coast Guard, the National Guard, or
Reserve component of any service branch?
Yes
No – Skip to Reasons for Owning the Business
(If yes) Do any of the following characteristics describe Owner 1’s military service? Select all that apply.
Served on active duty military service, not including training for the Reserves or National Guard
Disabled as the result of illness or injury incurred or aggravated during military service
Served on active duty military service after September 11, 2001
Served on active duty military service in 2014
Served in the National Guard or as a reservist of any branch of the U.S. Armed Forces in 2014
None of the above
REASONS FOR OWNING THE BUSINESS
How important to Owner 1 are each of the following reasons for owning this business? (Select one for each row.)
Not
Somewhat
Very
Important
Important
Important
Wanted to be my own boss
Flexible hours
Balance work and family
Opportunity for greater income/Wanted to build
wealth
Best avenue for my ideas/goods/services
Couldn’t find a job/Unable to find employment
Working for someone else didn’t appeal to me
Always wanted to start my own business
An entrepreneurial friend or family member was a
role model
Other (Specify) C

________________________________________________________________________________

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4

OWNER 2 - If applicable, if not skip to page 14
INITIAL ACQUISITION
How did Owner 2 initially acquire ownership of this business? Select all that apply.
Founded or started
Purchased
Inherited
Received transfer of ownership or gift
INITIAL ACQUISITION YEAR
In what year did Owner 2 acquire ownership of this business?
Year
Don’t Know
_________
JOB FUNCTION(S)
In 2014, which of the following were Owner 2’s function(s) in this business? Select all that apply.
Managing day-to-day operations
Providing services and/or producing goods
Financial control with the authority to sign loans, leases, and contracts
None of these functions
AVERAGE NUMBER OF HOURS WORKED
In 2014, what was the average number of hours per week that Owner 2 spent managing or working in this business?
None
40 hours
Less than 20 hours
41-59 hours
20-39 hours
60 hours or more
PRIMARY INCOME SOURCE
In 2014, did this business provide Owner 2’s primary source of personal income?
Yes
No
PRIOR BUSINESS OWNERSHIP
Prior to establishing, purchasing, or acquiring this business, had Owner 2 ever owned a business?
Yes
No
EDUCATION
What was the highest degree or level of school Owner 2 completed prior to establishing, purchasing, or acquiring this
business? Select ONE box only.
Less than high school graduate
High school graduate- Diploma or GED
Technical, trade, or vocational school
Some college, but no degree
Associate Degree
Bachelor’s Degree
Master’s, Doctorate, or Professional Degree

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5

SEX
What is the sex of Owner 2?
Male
Female
AGE
What was the age of Owner 2 as of December 31, 2014?
Under 25
45-54
25-34
55-64
35-44
65 or over
US CITIZENSHIP
Was Owner 2 born a citizen of the United States?
Yes
No
ETHNICITY
Is Owner 2 of Hispanic, Latino, or Spanish origin?
No, not of Hispanic, Latino, or Spanish origin
Yes, Mexican, Mexican American, Chicano
Yes, Puerto Rican
Yes, Cuban
Yes, another Hispanic, Latino, or Spanish origin- please enter origin below. For example, Argentinean,
Colombian, Dominican, Nicaraguan, Salvadoran, Spaniard, and so on. C
________________________________________________________________________________
RACE
What is Owner 2’s race? NOTE: For this survey, Hispanic origins are not races. Select all that apply.
White
Black or African American
American Indian or Alaska Native - please enter name of enrolled or principal tribe below C
________________________________________________________________________________
Japanese
Native Hawaiian
Asian Indian
Chinese
Korean
Guamanian or Chamorro
Filipino
Vietnamese
Samoan
Other Asian - please enter race below. For example, Hmong, Laotian, Thai, Pakistani, Cambodian, and so on. C
________________________________________________________________________________
Other Pacific Islander - please enter race below. For example, Fijian, Tongan, and so on. C
________________________________________________________________________________
Some other race - please enter race below. C
________________________________________________________________________________

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6

MILITARY SERVICE
Has Owner 2 ever served in any branch of the U.S. Armed Forces, including the Coast Guard, the National Guard, or
Reserve component of any service branch?
Yes
No – Skip to Reasons for Owning the Business
(If yes) Do any of the following characteristics describe Owner 2’s military service? Select all that apply.
Served on active duty military service, not including training for the Reserves or National Guard
Disabled as the result of illness or injury incurred or aggravated during military service
Served on active duty military service after September 11, 2001
Served on active duty military service in 2014
Served in the National Guard or as a reservist of any branch of the U.S. Armed Forces in 2014
None of the above
REASONS FOR OWNING THE BUSINESS
How important to Owner 2 are each of the following reasons for owning this business? (Select one for each row.)
Not
Somewhat
Very
Important
Important
Important
Wanted to be my own boss
Flexible hours
Balance work and family
Opportunity for greater income/Wanted to build
wealth
Best avenue for my ideas/goods/services
Couldn’t find a job/Unable to find employment
Working for someone else didn’t appeal to me
Always wanted to start my own business
An entrepreneurial friend or family member was a
role model
Other (Specify) C

________________________________________________________________________________

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7

OWNER 3 - If applicable, if not skip to page 14
INITIAL ACQUISITION
How did Owner 3 initially acquire ownership of this business? Select all that apply.
Founded or started
Purchased
Inherited
Received transfer of ownership or gift
INITIAL ACQUISITION YEAR
In what year did Owner 3 acquire ownership of this business?
Year
Don’t Know
_________
JOB FUNCTION(S)
In 2014, which of the following were Owner 3’s function(s) in this business? Select all that apply.
Managing day-to-day operations
Providing services and/or producing goods
Financial control with the authority to sign loans, leases, and contracts
None of these functions
AVERAGE NUMBER OF HOURS WORKED
In 2014, what was the average number of hours per week that Owner 3 spent managing or working in this business?
None
40 hours
Less than 20 hours
41-59 hours
20-39 hours
60 hours or more
PRIMARY INCOME SOURCE
In 2014, did this business provide Owner 3’s primary source of personal income?
Yes
No
PRIOR BUSINESS OWNERSHIP
Prior to establishing, purchasing, or acquiring this business, had Owner 3 ever owned a business?
Yes
No
EDUCATION
What was the highest degree or level of school Owner 3 completed prior to establishing, purchasing, or acquiring this
business? Select ONE box only.
Less than high school graduate
High school graduate - Diploma or GED
Technical, trade, or vocational school
Some college, but no degree
Associate Degree
Bachelor’s Degree
Master’s, Doctorate, or Professional Degree

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8

SEX
What is the sex of Owner 3?
Male
Female
AGE
What was the age of Owner 3 as of December 31, 2014?
Under 25
45-54
25-34
55-64
35-44
65 or over
US CITIZENSHIP
Was Owner 3 born a citizen of the United States?
Yes
No
ETHNICITY
Is Owner 3 of Hispanic, Latino, or Spanish origin?
No, not of Hispanic, Latino, or Spanish origin
Yes, Mexican, Mexican American, Chicano
Yes, Puerto Rican
Yes, Cuban
Yes, another Hispanic, Latino, or Spanish origin - please enter origin below. For example, Argentinean,
Colombian, Dominican, Nicaraguan, Salvadoran, Spaniard, and so on. C
________________________________________________________________________________
RACE
What is Owner 3’s race? NOTE: For this survey, Hispanic origins are not races. Select all that apply.
White
Black or African American
American Indian or Alaska Native - please enter name of enrolled or principal tribe below C
________________________________________________________________________________
Asian Indian
Japanese
Native Hawaiian
Chinese
Korean
Guamanian or Chamorro
Filipino
Vietnamese
Samoan
Other Asian - please enter race below. For example, Hmong, Laotian, Thai, Pakistani, Cambodian, and so on. C
________________________________________________________________________________
Other Pacific Islander - please enter race below. For example, Fijian, Tongan, and so on. C
________________________________________________________________________________
Some other race- please enter race below. C
________________________________________________________________________________

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9

MILITARY SERVICE
Has Owner 3 ever served in any branch of the U.S. Armed Forces, including the Coast Guard, the National Guard, or
Reserve component of any service branch?
Yes
No – Skip to Reasons for Owning the Business
(If yes) Do any of the following characteristics describe Owner 3’s military service? Select all that apply.
Served on active duty military service, not including training for the Reserves or National Guard
Disabled as the result of illness or injury incurred or aggravated during military service
Served on active duty military service after September 11, 2001
Served on active duty military service in 2014
Served in the National Guard or as a reservist of any branch of the U.S. Armed Forces in 2014
None of the above
REASONS FOR OWNING THE BUSINESS
How important to Owner 3 are each of the following reasons for owning this business? (Select one for each row.)
Not
Somewhat
Very
Important
Important
Important
Wanted to be my own boss
Flexible hours
Balance work and family
Opportunity for greater income/Wanted to build
wealth
Best avenue for my ideas/goods/services
Couldn’t find a job/Unable to find employment
Working for someone else didn’t appeal to me
Always wanted to start my own business
An entrepreneurial friend or family member was a
role model
Other (Specify) C

________________________________________________________________________________

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10

OWNER 4 - If applicable, if not skip to page 14
INITIAL ACQUISITION
How did Owner 4 initially acquire ownership of this business? Select all that apply.
Founded or started
Purchased
Inherited
Received transfer of ownership or gift
INITIAL ACQUISITION YEAR
In what year did Owner 4 acquire ownership of this business?
Year
Don’t Know
________
JOB FUNCTION(S)
In 2014, which of the following were Owner 4’s function(s) in this business? Select all that apply.
Managing day-to-day operations
Providing services and/or producing goods
Financial control with the authority to sign loans, leases, and contracts
None of these functions
AVERAGE NUMBER OF HOURS WORKED
In 2014, what was the average number of hours per week that Owner 4 spent managing or working in this business?
None
40 hours
Less than 20 hours
41-59 hours
20-39 hours
60 hours or more
PRIMARY INCOME SOURCE
In 2014, did this business provide Owner 4’s primary source of personal income?
Yes
No
PRIOR BUSINESS OWNERSHIP
Prior to establishing, purchasing, or acquiring this business, had Owner 4 ever owned a business?
Yes
No
EDUCATION
What was the highest degree or level of school Owner 4 completed prior to establishing, purchasing, or acquiring this
business? Select ONE box only.
Less than high school graduate
High school graduate - Diploma or GED
Technical, trade, or vocational school
Some college, but no degree
Associate Degree
Bachelor’s Degree
Master’s, Doctorate, or Professional Degree

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11

SEX
What is the sex of Owner 4?
Male
Female
AGE
What was the age of Owner 4 as of December 31, 2014?
Under 25
45-54
25-34
55-64
35-44
65 or over
US CITIZENSHIP
Was Owner 4 born a citizen of the United States?
Yes
No
ETHNICITY
Is Owner 4 of Hispanic, Latino, or Spanish origin?
No, not of Hispanic, Latino, or Spanish origin
Yes, Mexican, Mexican American, Chicano
Yes, Puerto Rican
Yes, Cuban
Yes, another Hispanic, Latino, or Spanish origin - please enter origin below. For example, Argentinean,
Colombian, Dominican, Nicaraguan, Salvadoran, Spaniard, and so on. C
________________________________________________________________________________
RACE
What is Owner 4’s race? NOTE: For this survey, Hispanic origins are not races. Select all that apply.
White
Black or African American
American Indian or Alaska Native - please enter name of enrolled or principal tribe below C
________________________________________________________________________________
Asian Indian
Japanese
Native Hawaiian
Chinese
Korean
Guamanian or Chamorro
Filipino
Vietnamese
Samoan
Other Asian - please enter race below. For example, Hmong, Laotian, Thai, Pakistani, Cambodian, and so on. C
________________________________________________________________________________
Other Pacific Islander - please enter race below. For example, Fijian, Tongan, and so on. C
________________________________________________________________________________
Some other race - please enter race below. C
________________________________________________________________________________

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12

MILITARY SERVICE
Has Owner 4 ever served in any branch of the U.S. Armed Forces, including the Coast Guard, the National Guard, or
Reserve component of any service branch?
Yes
No – Skip to Reasons for Owning the Business
(If yes) Do any of the following characteristics describe Owner 4’s military service? Select all that apply.
Served on active duty military service, not including training for the Reserves or National Guard
Disabled as the result of illness or injury incurred or aggravated during military service
Served on active duty military service after September 11, 2001
Served on active duty military service in 2014
Served in the National Guard or as a reservist of any branch of the U.S. Armed Forces in 2014
None of the above
REASONS FOR OWNING THE BUSINESS
How important to Owner 4 are each of the following reasons for owning this business? (Select one for each row.)
Not
Somewhat
Very
Important
Important
Important
Wanted to be my own boss
Flexible hours
Balance work and family
Opportunity for greater income/Wanted to build
wealth
Best avenue for my ideas/goods/services
Couldn’t find a job/Unable to find employment
Working for someone else didn’t appeal to me
Always wanted to start my own business
An entrepreneurial friend or family member was a
role model
Other (Specify) C

________________________________________________________________________________

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13

Business Specific Questions
The next questions apply to the entire business and only require one response from the respondent regardless of how
many owners were entered.
ONE FAMILY MAJORITY OWNERSHIP
In 2014, did two or more members of one family own the majority of this business? (Family refers to spouses,
parents/guardians, children, siblings, or close relatives.)
Yes
No – Skip to Business Aspirations
(If Yes) Did spouses jointly own this business?
Yes
No – Skip to Business Aspirations
(If Yes) Was this business operated equally by both spouses?
Yes, equally operated by spouses
No, primarily operated by Owner 1
No, primarily operated by Owner 2
BUSINESS ASPIRATIONS
Where would the owner(s) like this business to be in five years? (Select one)
Larger in terms of sales or profits
About the same amount of sales or profits
Smaller in terms of sales or profits
Other (specify) C
________________________________________________________________________________
FUNDING FROM OWNER(S)
For 2014, what was the total amount of money that the owner(s) personally put into the business? Your best estimate is
fine. Please report in thousands.
Include:
• Investments from personal savings
• Personal retirement accounts
• Home equity loans
• Personally borrowed funds
$_________________ ,000
YEAR OF BUSINESS ESTABLISHMENT
In what year was this business originally established?
Don’t know
__________
FRANCHISE OPERATION
In 2014, did all or part of this business operate as a franchise?
Yes
No

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14

CAPITAL FUNDING
For the owners reported, what was the source(s) of capital used to start or initially acquire this business? If you did not
report any owners skip to Amount of Capital Needed to Start or Initially Acquire Business. Select all that apply.
Personal/family savings of owner(s)
Personal/family assets other than savings of owner(s)
Personal/family home equity loan
Personal credit card(s) carrying balances
Business credit card(s) carrying balances
Government-guaranteed business loan from a bank or financial institutions, including SBA-guaranteed loans
Business loan from a bank or financial institution
Business loan from a federal, state, or local government
Business loan/investment from family/friend(s)
Investment by venture capitalist(s)
Grants
Other source(s) of capital
Don’t know
None needed – Skip to Family, Friends, and Employees
For the owners you reported, what was the total amount of capital used to start or initially acquire this business?
(Capital includes savings, other assets, and borrowed funds of owner(s).)
Less than $5,000
$100,000 - $249,999
$5,000 - $9,999
$250,000 - $999,999
$10,000 - $24,999
$1,000,000 - $2,999,999
$25,000 - $49,999
$3,000,000 or more
$50,000 - $99,999
Don’t know
FUNDING FROM FAMILY, FRIENDS, AND EMPLOYEES
For 2014, what was the amount of money this business received from family, friends, and employees? Your best
estimate is fine. Please report in thousands.
$____________________ ,000
FUNDING FROM BANKS OR OTHER FINANCIAL INSTITUTIONS
For 2014, what was the total amount of money this business borrowed from a bank or other financial institutions,
including business loans, a business credit card carrying a balance, or a business line of credit? Include all draws on
a business line of credit, even if paid off during the year. Your best estimate is fine. Please report in thousands.
$___________________ ,000
FUNDING FROM OUTSIDE INVESTORS
For 2014, what was the total amount of money this business received from angel investors, venture capitalists, or other
businesses in return for a share of ownership in this business? Your best estimate is fine. Please report in thousands.
(An “angel investor” is an affluent individual who provides capital for a business start-up, usually in exchange for
convertible debt or ownership equity.)
$___________________ ,000

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FUNDING FROM GOVERNMENT GRANTS
For 2014, what was the total amount of money this business received from government grants (such as the Small
Business Innovation Research (SBIR) and/or Small Business Technology Transfer (STTR) programs)? Your best estimate is
fine. Please report in thousands.
$___________________ ,000
NEW FUNDING RELATIONSHIPS
In 2014, did this business attempt to establish any new funding relationships (for example, loans, investments, or gifts)
with any of the following sources? (Select one for each row)
No

Yes, received total
amount of the
funding requested

Yes, but did not
receive the total
amount requested

Other owner(s) (if applicable)
Family, friends, or employees
Banks, credit unions, or other financial institutions
Home equity loans in name of business owners
Credit cards
Trade credit (for example, buy now, pay later)
Angel Investors
Venture capitalists
Other investor businesses
Crowdfunding platform (for example, Prosper, Kickstarter, etc.)
Grants (for example, Federal government’s Small Business
Technology Transfer Program (STTR) or Small Business
Innovation Research Program (SBIR)
Other (Specify) C
________________________________________________________________________________________
AVOIDANCE OF ADDITIONAL FINANCING
At any time during 2014, did this business need additional financing and the owner(s) chose not to apply?
Yes
No - Skip to Profitability

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AVOIDANCE OF ADDITIONAL FINANCING CONTINUED
Why did this business choose not to apply for additional financing? (Select all that apply)
Did not think business would be approved by lender
Did not want to accrue debt
Decided the financing costs would be too high
Preferred to reinvest the business profits instead
Felt the loan search/application process would be too timing consuming
Decided the additional financing was no longer needed
Decided to wait until funding conditions improved
Decided to wait until company hit milestones to be in stronger position to raise funds
Other (Specify) C
________________________________________________________________________________
PROFITABILITY
For 2014, did this business have profits, losses, or break even? (Select one)
Profits
Losses
Break even
NEGATIVE IMPACT ON PROFITABILITY
For 2014, did each of the following negatively impact the profitability of this business? (Select one in each row)
Yes

No

Access to financial capital
Cost of financial capital
Finding qualified labor
Taxes
Slow business or lost sales
Customers or clients not making payments or paying late
The unpredictability of business conditions
Changes or updates in technology
Other (Specify) C
____________________________________________________________________________________
TYPES OF CUSTOMERS
In 2014, which of the following types of customers accounted for 10% or more of this business’s total sales of goods
and/or services? Select all that apply.
Federal government
State and local government, including school districts, transportation authorities, etc.
Other businesses and/or organizations, including distributors of your product(s)
Individuals

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17

CUSTOMER LOCATIONS
During 2014, where were this business’s customers or clients located? Round to the nearest whole percent. Your best
estimate is fine. If none, report “0.”
Same region as the business
____%
Outside of the region but within U.S. (Domestic)
____%
Outside the United States (International)
____%
Total
100%
SALES OR EXPORTS OUTSIDE THE UNITED STATES
In 2014, what percent of the business’s total sales of goods and/or services consisted of exports outside the United
States?
______.0%
None
Don’t know
OPERATIONS OUTSIDE THE UNITED STATES
In 2014, did this business have operations outside the United States?
Yes
No
OUTSOURCING OR TRANSFERS OUTSIDE THE UNITED STATES
In 2014, did this business outsource or transfer any business function and/or service to another company outside the
United States?
Yes
No
LANGUAGE
In 2014, which language(s) did this business conduct transactions with its customers? Select all that apply.
English
German
Portuguese
African language(s)
Hindi/Urdu
Russian
Arabic
Italian
Spanish
Chinese
Japanese
Tagalog
French
Korean
Vietnamese
French Creole
Polish
Other
TYPES OF WORKERS
In 2014, which of the following types of workers were used by this business? Select all that apply.
Full-time paid employees
Part-time paid employees
Paid by day laborers
Temporary staffing obtained from a temporary help service
Leased employees from a leasing service or a professional employer organization
Contractors, subcontractors, independent contractors, or outside consultants
None of the above

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18

EMPLOYEE BENEFITS
In 2014, which of the following employee benefits were paid totally or partly by this business? Select all that apply.
Health insurance
Contributions to retirement plans, including 401(k), Keogh, etc.
Profit sharing and/or stock options
Paid holidays, vacation, and/or sick leave
Tuition assistance and/or reimbursement
None of the above
WEBSITE
In 2014, did this business have a website?
Yes
No
E-COMMERCE
In 2014, did this business have any e-commerce sales? (E-commerce sales are sales of goods and/or services where an
order is placed by the buyer or price and terms of the sale are negotiated over the Internet, extranet, EDI network,
electronic mail, or other online system. Payment may or may not be made online.)
Yes
No – Skip to Home Operation
(If yes) In 2014, what percent of this business’s total sales of goods and/or services were e-commerce sales?
Less than 1%
20% - 49%
1% - 4%
50% - 99%
5% - 9%
100%
10% - 19%
Don’t know
HOME OPERATION
In 2014, did this business operate primarily from somebody’s home?
Yes
No
COPYRIGHTS, TRADEMARKS, AND PATENTS
In 2014, did this business own one or more of the following? Select all that apply.
Copyright
Patent (granted)
None
Trademark
Patent (pending)
BUSINESS ACTIVITY
In 2014, did any of the following characteristics describe the activity of this business? Select all that apply.
Operated less than 40 hours per week on average
Operated less than 12 months
Seasonal business (for example, fireworks sales or tax preparer)
Operated occasionally (for example, event organizer or guest speaker)
None of the above

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19

PRODUCT INNOVATION
During the last three years (2012, 2013, 2014) did this business do each of the following regarding the goods or services
it offers? (Select one for each row)
• Do not include adaptation or customization of a good or service for a specific customer’s needs.
Yes

No

Sold a new good or service that no other
business has ever offered before
Sold a new good or service that this business has
never offered before
Improved a good or service’s performance by
making changes in materials, equipment,
software or other components
Developed a new use for a good or service
Added a new feature to a good or service
Made it easier for customers to use a good or
service
PROCESS IMPROVEMENT
During the last three years (2012, 2013, 2014), did this business do each of the following regarding the goods or services
it offers? (Select one for each row)
Yes

No

Applied a new way of purchasing, accounting,
computing, maintenance, inventory control, or
other support activity
Reduced costs by changing the way a good or
service was distributed
Upgraded a technique, equipment, or software
to significantly improve a good or service
Made a significant improvement in a technique
or process by increasing automation, decreasing
energy consumption, or using better software
Decreased production costs by improving the
materials, software, or other components
Changed a delivery method to be faster or more
reliable

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RESEARCH AND DEVELOPMENT ACTIVITY
In 2014, did this business do any of the following research and development (R&D) activities? (Select one for each row)
If No to ALL – Skip to Currently Operating
• Include R&D activities that this business performed, others paid this business to do, or this business paid
others to do.
Yes

No

Conducted work that might lead to a patent
Developed and tested prototypes that were
derived from scientific research or technical
findings
Produced findings that could be published in
academic journals or presented at scientific
conferences
Applied scientific or technical knowledge in a
way that has never been done before
Created new scientific research or technical
solutions that can be generalized to other
situations
Conducted work to discover previously unknown
scientific facts, structures, or relationships
Conducted work to extend the understanding of
scientific facts, relationships or principles in a
way that could be useful to others
TOTAL R&D COST
In 2014, what was this business’s total cost for R&D activities?
Include:
• Labor paid for employees, temporary staffing, contractors, independent contractors, or outside
consultants
• Materials, equipment, software, or other supplies purchased
• Money spent for rent, utilities or other overhead
$____________________ ,000
PURCHASED R&D COSTS
In 2014, of the total R&D costs, what was the amount used to purchase R&D services from others?
Include labor paid for:
• Employees
• Temporary staff
• Contractors
• Independent contractors
• Outside consultants
$____________________ ,000

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BUSINESS R&D COSTS
In 2014, what percent of the costs of R&D services performed by this business consisted of the following purchase?
Note: To calculate R&D services performed by this business, subtract the Purchased R&D costs from the Total R&D costs.
Round to the nearest whole percent. Your best estimate is fine. If none, report “0.”
Employee payroll
____%
Equipment purchases
____%
Software and licensing purchases
____%
Other R&D expenses
____%
Total
100%
FUNDING SOURCES FOR R&D ACTIVITIES
In 2014, what percent of the costs of R&D services performed by this business was paid by the following sources? Note:
To calculate R&D services performed by this business, subtract the Purchased R&D costs from the Total R&D costs.
Round to the nearest whole percent. Your best estimate is fine. If none, report “0.”
This business
____%
Another U.S. business
____%
U.S. college or university
____%
U.S. nonprofit organization
____%
U.S. federal government (Include R&D grants)
____%
U.S. state or local government (Do not include public schools)
____%
Other (specify)
____%
Total
100%
NUMBER OF R&D EMPLOYEES
For the pay period including March 12, 2014, how many of each type of the following workers worked on R&D activities?
Owner(s)
Paid Employees
Other Paid Workers - Include labor paid for temporary staff, contractors,
independent contractors, and outside consultants.
Unpaid Workers/Interns

Number of workers
_____
_____
_____
_____

CURRENTLY OPERATING
Is this business currently operating?
Yes – Skip to Remarks
No
CEASE OPERATION
Did the operations cease for any of the following reasons? Select all that apply.
Owner’s military deployment
Lack of business loans/credit
Owner’s illness or injury
Lack of personal loans/credit
Owner(s) retired
Started another business
Owner(s) deceased
Sold this business
Operated for a specific or one-time event
Other
Inadequate cash flow or low sales

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REMARKS
Please use this space for any explanations that may be essential in understanding your reported data.

THANK YOU

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