SM4212-E Monthly Wholesale Trade Report

Attachment 3

OMB No. 0607-0190: Approval Expires 5/31/2014
U.S. DEPARTMENT OF COMMERCE
Economics and Statistics Administration

U.S. CENSUS BUREAU

MONTHLY WHOLESALE TRADE REPORT

FORM

SM4212-E

(09-10-2012)

Due Date

Need help or have questions?
Call 1-800-772-7852
(8:30 a.m. - 4:30 p.m. ET, M-F)
YOUR CENSUS REPORT IS
CONFIDENTIAL. It may be
seen only by persons sworn to
uphold the confidentiality of U.S.
Census Bureau information and
may be used only for statistical
purposes. Under the same law,
information that you report
cannot be used for taxation,
regulation, or investigation and
are exempt from release under
the Freedom of Information Act.
Further, copies of your response
retained in your files are immune
from legal process.

(Please correct any errors in name, address, and ZIP Code.)

Return via Internet:
econhelp.census.gov/mwts

Return via Fax:
1-800-447-4613

To view survey results:
census.gov/wholesale

Username:
Password:
GENERAL INSTRUCTIONS
• This report should cover ALL wholesale distributor establishments in the United States reporting payroll
under the Employer Identification Number (EIN) as referenced in 1 on page 2
• Include data for auxiliary facilities primarily engaged in supporting services to this EIN's establishment(s)
such as warehouses, garages, and central administrative offices
• Any significant change in this EIN's operations should be noted in 5 on page 3
• For establishments sold or acquired during the month, report data only for the period the establishments
were operated by this EIN
• Estimates are acceptable if book figures are not available
• Enter "0" where applicable

42060012

ANNOUNCEMENTS AND SPECIAL INSTRUCTIONS

CONTINUE ON PAGE 2

Form SM4212-E
1

Attachment 3
Page 2

(09-10-2012)

FEDERAL EMPLOYER IDENTIFICATION NUMBER (EIN)
Does this firm report payroll under EIN
Yes
EIN (9 digits)

No - Enter current 9-digit EIN AND date payroll was first
reported for this EIN . . . . . . . . . . . . . . . . . . . . . . . . .

Month

2

Day

Year

NUMBER OF ESTABLISHMENTS
Number

How many wholesale establishments (including auxiliary facilities primarily engaged in
supporting services such as warehouses, garages, and central administrative offices) did this
EIN operate in
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
The remainder of this report refers to the establishments reported here.
3

SALES, RECEIPTS, OR REVENUE
Exclude
• Sales from establishments that are primarily
selling products manufactured or mined in the
United States by this EIN
• Foreign sales of products that never entered the
United States
• Nonoperating receipts (such as interest income,
income from investments, and receipts from the
rental or sale of real estate)
• Commissions earned for the sale of products
• Receipts from customers for carrying or other
credit charges

Include:
• Sales of products that are shipped on this EIN's
orders directly to customers
• Retail sales made by wholesale establishments
covered by this report
• Gross value of sales made on a commission
basis (not this firm's actual commissions)
• Receipts from freight, installations, rentals,
maintenance, repairs, alterations, storage, and
other such services
• 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 EIN

A. What type of reporting period do this month's sales represent?
Calendar month reporting period - Go to

3

C

4-week reporting period
5-week reporting period
Ending Date
Month Day

B. If not a calendar month reporting period, what is the ending date for the period you are
reporting sales? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
$ Bil.

Mil.

Thou.

Dol.

42060020

C. What were this EIN's sales and other operating receipts in

CONTINUE ON PAGE 3

Form SM4212-E
4

Attachment 3
Page 3

(09-10-2012)

VALUE OF INVENTORIES
EXCLUDE
• Items such as fixtures, equipment, and
supplies not held for resale
• Products owned by others that are being held
on consignment

INCLUDE
• All inventories of products covered by this
report, including auxiliary locations (such as
warehouses, garages, and central administrative
offices) servicing these establishments,
regardless of where held
• Inventory held in Foreign Trade Zones or in bond
warehouses in the United States
• Report at cost or market value as of the end of this
EIN's reporting period

A. Did this EIN own inventories, regardless of where held, at the end of the month (or the end of
the period for which you are reporting)?
Yes
No - Go to

5

$ Bil.

Mil.

Thou.

Dol.

B. What was the value of inventories (before Last-in, First-out (LIFO)
adjustment)? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
C. Were inventories reported as of
Yes - Go to

5

No
Month Day

42060038

D. If not end of the month, inventories were reported as of what date? . . . . . . . . . . . . . .
5

REMARKS - Please use this space to explain any significant month-to-month changes, to clarify responses, or indicate
where data were estimated.

6

CONTACT INFORMATION
Name of person to contact regarding this report (Please print)

Area code
Telephone

Number

-

Title

Extension

Area code
Fax

Number

-

THANK YOU
for completing your Monthly Wholesale Trade Report.
We suggest you keep a copy for your records.
Public reporting burden for this collection of voluntary information is estimated to average 7 minutes per response, including the time for assembling data
from existing records and completing the form. Send comments regarding this burden estimate or any other aspect of this collection of information, including
suggestions for reducing this burden, to: Paperwork Project 0607-0190, 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 0607-0190" 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 of this form.