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pdfU.S. DEPARTMENT OF COMMERCE
Economics and Statistics Administration
U.S. CENSUS BUREAU
2013 REPORT OF ORGANIZATION
FORM
NC-99001
OMB No. 0607-0444: Approval Expires
(DRAFT)
NC-99001
Need help or have questions about
filling out this form?
Visit census.gov/econhelp
- OR Write to the address below. Include
your 11-digit Census File Number (CFN)
printed in the mailing address.
Mail your completed form to:
U.S. CENSUS BUREAU
1201 East 10th Street
(Please correct any errors in name and address, including ZIP Code.)
Jeffersonville, IN 47132-0001
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. By the same law, YOUR CENSUS REPORT IS
CONFIDENTIAL. It may be seen only by persons sworn to uphold the confidentiality of Census Bureau information and may be used
only for statistical purposes. Further, copies retained in respondents' files are immune from legal process.
The purpose of this form is to obtain an accurate and up-to-date list of your establishments, i.e., separate business locations that were in
operation or new plant(s) under construction during part or all of 2013. This list should include establishments of your company and each of its
subsidiaries. To make it easier for you to complete this report, we have prelisted information in 5 A that you have previously provided to the
U.S. Census Bureau. Please list all other establishments of your organization on 5 B. Do not duplicate establishments already prelisted in 5 A.
Be sure to include items 1 through 4 when returning your completed report form. Before completing this form, please read the enclosed
definitions and instructions.
• Use blue or black ballpoint pen.
• Do not use pencil or felt-tip pen.
• Do not put slashes through 0 or 7.
1
Examples:
COMPANY OWNERSHIP OR CONTROL
A. DOMESTIC OWNERSHIP OR CONTROL
1. Does another domestic company hold more than 50 percent of the voting stock of your company or have the
power to control the management and policies of your company?
0008
0080
99001018
• Please center numbers in
their respective boxes.
• Place an "X" inside the box.
Yes - Enter the following information of the owning or
controlling company
Name of owning or controlling company
0082
Home office address (Number and street)
0083
City, town, village, etc.
0081
0009
No - Go to line B
Employer Identification
Number (EIN) of
owning or controlling
company (9 digits)
0084
State
-
0085
ZIP Code
2. What percent of voting stock was held by the owning or controlling company? (Mark "X" only ONE box.)
0027
Less than 50%
0028
50%
CONTINUE WITH
PENALTY FOR FAILURE TO REPORT
More than 50%
0029
1
ON PAGE 2
Form NC-99001
1
(DRAFT)
COMPANY OWNERSHIP OR CONTROL - Continued
B. FOREIGN OWNERSHIP OR CONTROL
Does a foreign entity (company, individual, government, etc.) own directly or indirectly 10 percent or more of the
voting stock or other equity rights of your company?
Yes - Enter the following information of the owning
entity
6101
6103
Name of foreign beneficial owner
6104
Home office address (Number and street)
6105
City
6106
What was the percent
ownership (direct and
indirect)? (Mark "X"
only ONE box.)
No - Go to line C
6102
6111
10% - 24%
6113
50%
6112
25% - 49%
6114
51% - 99%
Country
6115
100%
C. FOREIGN AFFILIATES
Does this company alone, or with its domestic affiliates, own 10 percent or more of the voting stock of an
incorporated foreign business enterprise, or an equivalent interest in an unincorporated business enterprise,
including ownership of real estate?
2
6126
Yes
6127
No
RESEARCH AND DEVELOPMENT
A. Did your company perform or fund research and development (R&D) in 2013?
6129
Yes - Go to line B
6130
No - Go to
3
on the next page
99001026
B. What were your company's worldwide expenses for research and development (R&D) in 2013?
6132
Less than $3 million
6133
$3 million or more
Form NC-99001
(DRAFT)
Mark "X"
if None
Dollar figures should be rounded to
thousands of dollars.
HOW TO
REPORT
DOLLAR
FIGURES
If a figure is $2,035,628.79:
$ Bil.
Thou.
2
Report
0 3 6
EXAMPLE
If a value is "0" (or less than $500.00): Report
3
2013
Mil.
COMPANY ACTIVITIES
A. EMPLOYEES FROM A PROFESSIONAL EMPLOYER ORGANIZATION
Did your company lease 50 percent or more of its permanent full- and part-time workforce from a
Professional Employer Organization during 2013? (Permanent workforce excludes temporary staffing from a
staffing service and contractors.)
0244
Yes
0245
No
B. OPERATING REVENUES AND NET SALES
1. Your company's operating revenues and net sales generated from U.S. operations (i.e., located in the 50 states
and the District of Columbia) in 2013.
Include:
• Sales of goods and services to foreign firms.
• Revenues of discontinued operations.
• Sales to a foreign parent firm and its affiliates not owned by your company.
Exclude:
• Sales generated by your company's foreign operations.
• Domestic inter-company sales.
Special instructions for tax-exempt firms: Report revenues, realized gains and losses, and contributions for
all classes of net assets regardless of restrictions.
Mark "X"
if None
Operating revenues and net sales . . . . . . . . . . . . .
$ Bil.
2013
Mil.
Thou.
0100
2. Did your company have foreign subsidiaries in 2013?
9760
Yes - Go to line 3
9761
No - Go to line 1 on the next page
99001034
3. Does the amount reported on line 1 include inter-company sales by your company's domestic operations to
foreign subsidiaries?
9755
Yes - Go to line 1 on the next page
9756
No - Go to line 4
Mark "X"
if None
4. Report inter-company sales by your company's domestic
operations to foreign subsidiaries . . . . . . . . . . . . .
CONTINUE WITH
3
9758
ON PAGE 4
$ Bil.
2013
Mil.
Thou.
Form NC-99001
3
(DRAFT)
COMPANY ACTIVITIES - Continued
C. ROYALTIES AND LICENSE FEES FOR THE USE OF INTELLECTUAL PROPERTY
1. Did your company's U.S. operations earn revenue in 2013 from royalties or license fees for rights to use
intellectual property?
Include:
• Revenues from royalties and license fees for intellectual property owned by your domestic
company's domestic operations (i.e., located in the 50 states and the District of Columbia).
• Royalties and license fees paid to your company's domestic operations by foreign subsidiaries.
Exclude:
• Sales involving the transfer of ownership rights.
• Sales of and products sold with end-use licenses.
• Franchise fees.
9701
Yes - Go to line 2
9702
No - Go to line 1 on the next page
2. Revenues from royalties and license fees in 2013 for
rights to use intellectual property . . . . . . . . . . . . .
a. Technological or industrial processes (Include patents,
trade secrets, and proprietary technology. Exclude
computer software.) . . . . . . . . . . . . . . . . . .
9704
b. Entertainment, artistic, educational, and literary original
works (Include royalties and license fees for rights to
perform, broadcast, reproduce, and sell copyrighted
materials and other intellectual property such as films,
television and radio programs, written works, and
musical and other artistic works. Exclude computer
software.) . . . . . . . . . . . . . . . . . . . . . . .
9705
c. Software - Rights to reproduce, distribute, or use
software protected by copyright and owned or
controlled by the licensor (Exclude sales of software sold
with end-use licenses, as well as custom software and
programming services.) . . . . . . . . . . . . . . . .
9706
d. Other revenues from royalties and license fees for
rights to use intellectual property - Specify
9751
9708
99001042
e. TOTAL revenues from royalties and license fees in 2013
for rights to use intellectual property (Sum of lines 3a
through 3d should equal line 2.) . . . . . . . . . . . .
CONTINUE WITH
3
$ Bil.
2013
Mil.
Thou.
Mark "X"
if None
$ Bil.
2013
Mil.
Thou.
9703
3. Revenues from your company's U.S. operations, as
reported in line 2, for the following types of royalties
and license fees in 2013:
9752
Mark "X"
if None
ON PAGE 5
Form NC-99001
3
(DRAFT)
COMPANY ACTIVITIES - Continued
D. MANUFACTURING ACTIVITIES - Please respond even if you are not a manufacturer.
In 2013, did your company do any of the following activities related to manufacturing?
1. Operate manufacturing facilities (such as a factory, plant, or mill) where products are completed or partially
produced?
9709
Yes - Go to line 2
9710
No - Go to line 3
2. Provide contract manufacturing services to other companies incorporating their patents, trade secrets, or
proprietary technology?
9711
Yes
9712
No - Go to line 3
Estimate the percent of operating revenues and net sales, as reported in
AND NET SALES, from contract manufacturing services.
9713
Less than 25%
9714
25% - 49%
9715
50% - 74%
9716
75% - 99%
9717
100%
3
B, OPERATING REVENUES
3. Purchase contract manufacturing services from other companies or foreign subsidiaries of your company
incorporating your company's patents, trade secrets, or proprietary technology?
9718
Yes
9719
No - Go to
4
on the next page
a. Use 3rd party contract manufacturing services inside the United States (i.e., located in the 50 states and
the District of Columbia)?
9720
Yes
9721
No
b. Use 3rd party contract manufacturing services outside the United States (i.e., located outside the 50
states and the District of Columbia)?
9722
Yes
9723
No
99001059
c. Use your company's foreign subsidiaries' or affiliates' contract manufacturing services at locations
outside the United States (i.e., located outside the 50 states and the District of Columbia)?
9724
Yes
9725
No
d. Estimate the percent of the cost of sales from expenses for contract manufacturing services.
9726
Less than 25%
9727
25% - 49%
9728
50% - 74%
9729
75% - 99%
9730
100%
Form NC-99001
(DRAFT)
REMARKS (Please use this space for any explanations that may be essential in understanding your reported data.)
$$CENSUS_REMARKS$$
4
CERTIFICATION - This report is substantially accurate and was prepared in accordance with the instructions.
Is the time period covered by this report a
calendar year?
99001067
Yes
Month
No - Enter time period covered
Telephone
-
Year
TO
Title
Number
-
Month
FROM
Name of person to contact regarding this report
Area code
Year
Extension
-
Area code
Fax
E-mail address
Number
Month
Day
Date
completed
Thank you for completing your 2013 REPORT OF ORGANIZATION form.
PLEASE PHOTOCOPY THIS FORM FOR YOUR RECORDS AND RETURN THE ORIGINAL.
Year
FORM NC-99002
(DRAFT)
U.S. DEPARTMENT OF COMMERCE Refer to this
Economics and Statistics Administration
U.S. CENSUS BUREAU CENSUS FILE NUMBER
in any correspondence
pertaining to this report
2013 REPORT OF ORGANIZATION
5
A. PRE-IDENTIFIED LOCATIONS OF OPERATION
We have listed establishments of your company based
on Census records. Please update this list as follows:
Column (a) - Correct any errors or omissions in the
information. The establishments are listed in the following
sequence: Employer Identification Number (EIN), major
activity, and geographic location.
Column (b) - Report the number of employees and
payroll for full- and part-time employees working at
each establishment whose payroll was reported on
your Internal Revenue Service Form 941, Employer's
Quarterly Federal Tax Return. Include part-year
operations. Do not combine data for establishments.
If book figures are not available for employment and
payroll for each establishment, please provide your
best estimates.
Column (c) - Report operational status of each
establishment at the end of 2013.
Company Establishments and Subsidiaries
(Add store or plant number, if any, and
correct any errors or omissions.)
Employment and Payroll
Operational Status at the End of 2013
(Mark "X" only ONE box.)
(a)
(b)
(c)
Line No. EIN
2013
NAICS
Number of employees for pay
period including March 12
Major activity
Name
First quarter payroll
(January-March 2013)
Secondary name
Store/Plant No.
$Bil.
Mil.
Thou.
Physical location (Number and street)
In
operation
Ceased
operation
- Give
date
Temporarily or
seasonally inactive
Month
Day
Year
Sold or leased to another operator - Give date
above AND enter name and address of new
owner or operator below
Name of new owner or operator
Mailing address (Number and street, P.O. box, etc.)
2013
City, town, village, etc.
State
Annual payroll
ZIP Code
$Bil.
Mil.
City, town, village, etc.
State
ZIP Code
Thou.
Other Specify
Line No. EIN
2013
NAICS
Number of employees for pay
period including March 12
99002016
Major activity
Name
First quarter payroll
(January-March 2013)
Secondary name
Store/Plant No.
$Bil.
Mil.
Thou.
Physical location (Number and street)
In
operation
Ceased
operation
- Give
date
Temporarily or
seasonally inactive
Month
Day
Year
Sold or leased to another operator - Give date
above AND enter name and address of new
owner or operator below
Name of new owner or operator
Mailing address (Number and street, P.O. box, etc.)
2013
City, town, village, etc.
State
Annual payroll
ZIP Code
$Bil.
Mil.
City, town, village, etc.
Thou.
Other Specify
State
ZIP Code
Form NC-99002
(DRAFT)
A. PRE-IDENTIFIED LOCATIONS OF OPERATION - Continued
5
(a) Company Establishments and Subsidiaries
Line No. EIN
(b) Employment and Payroll
2013
NAICS
Number of employees for pay
period including March 12
Major activity
Name
First quarter payroll
(January-March 2013)
Secondary name
Store/Plant No.
$Bil.
Mil.
Thou.
Physical location (Number and street)
(c) Operational Status at the End of 2013
In
operation
Ceased
operation
- Give
date
Temporarily or
seasonally inactive
Month
Day
Year
Sold or leased to another operator - Give date
above AND enter name and address of new
owner or operator below
Name of new owner or operator
Mailing address (Number and street, P.O. box, etc.)
2013
City, town, village, etc.
State
Annual payroll
ZIP Code
$Bil.
Mil.
City, town, village, etc.
State
ZIP Code
Thou.
Other Specify
Line No. EIN
2013
NAICS
Number of employees for pay
period including March 12
Major activity
Name
First quarter payroll
(January-March 2013)
Secondary name
Store/Plant No.
$Bil.
Mil.
Thou.
Physical location (Number and street)
In
operation
Ceased
operation
- Give
date
Temporarily or
seasonally inactive
Month
Day
Year
Sold or leased to another operator - Give date
above AND enter name and address of new
owner or operator below
Name of new owner or operator
Mailing address (Number and street, P.O. box, etc.)
2013
City, town, village, etc.
State
Annual payroll
ZIP Code
$Bil.
Mil.
City, town, village, etc.
State
ZIP Code
Thou.
Other Specify
Line No. EIN
2013
NAICS
Number of employees for pay
period including March 12
Major activity
99002024
Name
First quarter payroll
(January-March 2013)
Secondary name
Store/Plant No.
$Bil.
Mil.
Thou.
Physical location (Number and street)
In
operation
Ceased
operation
- Give
date
Temporarily or
seasonally inactive
Month
Day
Year
Sold or leased to another operator - Give date
above AND enter name and address of new
owner or operator below
Name of new owner or operator
Mailing address (Number and street, P.O. box, etc.)
2013
City, town, village, etc.
State
Annual payroll
ZIP Code
$Bil.
Mil.
City, town, village, etc.
Thou.
Other Specify
State
ZIP Code
FORM NC-99003
(DRAFT)
U.S. DEPARTMENT OF COMMERCE Refer to this
Economics and Statistics Administration
U.S. CENSUS BUREAU CENSUS FILE NUMBER
in any correspondence
pertaining to this report
2013 REPORT OF ORGANIZATION
5
B. ADDITIONAL LOCATIONS OF OPERATION
Column (a) - List separately any establishments
of your company and its subsidiaries that were not
included on the PRE-IDENTIFIED LOCATIONS OF
OPERATION. If your company operates at locations for
which you have received separate report forms, do not
list them, instead complete those forms. For acquired
establishments that you list, complete column (c2).
MAJOR ACTIVITY CODES FOR COLUMN (c1)
Column (b) - Report the number of employees and
payroll for full- and part-time employees working at
each establishment whose payroll was reported on
your Internal Revenue Service Forms 941, Employer's
Quarterly Federal Tax Return. Include part-year
operations. Do not combine data for establishments.
If book figures are not available for employment and
payroll for each establishment, please provide your
best estimates.
05 - Utilities
Column (c1) - Enter the code from the MAJOR
ACTIVITY CODES list that best describes the activity of
each establishment and specify the principal products
or services.
12 - Transportation/public warehousing
Column (c2) - Complete for acquired establishments.
16 - Professional/scientific/technical service
01 - Agricultural production
02 - Agricultural services
03 - Minerals extraction/ore processing
04 - Mining services/oil and gas field services
06 - Construction
07 - Manufacturing
08 - Merchant wholesaler
09 - Commission merchant/broker/agent/electronic marketer
(business to business)
10 - Manufacturers' sales branch/manufacturers' sales office
11 - Retail
13 - Information services/publishing/telecommunications
14 - Finance/insurance
15 - Real estate/renting/leasing
17 - Waste management/remediation service/administrative/
support service
18 - Educational service
19 - Health care
20 - Social assistance
21 - Arts/entertainment/recreation
22 - Accommodation/food service
23 - Corporate/subsidiary/regional/managing office
24 - Other - Specify major activity along with principal products
or services in column (c1) below.
IMPORTANT - DO NOT DUPLICATE ESTABLISHMENTS PRELISTED IN
Company Establishments and Subsidiaries
(Enter Employer Identification Number (EIN),
establishment name, your store or plant number, if any,
address of physical location, including ZIP Code.)
Employment and Payroll
(a)
5
A.
Major Activity in 2013
(Enter code from the MAJOR ACTIVITY CODES list
and specify the principal products or services.)
(b)
EIN
(c1)
2013
Code
Specify
Number of employees for pay
period including March 12
Name
99003014
(c2) Former Owner or Operator
Secondary name
Store/Plant No.
Physical location (Number and street)
City, town, village, etc.
Date
establishment
opened or is
expected to
open . . . .
Month
State
Day
First quarter payroll
(January-March 2013)
$Bil.
Mil.
Thou.
ZIP Code
Year
Name of former owner or operator
Mailing address (Number and street, P.O. Box, etc.)
City, town, village, etc.
$Bil.
2013
Annual payroll
Mil.
Thou.
State
Month
Date acquired
. . .
ZIP Code
Year
Form NC-99003
(DRAFT)
B. ADDITIONAL LOCATIONS OF OPERATION - Continued
5
(a) Company Establishments and Subsidiaries
(b) Employment and Payroll
EIN
2013
(c1) Major Activity in 2013
Code
Specify
Number of employees for pay
period including March 12
Name
(c2) Former Owner or Operator
Secondary name
Store/Plant No.
Physical location (Number and street)
City, town, village, etc.
Date
establishment
opened or is
expected to
open . . . .
Month
State
Day
First quarter payroll
(January-March 2013)
$Bil.
Mil.
Thou.
ZIP Code
Year
Name of former owner or operator
Mailing address (Number and street, P.O. Box, etc.)
City, town, village, etc.
$Bil.
2013
Annual payroll
Mil.
Thou.
2013
ZIP Code
Month
Date acquired
EIN
State
Code
Year
. . .
Specify
Number of employees for pay
period including March 12
Name
(c2) Former Owner or Operator
Secondary name
Store/Plant No.
Physical location (Number and street)
City, town, village, etc.
Date
establishment
opened or is
expected to
open . . . .
Month
State
Day
First quarter payroll
(January-March 2013)
$Bil.
Mil.
Thou.
ZIP Code
Year
Name of former owner or operator
Mailing address (Number and street, P.O. Box, etc.)
City, town, village, etc.
$Bil.
2013
Annual payroll
Mil.
Thou.
2013
ZIP Code
Month
Date acquired
EIN
State
Code
Year
. . .
Specify
Number of employees for pay
period including March 12
Name
(c2) Former Owner or Operator
99003022
Secondary name
Store/Plant No.
Physical location (Number and street)
City, town, village, etc.
Date
establishment
opened or is
expected to
open . . . .
Month
State
Day
First quarter payroll
(January-March 2013)
$Bil.
Mil.
Thou.
ZIP Code
Year
Name of former owner or operator
Mailing address (Number and street, P.O. Box, etc.)
City, town, village, etc.
$Bil.
2013
Annual payroll
Mil.
Thou.
State
Month
Date acquired
. . .
ZIP Code
Year
FORM NC-99004
(DRAFT)
U.S. DEPARTMENT OF COMMERCE Refer to this
Economics and Statistics Administration
U.S. CENSUS BUREAU CENSUS FILE NUMBER
2013 REPORT OF ORGANIZATION
5
in any correspondence
pertaining to this report
A. PRE-IDENTIFIED LOCATIONS OF OPERATION
IMPORTANT - Please read
5 A should include an up-to-date list of
establishments of your company that were
in operation during 2013. We have prelisted
establishments of your company based on
Census records.
Company Establishments and Subsidiaries
Line No. EIN
NAICS
Major activity
Secondary name
Store/Plant No.
Physical location (Number and street)
State
Line No. EIN
ZIP Code
NAICS
99004012
Major activity
Name
Secondary name
Store/Plant No.
Physical location (Number and street)
City, town, village, etc.
The manufacturing establishments for which an Annual Survey of
Manufactures report form needs to be completed are prelisted in
the first page(s) of 5 A. Employment and payroll information is not
requested on this page for these establishments. All information
concerning these manufacturing establishments, including changes
to the prelisted information, should be entered on the MA-10000(L)
report forms and not on 5 A.
The establishments which are not in our Annual Survey of
Manufactures sample, including any manufacturing plants not
receiving an MA-10000(L), are prelisted on the following pages of
5 A. Employment, payroll, and status information is requested for
these establishments. Any changes to the prelisted information for
these establishments should be entered on the 5 A sheets.
Name
City, town, village, etc.
On 5 B list separately all establishments of your company
and its subsidiaries that were in operation or any new plant(s)
under construction during part or all of 2013 that were not
prelisted on 5 A.
State
ZIP Code
Review the establishments listed on 5 A. List separately on 5 B all
establishments of your company and its subsidiaries that are not
prelisted on 5 A but were in operation or under construction.
Form NC-99004
5
(DRAFT)
A. PRE-IDENTIFIED LOCATIONS OF OPERATIONS - Continued
Company Establishments and Subsidiaries
Line No. EIN
NAICS
Major activity
Name
Secondary name
Store/Plant No.
Physical location (Number and street)
City, town, village, etc.
State
Line No. EIN
ZIP Code
Major activity
Name
Store/Plant No.
Physical location (Number and street)
City, town, village, etc.
State
Line No. EIN
ZIP Code
NAICS
99004020
Major activity
Name
Secondary name
Store/Plant No.
Physical location (Number and street)
City, town, village, etc.
State
The establishments which are not in our Annual Survey of
Manufactures sample, including any manufacturing plants not
receiving an MA-10000(L), are prelisted on the following pages of
5 A. Employment, payroll, and status information is requested for
these establishments. Any changes to the prelisted information for
these establishments should be entered on the 5 A sheets.
Review the establishments listed on 5 A. List separately on 5 B all
establishments of your company and its subsidiaries that are not
prelisted on 5 A but were in operation or under construction.
NAICS
Secondary name
The manufacturing establishments for which an Annual Survey of
Manufactures report form needs to be completed are prelisted in
the first page(s) of 5 A. Employment and payroll information is not
requested on this page for these establishments. All information
concerning these manufacturing establishments, including changes
to the prelisted information, should be entered on the MA-10000(L)
report forms and not on 5 A.
ZIP Code
FORM NC-99005
(DRAFT)
U.S. DEPARTMENT OF COMMERCE Refer to this
Economics and Statistics Administration
U.S. CENSUS BUREAU CENSUS FILE NUMBER
in any correspondence
pertaining to this report
2013 REPORT OF ORGANIZATION
5
A. PRE-IDENTIFIED LOCATIONS OF OPERATION
IMPORTANT - Please read
5 A should include an up-to-date list of
establishments of your company that were
in operation during 2013. We have prelisted
establishments of your company based on Census
records.
Company Establishments and Subsidiaries
Line No. EIN
NAICS
Name
Secondary name
Store/Plant No.
Physical location (Number and street)
State
Line No. EIN
ZIP Code
NAICS
99005019
Major activity
Name
Secondary name
Store/Plant No.
Physical location (Number and street)
City, town, village, etc.
An MA-10000(L) report form is enclosed with the NC-99001 for
each of the establishments prelisted in 5 A. Please review the
list of establishments. Any changes in address or to the prelisted
information should be entered on the individual MA-10000(L) report
forms. Please do not make corrections on the 5 A sheets.
List separately on 5 B all establishments of your company and its
subsidiaries that are not prelisted on 5 A but were in operation or
under construction.
Major activity
City, town, village, etc.
On 5 B list separately all establishments of your company
and its subsidiaries that were in operation or any new plant(s)
under construction during part or all of 2013 that were not
prelisted on 5 A.
State
ZIP Code
Form NC-99005
(DRAFT)
Company Establishments and Subsidiaries
Line No. EIN
NAICS
Major activity
List separately on 5 B all establishments of your company and its
subsidiaries that are not prelisted on 5 A but were in operation or
under construction.
Name
Secondary name
Store/Plant No.
Physical location (Number and street)
City, town, village, etc.
State
Line No. EIN
ZIP Code
NAICS
Major activity
Name
Secondary name
Store/Plant No.
Physical location (Number and street)
City, town, village, etc.
State
Line No. EIN
ZIP Code
NAICS
99005027
Major activity
Name
Secondary name
Store/Plant No.
Physical location (Number and street)
City, town, village, etc.
An MA-10000(L) report form is enclosed with the NC-99001 for
each of the establishments prelisted in 5 A. Please review the
list of establishments. Any changes in address or to the prelisted
information should be entered on the individual MA-10000(L) report
forms. Please do not make corrections on the 5 A sheets.
State
ZIP Code
| File Type | application/pdf |
| File Title | C:\DOCUME~1\jamsk001\LOCALS~1\Temp\tmp2B4.tmp |
| Author | jamsk001 |
| File Modified | 2013-07-03 |
| File Created | 2013-04-03 |