Persinal interview worksheet for supplier and support bu

Regional Economic Data Collection Program for Southwest Alaska

Personal Interview Worksheet for Supplier and Support Businesses_OIRA (1)_Chang_ecw_CKS_CLEAN COPY

Interviews with input suppliers and processors

OMB: 0648-0722

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DRAFT

2014


Southwest Alaska Fisheries Data Collection Project


CONFIDENTIAL

Personal Interview Worksheet for

Supplier and Support Businesses



Conducted by



NOAA Fisheries

Alaska Fisheries Science Center





OMB Approval No. XXXX-XXXX

Expiration Date YYYY

Instructions

This worksheet contains the information we will be asking you about in the interview. Please examine the worksheet and have it available during the interview. The interviewer will answer any questions and help fill out the worksheet during the interview. You do not need to fill out or return a completed worksheet prior to the interview. your responses ARE VOLUNTARY AND will be strictly confidential and used only to estimate the economic contributions of sw alaska fisheries to southwest alaska and other u.s. regions.


Confidentiality


Per Section 402(b) of the Magnuson-Stevens Act (16 U.S.C. 1801, et seq.), all individual survey responses are confidential and will be held by only a limited number of researchers at Alaska Fisheries Science Center and contractors who are authorized to work with the data. After the data have been entered in an electronic format, only those researchers will have (password-protected) access to the data. Individual survey forms and electronic responses will be destroyed upon completion of the study. Your name, business name, and address will be used only for mailing and survey administration purposes. Only summary results of this survey will be reported to the public. NOAA Fisheries and other agencies will see only aggregate results in summary form, not individual responses.


YOUR RESPONSES AND THE DATA COLLECTED FROM THIS SURVEY WILL NOT BE SEEN OR USED FOR ANY OTHER PURPOSE BY NOAA FISHERIES, OTHER FEDERAL GOVERNMENT AGENCIES, THE STATE OF ALASKA OR OTHER PARTIES.


Paperwork Reduction Act Statement


Public reporting burden for this collection of information is estimated to average 45 minutes per response, including the time for reviewing instructions, gathering the data needed, and completing and reviewing the form. Please send comments regarding this burden estimate or any other suggestions for reducing this burden to Chang Seung, Alaska Fisheries Science Center (Address: 7600 Sand Point Way NE Seattle WA 98115-6349), Phone: 206-526-4250 Email: chang.seung@noaa.gov


Notwithstanding any other provisions of the law, no person is required to respond to, nor shall any person be subjected to a penalty for failure to comply with, a collection of information subject to the requirements of the Paperwork Reduction Act, unless that collection of information displays a currently valid U.S. Office of Management and Budget Approval Number. This collection of information has been approved by the U.S. Office of Management and Budget (Approval Number XXXX-XXXX expiration date yyyy).


Content

This worksheet is designed to ask pertinent questions needed to characterize the role of commercial fishing and related businesses in the Southwest Alaska (SW Alaska) economy and elsewhere. For purposes of this survey, the SW Alaska economy includes the following boroughs and census areas (BCAs): Aleutians West Census Area (AW), Aleutians East Borough (AE), Bristol Bay Borough (BB), Dillingham Census Area (DH), Lake and Peninsula Borough (LP), and Kodiak Island Borough (KI).

The worksheet contains three sections. Section A contains business contact information, which we have pre-filled. Section B asks for information about your customer base and where you sell products and services. Section C asks where your primary business operating expenditures are made.

Please record your responses to the following questions so as to reflect your business operations.



Section A: Contact Information (Please make any corrections.)


Information on Record

Corrections, if any

Supplier Name:

New Nets Co.





Address:




Kodiak AK 99615


Contact Pson:

Perchis Erman


Phone:

555-555-1234


Email:


hello@newnets.com


Interview Date:

Jan. aa, 20XX



Section B: Customer base and products and services sold

  1. Who are your customers? (e.g., vessels, processors, other commercial fishing industry businesses, recreational fishing businesses, repair yards, other)

    1. Primary: ____________________________________________________

    2. Secondary: _________________________________________________

    3. Other: _____________________________________________________



  1. What products and services do you offer?

    1. ________________________________

    2. ________________________________

    3. ________________________________

    4. ________________________________

    5. ________________________________

    6. ________________________________



  1. What proportion of those products and services are sold to buyers in the following regions?

Item

Approximate Percentage of Item Sales to Buyers in:

Southwest Alaska BCAs*

Other Alaska

West Coast

Other US

Outside the US

Total

AW

AE

BB

DH

LP

KI

a.











100%

b.











100%

c.











100%

d.











100%

e.











100%

f.











100%












100%

*Southwest Alaska BCAs: AW=Aleutians West Census Area, AE=Aleutians East Borough, BB=Bristol Bay Borough, DH=Dillingham Census Area, LP=Lake and Peninsula Borough, and KI=Kodiak Island Borough (see map).

Section C: Regional distribution of business operating expenditures?

  1. Where were your purchases and primary business operating expenditures made? (Including where do your employees reside?). (“I” = inventory item).

Item

Approximate Percentage of Item Purchases Made in:

Southwest Alaska BCAs*

Other Alaska

West Coast

Other US

Outside the US

Total

AW

AE

BB

DH

LP

KI

Labor











100%

Utilities











100%

Accounting











100%

Other











100%

I1:











100%

I2:











100%

I3:











100%

I4:











100%

*Southwest Alaska BCAs: AW=Aleutians West Census Area, AE=Aleutians East Borough, BB=Bristol Bay Borough, DH=Dillingham Census Area, LP=Lake and Peninsula Borough, and KI=Kodiak Island Borough (see map).



Map of Southwest Alaska BCAs and Associated Communities


SW Alaska Boroughs & Census Areas

Associated Communities

Aleutian West Census Area (AW)

Atak, Adak, Nikolski, St. Paul, St. George, Unalaska (Dutch Harbor)

Aleutian East Borough (AE)

Akutan, Belkofski Village,  Cold Bay, False Pass, King Cove, Nelson Lagoon, Pauloff Harbor, Sand Point, Unga

Bristol Bay Borough (BB)

King Salmon, Naknek, South Naknek

Dillingham Census Area (DH)

Aleknagik, Clarks Point, Dillingham, Ekwok, Ekuk, Koliganek, Manokotak, New Stuyahok, Portage Creek, Twin Hills, Togiak

Lake and Peninsula Borough (LP)

Chignik Lake, Chignik Lagoon, Chignik, Egegik, Ivanoff Bay, Iliamna, Igiugig, Kokhanok, Levelock, Nondalton, Newhalen, Port Heiden, Port Alsworth, Pilot Point, Perrysville, Pedro Bay, Ugashik

Kodiak Island Borough (KI)

Akhiok, Afognak, Kodiak, Karluk, Larsen Bay, Ouzinkie, Old Harbor, Port Lions





Comments:


Customer Base Comments






Products and Services Sold Comments







Regional Distribution of Expenditures Comments







Comments on Interview Questions and Other Comments







THANK YOU FOR YOUR PARTICIPATION!

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