Annual Survey of Entrepreneurs

Attachment C - Eletronic Instrument Screens
Survey: OMB No. 0607-0986 OMB Expiration Date: 06/30/2019

AN OFFICIAL WEBSITE OF THE UNITED STATES GOVERNMENT

Annual Survey of Entrepreneurs

Welcome to the 2016 Annual Survey of Entrepreneurs
Please use this website to complete this survey.
• Persons who reported business activity for all or any part of 2016 should respond to this survey.
• Note: Your session will expire if you remain on one screen for 50 minutes without navigating to another screen.
YOUR RESPONSE IS REQUIRED BY LAW. Title 13 United States Code (U.S.C.), Sections 8(b), 131, and 182 authorizes this collection. Sections 224 and
225 require your response. The U.S. Census Bureau is required by Section 9 of the same law to keep your information CONFIDENTIAL and can use your
responses only to produce statistics. The Census Bureau is not permitted to publicly release your responses in a way that could identify your business,
organization, or institution. Per the Federal Cybersecurity Enhancement Act of 2015, your data are protected from cybersecurity risks through screening
of the systems that transmit your data. On behalf of the Secretary of Commerce, pursuant to Section 1(a)(3) of Executive Order 11625, the MBDA may
enter into this agreement with the Census Bureau to establish a means for the development, collection, summation, and dissemination of information
that will be helpful to persons and organizations throughout the nation in undertaking or promoting the establishment and successful operation of
minority business enterprises.
This collection has been approved by the Office of Management and Budget (OMB). The eight digit- OMB approval number is 0607-0986 and appears
at the upper right of this screen. Without this approval we could not conduct this survey.

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For help, call 1-888-824-9954, between 8 a.m. and 6 p.m., Eastern time, Monday through Friday.

** WARNING **
You have accessed a UNITED STATES GOVERNMENT computer. Use of this computer without authorization or for purposes for which authorization has
not been extended is a violation of Federal law and can be punished with fines or imprisonment (PUBLIC LAW 99-474). System usage may be
monitored, recorded, and subject to audit. Any information you enter into this system may be used by the Census Bureau for statistical purposes,
including but not limited to improving the efficiency of our data collection programs. For information regarding the use of this system, and how your
privacy is protected, visit our online privacy webpage at http://www.census.gov/privacy/. Use of this system indicates consent to the collection,
monitoring, recording, and use of information provided inside this system.

Burden Statement

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Accessibility

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Privacy

|

Measuring America—People, Places, and Our Economy

Security

Attachment C - Eletronic Instrument Screens

Survey: ASE-1

OMB No. 0607-0986

OMB Expiration Date: 06/30/2019

A N O FF I C I A L W E BS I T E O F T H E U N I TE D S T A TE S G O V E R N M E N T

Annual Survey of Entrepreneurs
Main Menu

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About the Survey

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FAQs

| Contact Us

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Logout

Main Menu
Please complete the survey below by clicking on the Start button. You will have an opportunity to review your responses at the end.

Please use the 'Previous' or 'Save & Continue' buttons to navigate through the survey. We do not recommend using the 'Back' button
in your web browser.
Action

Status

Resume

Company Address

Survey Preview

View/Print
Responses

In Progress

The letters PDF or the
icon indicate a document is in the Portable Document Format (PDF). To view the file you will need the Adobe® Reader, which
is available for free from the Adobe web site.

Burden Statement

|

Accessibility

|

Privacy

|

Security

Measuring America—People, Places, and Our Economy

Attachment C - Eletronic Instrument Screens
Survey:

OMB No. 0607-0986

OMB Expiration Date: 06/30/2019

A N O FF I C I A L W E BS I T E O F T H E U N I TE D S T A TE S G O V E R N M E N T

Annual Survey of Entrepreneurs

Burden Statement
We estimate the average time to complete this survey is 35 minutes, 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:
EWD Survey Comments
0607-0986 U.S. Census Bureau
4600 Silver Hill Road
Room EWD-8K154
Washington, DC 20233
You may e-mail comments to ewd.surveys@census.gov. Be sure to use "EWD Survey Comments 0607-0986" as the subject.

Burden Statement

|

Accessibility

|

Privacy

|

Measuring America—People, Places, and Our Economy

Security

Attachment C - Eletronic Instrument Screens

Attachment C - Eletronic Instrument Screens

Attachment C - Eletronic Instrument Screens