NCS Form20 - 1P Private Industry Establishment Work Level and Schedule F

U.S. Department of Labor Bureau of Labor Statistics

National Compensation Survey

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ESTABLISHMENT COLLECTION FORM FOR PRIVATE INDUSTRY

(Work level and schedule)

Address # 1.

Physical Address Personal Visit Address Mailing Address

Schedule Number(#):

Company Name:

Secondary Name (Doing Business As):

Address:

City/State/ZIP:

Address # 2.

Physical Address Personal Visit Address Mailing Address

Company Name:

Secondary Name (Doing Business As):

Address:

City/State/ZIP:

Establishment Officials (Contact List)

# 1: Authorizing Supplying		Title:
Telephone #: FAX #:	E-mail: Address: 1, 2, or COC. Mail forms to
# 2: Authorizing Supplying		Title:
Telephone #: FAX #:	E-mail: Address: 1, 2, or COC. Mail forms to
# 3: Authorizing Supplying		Title:
Telephone #: FAX #:	Email: Address: 1, 2, or COC. Mail forms to

NCS Form20-1P (2020)

Central Office Clearance (Complete if clearance and/or data obtained from this source)

Clearance obtained: Schedule (data) obtained:

Company Name:

Address:

City/State/ZIP:

Remarks

COMPANY DATA

Establishment Information (current data) Schedule #:

State:	Collection Panel:	Sample Number:
Assigned Employment:	Total Employment:	PSO Employment:
NAICS:
Establishment Description:
Product Description:

Collection Information

Field Economist:	Method of Collection:
Collection Date:	Payroll Reference Date:

Respondent waived confidentiality Data obtained electronically

Document obtained (Secondary data source)

Written Permission: Yes, No	Name and Title of Official:
Date of Permission:	Permission on file at RO: Yes, No

Status (IDC Wage)

Establishment Status:	Remarks:
Usable
On strike
Vacant
Temporary non response
Refusal
Out of business
Out of scope
Abolished
No matching jobs
Duplicate

SMG Notification

Reason:	Remarks:
Ownership/NAICS change
Part of assigned unit
Collected unit larger than assigned
Employment +/- 20% of assigned
Employment up – business fluctuations
Sampled employment wrong
SMG chose establishment subsample
Overlap (set by system)
Other discrepancy

Remarks

NATIONAL COMPENSATION SURVEY - Leveling

Schedule Number:

Quote:

Occupation:

Establishment Grade:

SOC:

Establishment Rate Range:

Establishment Job Title:

Factor	Level	Education, experience, other comments
KNOWLEDGE
JOB CONTROLS AND COMPLEXITY
CONTACTS
PHYSICAL ENVIRONMENT

Remarks

NATIONAL COMPENSATION SURVEY - Leveling

Schedule Number:

Quote:

Occupation:

Establishment Grade:

SOC:

Establishment Rate Range:

Establishment Job Title:

Factor	Level	Education, experience, other comments
KNOWLEDGE
JOB CONTROLS AND COMPLEXITY
CONTACTS
PHYSICAL ENVIRONMENT

Remarks

U.S. Department of Labor Bureau of Labor Statistics

National Compensation Survey Leveling Form

NATIONAL COMPENSATION SURVEY - Leveling

Schedule Number:

Quote:

Occupation:

Establishment Grade:

SOC:

Establishment Rate Range:

Establishment Job Title:

Factor	Level	Education, experience, other comments
KNOWLEDGE
JOB CONTROLS AND COMPLEXITY
CONTACTS
PHYSICAL ENVIRONMENT

Remarks

U.S. Department of Labor Bureau of Labor Statistics

National Compensation Survey Leveling Form

NATIONAL COMPENSATION SURVEY - Leveling

Schedule Number:

Quote:

Occupation:

Establishment Grade:

SOC:

Establishment Rate Range:

Establishment Job Title:

Factor	Level	Education, experience, other comments
KNOWLEDGE
JOB CONTROLS AND COMPLEXITY
CONTACTS
PHYSICAL ENVIRONMENT

Remarks

U.S. Department of Labor Bureau of Labor Statistics

National Compensation Survey Leveling Form

NATIONAL COMPENSATION SURVEY - Leveling

Schedule Number:

Quote:

Occupation:

Establishment Grade:

SOC:

Establishment Rate Range:

Establishment Job Title:

Factor	Level	Education, experience, other comments
KNOWLEDGE
JOB CONTROLS AND COMPLEXITY
CONTACTS
PHYSICAL ENVIRONMENT

Remarks

U.S. Department of Labor Bureau of Labor Statistics

National Compensation Survey Leveling Form

NATIONAL COMPENSATION SURVEY - Leveling

Schedule Number:

Quote:

Occupation:

Establishment Grade:

SOC:

Establishment Rate Range:

Establishment Job Title:

Factor	Level	Education, experience, other comments
KNOWLEDGE
JOB CONTROLS AND COMPLEXITY
CONTACTS
PHYSICAL ENVIRONMENT

Remarks

U.S. Department of Labor Bureau of Labor Statistics

National Compensation Survey Leveling Form

NATIONAL COMPENSATION SURVEY - Leveling

Schedule Number:

Quote:

Occupation:

Establishment Grade:

SOC:

Establishment Rate Range:

Establishment Job Title:

Factor	Level	Education, experience, other comments
KNOWLEDGE
JOB CONTROLS AND COMPLEXITY
CONTACTS
PHYSICAL ENVIRONMENT

Remarks

U.S. Department of Labor Bureau of Labor Statistics

National Compensation Survey Leveling Form

NATIONAL COMPENSATION SURVEY - Leveling

Schedule Number:

Quote:

Occupation:

Establishment Grade:

SOC:

Establishment Rate Range:

Establishment Job Title:

Factor	Level	Education, experience, other comments
KNOWLEDGE
JOB CONTROLS AND COMPLEXITY
CONTRACTS
PHYSICAL ENVIRONMENT

Remarks

U.S. Department of Labor Bureau of Labor Statistics

National Compensation Survey Leveling Form

NATIONAL COMPENSATION SURVEY – Base Leveling Supervisor

Schedule Number:

Supervisor

1^st 2^nd 3^rd Line Supervisor/Manager

Quote:

Occupation:

Establishment Grade:

SOC:

	Establishment Rate Range:	Establishment Job Title:

Highest Level Non-Supervisory Subordinate Position _________________________________________________

Factor	Level	Education, experience, other comments
KNOWLEDGE
JOB CONTROLS AND COMPLEXITY
CONTACTS
PHYSICAL ENVIRONMENT

Remarks

U.S. Department of Labor Bureau of Labor Statistics

National Compensation Survey Leveling Form

NATIONAL COMPENSATION SURVEY – Leveling on Duties and Responsibilities of Supervisor

Schedule Number:

Supervisor

1^st 2^nd 3^rd Line Supervisor/Manager

Quote:

Occupation:

Establishment Grade:

SOC:

	Establishment Rate Range:	Establishment Job Title:

Factor	Level	Education, experience, other comments
KNOWLEDGE
JOB CONTROLS AND COMPLEXITY
CONTACTS
PHYSICAL ENVIRONMENT

Remarks

U.S. Department of Labor Bureau of Labor Statistics

National Compensation Survey Leveling Form

NATIONAL COMPENSATION SURVEY – Leveling Summary

Schedule Number:

Leveling Factors	QUOTE 1	QUOTE 2	QUOTE 3	QUOTE 4	QUOTE 5	QUOTE 6	QUOTE 7	QUOTE 8
KNOWLEDGE
JOB CONTROLS AND COMPLEXITY
CONTACTS
PHYSICAL ENVIRONMENT

Remarks

NATIONAL COMPENSATION SURVEY - Work Schedule
	Schedule Number:

Quote #	Work Schedule #	Description/occupation	Hours/day	Hours/week	Weeks/year	Type

For “Work Schedule #” note also if Alternate work schedule (Only needed for index schedules)

Remarks

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