Attachment 13 B Fo B Form

Bureau of Labor Statistics
U.S. Import I Export Price Information

U.S. Department of Labor
0MB No. 1220·0025

The �,\: ot �!>:,r statistks, its -em.pbye-i:.s, 2;-�r.b, .,n,3- �rtr.er �:Heti:,1 :i�i:�s. wiH �: � ir.te.rm.,-ti:r, you prov� r�r sti,thli::ii purp,:,.s:.s ordy .sri4 wiH f'-eU �
in'torm,!or, in conri!!=ftiCe to ct•.c tQ.b u�rt permitt:O by In,. In ,-::=rd,na: with tf'R Cor,M!!ntisl tntcrmatQn ?rot:alon ult S:t:itistal Erttc:i=I\C)' � (44 U.S.C, 3$71) :ind oU,-u
•pplie.011 ,.,d:ar1I t1w1, your rupo-""' ...,111 not ba a,ICkPn4 ln 1C,,.tirl,os1, rOffl'I w,�t yoi.r ,nf0ffll10 eon.uf'lt, Pu tl'-1 l'1C1tr1I Cyl>tl'HC11Nty en.tl1M:1l"l1.l"tt .4rou;l'I cybc�i:ci.nt'y .s::n:CJ'Urg or lnlri:.m.ith:d data.
Paperwork Reduction Act Pi.li: Burden Statement: We estimate it will take an average of 1 hour for ttl.is ,:.:,J�.:tr..n or ir,torm,tt:-n. This estimate takes into account time for
reviewing ir,stn.cti:-r,s, .si:,r.hir.; i:.x.etir.;; d:1t1 .s:.L'ren, 9,therin.g- 1nd m,ln.Uil'li� � 41t41 rt11d10. 11\CJ nivll'wir.; ttt. coli.Mn or inrom11tbr1. The obligation to respond to this
collection is voluntary. If you hive ,rvy �mmub r.91tdl� thl11Jtlm1t1 c1 •"Y ctfar np■cts or tl\i1 iraro.rm,f,o,l'I c.oll■�l'I. including suggestions for reducting this burdent, you may send them to the Bureau of Labor Statistics
!by email to BLS_PRA_Public@bls.gov. The OMB control number for IPP's survey is 1220-0025. Without a currently valid OMB number BLS would not be able to conduct this survey.

Quole No:

Schedule:

SCG: __________

TSUSA / Sched B:

MuttipleHtt:

Item Description

If off.cycle, mark
monlh(s) priced:

-----

(Number of OuotesReprueMed)

JAIi

FEB

MAR APR MAY JUH

Price related to size of order:
Price related to class of buyer/seller:

JUL

AUG SEP

OCT HOV

DEC

------------------------

D Market Sale

□
D
□
D

Intra-Co Transfer

Market-Based
Cost-Based

Other
Unknown

Price, Duty and Discounts
Date:

Currency of Price:

Price:

Unit Priced:

Price Basis:

Country imported from/counlry of destination:___________

Imports only Duty:$ _____
(If Included In CIF prlee)

Discounts
Type:
Amount: _____

Already deducted?
Amount Currency: ________

%:

Type: _____________Already deducted?
Amount:
Comments:

BLS-230

Amount Currency:

%:

-----------