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| Question | Answer |
|---|---|
| Form Name | Form Be 12 |
| Form Length | 4 pages |
| Fillable? | No |
| Fillable fields | 0 |
| Avg. time to fill out | 1 min |
| Other names | bea, fdi, BE-12, 2012 |
FORM |
OMB No. |
2012 BENCHMARK SURVEY OF FOREIGN DIRECT INVESTMENT IN THE UNITED STATES
MANDATORY — CONFIDENTIAL
CLAIM FOR NOT FILING FORM
Due date: May 31, 2013
Electronic filing: www.bea.gov/efile
Mail reports to:
U.S. Department of Commerce
Bureau of Economic Analysis
Washington, DC 20230
Deliver reports to:
U.S. Department of Commerce
Bureau of Economic Analysis
Fax reports to:
(202)
Assistance:
Telephone: (202)
Copies of blank forms: www.bea.gov/fdi
A. Name and address of U.S. business enterprise
1002 |
Name of U.S. business enterprise |
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1010 |
c/o (care of) |
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1003 |
Street or P.O. Box |
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1004 |
City |
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0098 |
State |
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1005 |
ZIP Code |
Foreign Postal Code |
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B. Enter Employer Identification Number(s) used by the U.S. business enterprise to file income and payroll taxes.
Primary |
Other |
Include your |
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1006 |
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Number with all requests. |
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Response Required
Section 801.3 of 15 CFR, Chapter VIII, requires that all persons subject to the reporting requirements of the
•certifyinginwriting,byMay31,2013,tothefactthatthepersonhadnodirectinvestmentwithinthepurviewofthereportingrequirementsofthe
Mandatory Confidentiality Penalties
This survey is being conducted under the International Investment and Trade in Services Survey Act (P.L.
Person to consult concerning questions about this report — Enter name and address
1000 |
Name |
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1029 |
Address |
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1030 |
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0 |
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1031 |
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1001 |
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Telephone number |
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Certification — The undersigned official certifies that this report has been prepared in accordance with the applicable instructions, is complete, and is substantially accurate except that estimates may have been provided.
Authorized official’s signature |
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Date |
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0990 |
Print or type name |
0991 |
Print or type title |
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0992 |
Telephone number |
0993 |
Fax number |
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May fax and/or
*Note — If you choose to communicate with BEA via fax or electronic mail, BEA cannot guarantee the security of the information during transmission, but will treat information we receive as confidential in accordance with Section 5(c) of the International Investment and Trade in Services Survey Act.
1027 |
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Yes (If yes, enter your
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No
1028
1032 |
Fax: |
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Yes (If yes, enter your fax number) |
Fax number |
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No |
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0999
WHICH SECTIONS TO COMPLETE?
Complete all items on page 1. Also, review the questions below to determine what additional information is required.
IWere at least 10 percent of the voting rights in your business enterprise directly or indirectly owned by a foreign person or entity at the end of your fiscal year that ended in calendar year 2012?
Yes – Continue with question II.
No – Complete item (a) or (b) or (c) or (d) on this page. If your business has been liquidated or dissolved, complete (a) or (b). Do not complete questions II and III.
IIWere more than 50 percent of the voting rights in this U.S. business enterprise owned by another U.S. affiliate, or was this U.S. business enterprise merged into another U.S. affiliate before the end of this U.S. business enterprise’s fiscal year that ended in calendar year 2012? Note: U.S. affiliate is defined on page 4.
Yes – Continue with question III.
No – You must file a Form
IIIWill the data for this U.S. business enterprise be consolidated into the 2012
Yes – Complete item (e)(1) or (e)(2) on page 3.
No – Contact BEA for guidance.
Select ONE type of exemption based on one of the reasons listed below, or on page 3.
Check box corresponding to the type of exemption you are claiming.
This U.S. business enterprise is exempt from filing a Form
(a) 0170 |
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This U.S. business enterprise was a U.S. affiliate of a foreign person or entity at some time during calendar year 2012, but ceased to |
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be a U.S. affiliate before the end of the fiscal year that ended in calendar year 2012. |
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Give date foreign ownership ceased or went below 10 percent, or when the business was liquidated or dissolved. |
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Year |
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7012 |
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(b) 0110 |
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This U.S. business enterprise was not a U.S. affiliate of a foreign person or entity at any time during calendar year 2012, but had |
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been a U.S. affiliate of a foreign person at some time before January 1, 2012. |
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Give date foreign ownership ceased or went below 10 percent, or when the business was liquidated or dissolved. |
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7010 |
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(c) 0180 |
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This U.S. business enterprise is a U.S. affiliate of a foreign person or entity, but became a U.S. affiliate after the end of its fiscal year |
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that ended in calendar year 2012, or if a newly formed company, its first fiscal year did not or will not end until after the end of calendar year 2012.
Complete items (1) and (2).
(1) Give date when the U.S. business enterprise became a U.S. affiliate of a foreign person.
7013
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Day |
Year |
1
(2)Give the ending date of the U.S. business enterprise’s fiscal year that ended in calendar year 2012. If a newly formed company, give the ending date of the U.S. business enterprise’s first fiscal year. NOTE: For a newly formed company this must be a date in calendar year 2013.
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Year |
7014 |
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1 |
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(d) |
0160 |
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This U.S. business enterprise is exempt from filing because its owners are citizens of the United States who are resident abroad as |
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a result of official employment by the U.S. Government (including the immediate family of such persons), or its owners have been and |
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expect to be resident abroad for less than one year. |
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FORM |
Page 2 |
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(e)This U.S. business enterprise was controlled by a U.S. affiliate of a foreign person or entity during the fiscal year that ended in calendar year 2012 and is (check appropriate box (1) or (2)):
(1)
(2)
0112 1 1
0112 2 1
Fully consolidated
OR
Merged into, and included on the 2012
On the lines below give the name, address, and
Name
0120 0
Street or P.O. Box
0130 0
City
0140 0
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State |
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Zip Code |
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0141 |
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0150 |
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7011 0
(f) 0190 1 |
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Other – Specify and include reference to section of regulations or instructions on which claim is based. |
7015 0
Remarks
FORM |
Page 3 |
Authority – This survey is being conducted under the International Investment and Trade in Services Survey Act (P.L.
Penalties – Whoever fails to report may be subject to a civil penalty of not less than $2,500, and not more than $25,000, and to injunctive relief commanding such person to comply, or both. The civil penalties are subject to inflationary adjustments. Those adjustments are found in 15 CFR 6.4. Whoever willfully fails to report shall be fined not more than $10,000 and, if an individual, may be imprisoned for not more than one year, or both. Any officer, director, employee, or agent of any corporation who knowingly participates in such violation, upon conviction, may be punished by a like fine, imprisonment, or both. (22 U.S.C. 3105)
Notwithstanding any other provision of the law, no person is required to respond to, nor shall any person be subject 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 OMB Control Number. The control number for this survey is at the top of page 1.
Respondent Burden – Public reporting burden for this form is estimated to be average of 20 minutes per response, 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 sug-
and to the Office of Management and Budget, Paperwork Reduction Project
Confidentiality – The Act provides that your report to this Bureau is CONFIDENTIAL and may be used only for analytical or statistical purposes. Without your prior written permission, the information filed in your report CANNOT be presented in a manner that allows it to be individually identified. Your report CANNOT be used for purposes of taxation, investigation, or regulation. Copies retained in your files are immune from legal process.
Definitions of Key Terms
Affiliate means a business enterprise located in one country that is directly or indirectly owned or controlled by a person or entity of another country to the extent of 10 percent or more of its voting stock for an incorporated business or an equivalent interest for an unincorporated business, including a branch.
Direct investment means the ownership or control, directly or indirectly, by one person or entity of 10 percent or more of the voting securities of an incorporated business enterprise or an equivalent interest in an unincorporated business enterprise.
U.S. affiliate means an affiliate located in the United States in which a foreign person or entity has a direct investment.
FORM |
Page 4 |