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Column (a) - List separately any establishments |
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MAJOR ACTIVITY CODES FOR COLUMN (c1) |
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of your company and its subsidiaries that were not |
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included on the PRE-IDENTIFIED LOCATIONS OF |
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01 |
- Agricultural production |
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OPERATION. If your company operates at locations for |
02 |
- Agricultural services |
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which you have received separate report forms, do not |
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03 |
- Minerals extraction/ore processing |
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list them, instead complete those forms. For acquired |
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establishments that you list, complete column (c2). |
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- Mining services/oil and gas field services |
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Column (b) - Report the number of employees and |
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- Utilities |
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06 |
- Construction |
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payroll for full- and part-time employees working at |
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each establishment whose payroll was reported on |
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- Manufacturing |
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your Internal Revenue Service Forms 941, Employer's |
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08 |
- Merchant wholesaler |
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Quarterly Federal Tax Return. Include part-year |
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09 |
- Commission merchant/broker/agent/electronic marketer |
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operations. Do not combine data for establishments. |
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If book figures are not available for employment and |
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(business to business) |
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payroll for each establishment, please provide your |
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- Manufacturers' sales branch/manufacturers' sales office |
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best estimates. |
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11 |
- Retail |
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Column (c1) - |
Enter the code from the MAJOR |
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- Transportation/public warehousing |
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ACTIVITY CODES list that best describes the activity of |
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- Information services/publishing/telecommunications |
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each establishment and specify the principal products |
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- Finance/insurance |
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or services. |
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15 |
- Real estate/renting/leasing |
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Column (c2) - Complete for acquired establishments. |
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- Professional/scientific/technical service |
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17 |
- Waste management/remediation service/administrative/ |
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support service |
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18 |
- Educational service |
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19 |
- Health care |
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20 |
- Social assistance |
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21 |
- Arts/entertainment/recreation |
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22 |
- Accommodation/food service |
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23 |
- Corporate/subsidiary/regional/managing office |
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24 |
- Other - Specify major activity along with principal products |
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or services in column (c1) below. |
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IMPORTANT - DO NOT DUPLICATE ESTABLISHMENTS PRELISTED IN 5 A. |
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Company Establishments and Subsidiaries |
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Major Activity in 2015 |
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(Enter Employer Identification Number (EIN), |
Employment and Payroll |
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(Enter code from the MAJOR ACTIVITY CODES list |
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establishment name, your store or plant number, if any, |
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and specify the principal products or services.) |
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address of physical location, including ZIP Code.) |
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(a) |
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(b) |
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(c1) |
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EIN |
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2015 |
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Code |
Specify |
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- |
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Number of employees for pay |
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period including March 12 |
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Name |
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(c2) Former Owner or Operator |
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Secondary name |
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Store/Plant No. |
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First quarter payroll |
Name of former owner or operator |
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(January-March 2015) |
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Physical location (Number and street) |
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$Bil. |
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Mil. |
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Thou. |
Mailing address (Number and street, P.O. Box, etc.) |
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City, town, village, etc. |
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State |
ZIP Code |
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City, town, village, etc. |
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ZIP Code |
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2015 |
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Annual payroll |
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Date |
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Month |
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Day |
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$Bil. |
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Mil. |
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Thou. |
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Month |
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Year |
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establishment |
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opened or is |
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expected to |
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open . . . . |
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Date acquired . . . |
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