U.S. DEPARTMENT OF COMMERCE

U.S. CENSUS BUREAU

FORM

SM-4417SS-E MONTHLY RETAIL TRADE REPORT

(08-31-2021)

CONTINUE ON PAGE 2

44116010 Due Date

 Need help or have questions?

 Call 1-800-772-7852

 (8:30 a.m. - 5:00 p.m. ET, M-F)

 or Visit

 https://econhelp.census.gov/mrts

Title 13 United States Code (U.S.C.),

Sections 131 and 182, authorizes the

Census Bureau to conduct this collection

and to request your assistance. 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.

This collection has been approved by the

Office of Management and Budget (OMB).

The eight-digit OMB approval number is

0607-0717 and appears at the upper right of

this page. Without this approval, we could

not conduct this survey.

Return via Internet:

 Return via Fax: To view Survey Results:

https://econhelp.census.gov/mrts

 1-800-447-4613 https://www.census.gov/retail

Username:

Password:

 GENERAL INSTRUCTIONS

 

• This report should cover all establishments in the U.S. (including the District of Columbia) reporting payroll on its latest Federal Tax Return

(Treasury Form 941 or 944), under the Employer Identification Number (EIN) as shown in 1

 

• Any significant change in this EIN's operations should be noted in 4

 

• For establishments sold or acquired during the month, report data only for the period the establishment was operated by this EIN

 

• Estimates are acceptable if book figures are not available

 

• Enter "0" where applicable

INCLUDE

 EXCLUDE

 

•

 

•

Data for auxiliary facilities primarily engaged in supporting services

to this EIN's establishment(s) such as warehouses, garages, central

administrative offices, and repair services

Leased departments and concessions operated in other establishments

 

•

 

•

 

•

Leased departments and concessions operated by other firms in this

EIN's establishments

Sales taxes and finance charges

Data for establishments operated by other firms, such as franchises

 ANNOUNCEMENTS AND SPECIAL INSTRUCTIONS

We estimate this survey will take an average of 7 minutes to complete. More information about this estimate and an address where you may write

with comments is on the back of this form.

1 FEDERAL EMPLOYER IDENTIFICATION (EIN)

Does this firm report payroll under EIN

Yes

No - Enter current 9-digit EIN AND date payroll was first

reported for this EIN . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

EIN (9 digits)

 

Month

 

Day

 Year

2 NUMBER OF RETAIL ESTABLISHMENTS

 Number

How many retail establishments did this EIN operate? . . . . . . . . . . . . . . . . . . . . . . . . . .

The remainder of this report refers to the establishments reported here.
Form SM-4417SS-E (08-31-2021) Page 2

44116028

3 SALES, RECEIPTS, OR REVENUE

INCLUDE

 EXCLUDE

 

• Cash and credit sales of merchandise whether or not payment

was received 

• Commissions from vending machine operators and from sales

of government lottery tickets

 

• E-commerce sales if not submitted on a separate monthly

retail report 

• Nonoperating receipts (such as interest income, income from

investments, and receipts from the rental or sale of real estate)

 

•

 

•

Wholesale sales and services revenue made by retail

establishments covered by this report

Value of trade-ins taken as part payment for other

merchandise

 

•

 

•

Refunds and allowances for returned goods

The actual value of rebates and discounts granted to the

purchaser, even if granted as an increase in trade-in allowance

A.

 

What type of reporting period do this month's sales represent?

Calendar month reporting period - Go to 3 C

4-week reporting period

5-week reporting period 

Ending Date

 

Month

 

Day

B.

 

If not a calendar month reporting period, what is the ending date for the period you are reporting sales?

 Dollars

C.

 

What were the total sales in

 . . . . . . . . . . . . . . . . . . . . . .

D.

 

Do the sales reported in 3 C represent book figures or estimates?

Book Figure

Estimate

E.

 

Did this EIN have any e-commerce sales in

Yes

No - Go to 4

 Dollars

F.

 

What were the total e-commerce sales in

 . . . . . . . . . . . . . . .

OR Percent

If e-commerce sales not available - What was the percent of total sales in 3 C that represents e-commerce? 

%

4 REMARKS - Please use this space to explain any significant month-to-month changes, to clarify responses, or indicate where data were

estimated.

CONTACT INFORMATION

Name of person to contact regarding this report Title

Telephone

Area code

 Number

 

- Extension E-mail address

 DEFINITIONS OF E-COMMERCE SALES, AUXILIARY ESTABLISHMENTS, LEASED DEPARTMENTS AND CONCESSIONS

 

• E-commerce is the sale of goods and services where the buyer places an order, or the price and terms of the sale are negotiated, over an Internet, mobile device (M-Commerce),

extranet, EDI network, electronic mail, or other comparable online system. Payment may or may not be made online.

 

• Auxiliary Establishments are facilities primarily engaged in furnishing supporting services (such as warehouses, garages and central administrative offices) to this EIN's establishments.

 

• Leased Departments and Concessions are separate businesses that lease space on the premises of another business.

We estimate this survey will take an average of 7 minutes to complete, 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 voluntary collection of information, including

suggestions for reducing this burden, to: eid.retail.indicator.branch@census.gov. Be sure to use "EID Survey Comments 0607-0717" as the subject.