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REPUBLIC OF INDOENSIA KIPCENTRAL BUREAU OF STATISTICS Questionnaire II-A

1995 ANNUAL MANUFACTURING SURVEY

1. Province : ……………………………….2. District/Municipality *) : ……………………………….3. Administrative City : ……………………………….4. Sub-district : ……………………………….5. Village/Village Unit : ……………………………….6. Survey Year : ……………………………….

Filled in by CBS

7. Name of Company : ………………………………..8. Address of Company : ………………………………..

………………………Postal codePhone: ( )……….Fax: ( )……..

*) Cross out inapplicable category

Objective of the survey:To obtain reliable and accurate data for development planning

Legal Status:Implementation of the survey is based on Law no.7 on Statistics, 1960

ConfidentialityConfidentiality of the data is guaranteed under Law no. 7 on Statistics, 1960

Survey expenses:Government of Indonesia fully guarantees the survey. There is no charge to the Company

For further information,Please contact: Sri Kusmiati atau Aswyzar

Biro Statistik Industri BPS Jl. Dr. Sutomo 8 Jakarta, 10710 Tel/Fax: (021) 386-3816 Or the nearest Bureau of Statistics Regional Office in your province (see the last page)

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Instructions

Prior to filling in the questionnaire, please read the following information carefully:

A manufacturing establishment is defined as a production unit located in a building or in a certainlocation, engaged in economic activities, processing or transforming materials mechanically, chemically,or manually, from raw materials into finished or semi finished products having higher value, bringingthese closer to the end user. An establishment that provides manufacturing services or assembles parts isincluded as a manufacturing establishment.

Manufacturing services are industrial activities that serve others. In these activities the basic materials aresupplied by others while the processor only conducts the processing and receives payment or goods as acompensation, for example a rice mill which grinds the farmer’s rice receives profit share.

For industries whose activities are closely linked with other sectors, data should be limited tomanufacturing activities only. Separation of those activities should apply for every variable,such as number of workers, wages/salaries, raw materials, production, etc.

Example of manufacturing activities that are linked to other sectors:The tapping of rubber trees to produce latex as a raw material to make crumb rubber should beincluded in the agricultural (estate) sector, but production of smoked rubber or rubber processingshould be included in the manufacturing sector.

Data should cover activities from 1 January 1995 to 31 December 1995

Data in value term should be expressed in thousands of Rupiah.Example: Suppose wage/salary of production workers in cash during 1996 is 100.000.850,00 rupiahs,thus the entry in part II question 13.1.a is as follow:

In cash (Rp)

a. Wage/salary100.01 000

Please use block letters for information having descriptive answers.

For questions with pre-coded answers, please choose the ppropriate code and then write it down inthe box provided.

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PART I: GENERAL CHARACTERISTICS

1. Time reference of reported data.

The data reported in this questionnaire covers activities from

/ /1995 to / /1995

If the data reported covers less than 12 months, please state the reason

2. What is the status of this companyCentral Office -1Branch -2 (go to Q. 4)Without branch -3 (go to Q. 5)

3. If question 2 is coded 1 (Central Office)1). State name and address of the branch office

A. Name: ……………..Address: ……………

Postal code

Tel. ( ) ………..Fax: ( )……Number of workers: …………

B. Name: ……………..Address: ……………

Postal code

Tel. ( ) ………..Fax: ( )……Number of workers: …………

C. Name: ……………..Address: ……………

Postal code

Tel. ( ) ………..Fax: ( )……Number of workers: …………

D. Name: ……………..Address: ……………

Postal code

Tel. ( ) ………..Fax: ( )……Number of workers: …………

2). The data reported here cover data of companies: (please put a V mark in the respective boxbelow with respect to the answers of question 3.1)

A B C. D.

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4. If question 2 is coded 2 (branch) please fill in information of the Central Office

a. Name: ………………………………………Address: ………………………………………

Postal code Tel: Fax:b. Number of workers in the Central Officec. Expenditure of the Central Office ,000 Rupiahd. Do the data reported in the questionnaire also cover data of the Central Office?

Yes -1 No -2

5. Activity of this manufacturing establishment

If the company is engaged in more than one activity, please choose the one having the largestproduction value

6. Main product (please state in detail, for example: leather sport shoes)

Filled in by CBS

7. Legal status:

Government Company -1 Cooperative -5Limited Corporation -2 Non profit firm -6Commandditer Venotschaft -3 Other legal entity -7Personal Firm -4 Firm having no legal status -8

8. Capital Source

a. Domestic -1 Foreign -2 Others -3

b. If question 8a is coded 2 (Foreign), state the main country of the investors ………………………………………………………………………..

9. Percentage of capital owned by:

a. Central Government % c. National Private %b. Local Government % d. Foreign %

Total (a+b+c+d) 100 %

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10.Starting year of commercial production in this province

11. Number of working shifts

12. Average number of workers each month during 1995

1). Paid workers a. Production worker Male Female Total

b. Other workersc. Total (1a + 1b)

2). Unpaid workersTotal (1c + 2)

3). Average number of workers each month during previous year …………. Persons

4). If the average number of workers in the previous year differs from those in 1995,please explain the reason

5). Average number of paid workers each month during 1995 by educational attainment

Educational attainment Production workers Other workers

Male Female Male Female

a. Not finished primary school

b. Primary school

c. Junior High school

d. Senior high school

e. Diploma 3

f.. Bachelor

g. Master

h. Ph.D.

Total

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PART II: EXPENSES

Goods given by the establishment to workers as in-kind payments must be valued according to the marketprice of .those goods at that time If the establishment provided goods to its workers at a price below themarket value, the value of the goods recorded in this form should be their market price minus the pricepaid by the workers

Housing and vehicles provided by establishments to workers are also classified as in-kind payments. Tovalue this, estimate the rent or depreciation value of those goods

13.Wage/salary of workers in 1995

1). Production workers In cash (Rp) In-kind (Rp) Total (Rp)a. Wage/salary 000 000 000b. Overtime 000 000 000c. Gift, bonus, etc 000 000 000d. Others 000 000 000Total 000 000 000

2). Other workers In cash (Rp) In-kind (Rp) Total (Rp)a. Wage/salary 000 000 000b. Overtime 000 000 000c. Gift, bonus, etc 000 000 000d. Others 000 000 000Total 000 000 000

Expenses in question 14 and 15 refers to expenses paid during 1995 to an institution dealing with pension,social security funds, insurance, and similar matters for workers.

14.Pension funds, social security, insurance and other during 1995

In cash (Rp) In-kind (Rp) Total (Rp)1). Production workers 000 000 0002). Other workers 000 000 000

15. Accident allowance during 1995

In cash (Rp) In-kind (Rp) Total (Rp)1). Production workers 000 000 0002). Other workers 000 000 000

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16. Fuel and lubricants

1). Quantity and value of fuel and lubricants used during 1995

Total For electric generatoronly

Standardunit

Quantity Value (Rp) Quantity Value (Rp)a. Gasoline Liter 000 000b. Diesel fuel/HSD/ADO Liter 000 000c. Diesel oil /IDO Liter 000 000d. Fuel oil/FO/Bunker

C/MFOLiter 000 000

e. Kerosene Liter 000 000f. Coal Kg 000 000g. Coke Kg 000 000h. Public gas M3 000 000i. LPG Kg 000 000j. Charcoal Kg 000 000k. Firewood Kg 000 000l. Other fuel 000 000m. Lubricant Liter 000 000 Total 000 000

2). Quantity and value of fuel used for generating electricity in 1995Type of fuel Standard Unit Quantity Value (Rp)

000000000000

Total 000

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17. Raw materials and additional inputs/intermediates

State the kind of raw materials used during 1995, in both quantity and value, as well as its origin.

For an establishment that uses many kinds of raw materials, materials having smaller values may begrouped together and only their total value is written down, provided that their total value is not morethan 10 percent of the total value of all materials used.

RAW MATERIALS USED DURING 1995Domestic Imported TotalNO Type of

materialsStandardunit Quantity Value

(Rp)Quantity Value

(Rp)Quantity Value

(Rp)(1) (2) (3) (4) (5) (6) (7) (8) (9)1. 000 000 0002. 000 000 0003. 000 000 0004. 000 000 0005. 000 000 0006. 000 000 0007.89.10. Sub total 000 000 000Continued to the next page

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RAW MATERIALS USED DURING 1995Domestic Imported TotalNO Type of

materialsStandardunit Quantity Value

(Rp)Quantity Value

(Rp)Quantity Value

(Rp)(1) (2) (3) (4) (5) (6) (7) (8) (9)11. 000 000 00012. 000 000 00013. 000 000 00014. 000 000 00015. 000 000 00016 000 000 00017. 000 000 00018. 000 000 00019 000 000 00020. 000 000 00021. 000 000 00022. 000 000 00023. 000 000 00024. 000 000 000

Sub total 000 000 000

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18.Other expenses

Fill in other expenses outside of expenses for raw materials during 1995

1). Expenses for other goods

Domestic(Rp)

Imported(Rp)

a. Packaging 000 000b. Spare parts, maintenanceand small repairs (notincluding those bought byothers)

000 000

c. Stationery and officesupplies

000 000

Total 000 000

2). Expenses for manufacturing servicesIncluding expenses for spare parts/goods provided by others

Value(Rp)

a. Manufacturing servicesprovided by others

000

b. Maintenance and repairexpenses for capital goods

000

Total 000

3). Expenses for rent For rent of more than one year, estimate only the portion that corresponds to 1995

Value(Rp)

a. Building, machinery andtools

000

b. Land 000Total 000

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4). Indirect taxes

Value(Rp)

For example: sales tax, establishment license, building, and landtax (PBB), SWP3D, import duty, custom fee, etc. exceptincome and personal taxes.

000

5). Other expenses

Value(Rp)

a. Net interest on loan 000b. Gifts, charities, donations, etc. 000c. Representation costs 000d. Royalty 000e. Management fee 000f. Promotion/advertising 000g. Water expenses 000h. Postage, telex, facsimile and phone expenses 000i. Travel expenses 000j. Preventive environment pollution expenses 000k. Research and Development, production engineering expenses 000l. Human resources development cost (Example: Employee skill

development course000

m. Others 000Total 000

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PART III: PRODUCTIONS (GOODS PRODUCED)

19. State all goods produced during 1995 (by product name, quantity and value)

No Type of goods Standard unit Quantity Value (Rp)1. 0002. 0003. 0004. 0005. 0006. 0007. 0008. 0009. 00010. 00011. 00012. 00013. 00014. 00015. 00016. 00017. 00018. 00019. 00020. 000

Total 000

20. Percentage of actual production to production capacity during 1995: ………%

If less than 50 % please explain why

21. Percentage of production exported in 1995: ……....%

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PART IV. OTHER INCOME SOURCES

Fill in all other income sources during 1995Value (Rp)

22. Manufacturing services 000

23. Goods sold without modificationa). Purchase value 000b). Sale value 000c). Profit/loss (23b-23a) 000

24. Gross income from building or machinery leasing,transport

services and other income from non manufacturingactivities

000

Total (22+23c+24) 000

PART V: POWER MACHINERY AND ELECTRIC MOTORS USED ON DECEMBER31, 1995 OR THE LAST TIME THESE WERE USED IN 1995

Quantity Capacity25. Prime movers used directly to drive

production equipment PK

26. Prime movers used for generatingelectricity PK

27. Electric motors PK

28. Generators KVA/KW

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PART VI. PRODUCTION, PURCHASE AND SALE OF ELECTRICITY DURING 1995

29. Electricity for production activity (choose one only)

No electricity used -0Own production -1Purchase (PLN/.non PLN) -2Own production and purchased -3

30. Source of purchased electricityQuantity Value (Rp)

a. From PLN KwH 000b. From non PLN KwH 000

31. Electricity produced by the establishment KwH

Quantity Value (Rp)

32. Electricity sold to othersKwH 000

PART VII: STOCK

33. Stock at the beginning (January 1, 1995) and the end (December 31, 1995)

Beginning (Rp) End (Rp) End-Beginning (Rp)a. Stock of raw materials, fuel,

packaging, and other materials000 000 000

b. Stock of semi-finished products(still in process)

000 000 000

c. Stock of finished products 000 000 000

Total 000 000 000

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PART VIII: ACTUAL INVESTMENT

34. Actual investment during 1995 based on current prices

Source of capital Value (Rp)1. Private 0002. Reinvested earnings 0003. Stock/bonds 0004. Domestic loan 0005. Foreign loan 0006. Foreign investment 0007. Government 0008. Capital market 000 Total 000

PART IX : FIXED ASSETS

Major reparations are re-structurations/renovation works that increase capacity/work capacityand change the form or life span of a fixed asset.The value of construction and major reparation works is categorized into those that wereconducted by another party and those executed by the establishment itself.The value of construction and major reparations conducted by the establishment is based onmarket price. If this is not possible, the value is calculated by adding all the values of materialsused, of services and other charges and based on the current price.

For assets needing more than one year to complete/finish, write down the actual investment up to1995.

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35. Addition/Reduction/Major Repairs of fixed assets in 1995

Purchased/additions Construction/major repairNew assets Used goods

of local origin(Rp)

By others(Rp)

By ownestablishment

Sale/reductions of usedgoods (Rp)

1. Land 000 000 000 000 0002. Building/

construction000 000 000 000 000

3. Machinery andaccessories

000 000 000 000 000

4. Vehicle 000 000 000 000 0005. Other assets 000 000 000 000 000Total 000 000 000 000 000

PART X: ESTIMATED VALUE OF ASSETS

36. The book value per December 31, 1995 is the value recorded in the establishment’s ledgers minusdepreciation starting from when the asset was first purchased. The depreciation value for asset in 1995is the depreciation value for each asset specifically for the year 1995 only (not the cumulativedepreciation). For assets that require more than one year to complete/finish, what is recorded here isthe value of what has been invested until 1995.

According toprevailing valueas of Dec, 311995

Book value asof Dec, 31, 1995

Depreciationfor 1995 (Rp)

1. Land 000 000 0002. Building/ construction 000 000 000

3. Machinery and itsaccessories

000 000 000

4. Vehicle 000 000 0005. Other assets 000 000 000Total 000 000 000

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PART XI: STATEMENT

37. Data stated in this form has been filled out truthfully and accurately by

1). Name

2). Occupation

3). Signature and company seal

4). Date / / 1996

38. Person to be contacted if clarification is required regarding this form

1). Name

2). Occupation

3). Telephone

4). Facsimile

PART XII: COMMENTS/NOTES

39. If CBS (Central Bureau of Statistics) were to promote your establishment by publishing yourdata, which part of the questionnaire should not be published (put check mark).

Part II Part III Part IV Part V Part VIPart VII Part VIII Part IX Part X

40. If are any further explanation to be given, please state below:

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PART XIII: ENUMERATION PARTICULARS

41. For CBS enumerator’s use only

1). Name & work identification number:: ……./……/1996

2). Date of document delivery: ……./……./1996

3). Date received document

4). Signature

5). Name of Supervisor

6). Date of supervision: ……../……/1996

7). Signature

42. Enumerator’s notes

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PART XIV: SUMMARY (To be filled by supervisor)

43. EXPENDITURES

Value (Rp)1. Expenditures for workers (13+14+15) 0002. Fuel utilization (16.1) 0003. Utilization of raw materials (17.1 + 17.2) 0004. Other expenses (18.1+18.2+18.2+18.3+18.4+18.5) 0005. Purchased of electricity (30) 000

Total 000

44. INCOMEValue (Rp)

1. Goods produced (19) 0002. Income from industrial services (22) 0003. Sale of goods (23c) 0004. Gross income from building or machinery leasing and

the equipment’s (24)000

5. Sale of electricity (32) 0006. Differences in stock value for semi finished products

(33b)000

Total 000

45. ADDITIONAL VALUEValue (Rp)

a. Other expenses which are Added Value component1. Question 18.3b 0002. Question 18.4 0003. Question 18.5a 0004. Question 18.5b 000

Total 000

b. Additional Value (44 – 43 + 43.1 + 45.a) 000