2017 BENCHMARK SURVEY OF FOREIGN DIRECT INVESTMENT IN THE UNITED STATES
MANDATORY — CONFIDENTIAL
CLAIM FOR NOT FILING FORM BE-12A, BE-12B, OR BE-12C
OMB No. 0608-0042: Approval Expires 12/31/2020
FORM
BE-12 Claim for Not Filing (REV 9/2017)
Name of U.S. business enterprise
c/o (care of)
Street or P.O. Box
City
ZIP Code
State
Foreign Postal Code
1002
1010
1003
1004
1005
0
0
0
0
0
Or
Name and address of U.S. business enterprise
BE-12 Identification Number
Response Required
Section 801.3 of 15 CFR, Chapter VIII, requires that all persons subject to the reporting requirements of the BE-12 survey respond, whether or not
they are contacted by BEA. It also requires that persons who are contacted by BEA about reporting in this survey must respond in writing. They
may respond by:
• filing the properly completed Form BE-12A, BE-12B, or BE-12C by May 31, 2018;
• completing and returning the Form BE-12 Claim for Not Filing Form BE-12A, BE-12B, or BE-12C, by May 31, 2018;
Mandatory and Confidential
This survey is being conducted under the International Investment and Trade in Services Survey Act (P.L. 94–472, 90 Stat. 2059, 22 U.S.C.
3101–3108, as amended). The filing of reports is mandatory, and the Act provides that your report to this Bureau is confidential. Whoever fails to
report may be subject to penalties. See page 4 for more details.
0998
Due date: May 31, 2018
Electronic filing: www.bea.gov/efile
Mail reports to: U.S. Department of Commerce
Bureau of Economic Analysis
Direct Investment Division, BE–49(A)
4600 Silver Hill Rd
Washington, DC 20233
Deliver reports to: U.S. Department of Commerce
Bureau of Economic Analysis
Direct Investment Division, BE–49(A)
4600 Silver Hill Rd
Suitland, MD 20746
Fax reports to: (301) 278–9500
Assistance: E-mail: be12/15@bea.gov
Telephone: (301) 278-9247
Copies of blank forms: www.bea.gov/fdi
Include your BE–12 Identification Number with all
requests.
*Do not enter Social Security Number as Identification Number
1000
Name
0
1029
Street 1
0
Signature of Authorized Official Date
0
1030
Street 2
0
0990
Name
0
1031
City
0
State Zip
0991
Title
0
1001
Telephone Number
0
Extension
0
0992
Telephone Number
0
Extension
0
0999
Fax Number
0
0993
Fax Number
0
1028
E-mail Address
0
NOTE: BEA uses a Secure Messaging System to correspond with you via encrypted message to discuss questions relating to this form. We may use
your e-mail address for survey-related announcements and to inform you about secure messages. When communicating with BEA by e-mail, please do
not include any confidential business or personal information. This includes your social security number which should never be provided to BEA via any
method of transmission.
CONTACT INFORMATION
Provide information of person to consult about this report:
CERTIFICATION
The undersigned official certifies that this report has been prepared
in accordance with the applicable instructions, is complete, and is
substantially accurate including estimates that may have been provided.
Enter Employer Identification Number(s) used by the U.S. business enterprise to file
income and payroll taxes
.
Primary Other
1006 1 2
OR
FORM BE-12 Claim for Not Filing (REV 9/2017)
0170 1 1
0110 1 1
0180 1 1
Month Day Year
7012 1
Month Day Year
7010 1
Month Day Year
7013 1
Month Day Year
7014 1
0160 1
WHICH SECTIONS TO COMPLETE?
Complete all items on page 1. Also, review the questions below to determine what additional information is required.
I Were 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 2017?
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, III, or IV.
II Were 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 2017?
Note: U.S. affiliate is defined on page 4.
Yes – Continue with question III.
No – Skip to question IV.
III Will the data for this U.S. business enterprise be consolidated into the 2017 BE-12 report filed for the U.S. affiliate that owns it more than
50 percent, or be included on the 2017 BE-12 report filed for the U.S. affiliate into which it was merged?
Yes – Skip question IV. Complete item (e) on page 3.
No – Contact BEA for guidance.
IV Is the U.S. entity a private fund? Note: Private fund is defined on page 4.
Yes – Complete item (f) on page 3 if the private fund meets the additional criteria described in item (f).
No – You must file a Form BE-12A, BE-12B, or BE-12C. These forms can be accessed via eFile or downloaded at: www.bea.gov/fdi
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 Forms BE-12A, BE-12B, and BE-12C because:
(a) This U.S. business enterprise was a U.S. affiliate of a foreign person or entity at some time during calendar year 2017, but ceased to
be a U.S. affiliate before the end of the fiscal year that ended in calendar year 2017.
Give date foreign ownership ceased or went below 10 percent, or when the business was liquidated or dissolved. Select reason
for change.
(b) This U.S. business enterprise was not a U.S. affiliate of a foreign person or entity at any time during calendar year 2017, but had
been a U.S. affiliate of a foreign person at some time before January 1, 2017.
Give date foreign ownership ceased or went below 10 percent, or when the business was liquidated or dissolved. Select reason
for change.
(c) 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
that ended in calendar year 2017, or if a newly formed company, its first fiscal year did not or will not end until after the end of calendar
year 2017.
Complete items (1) and (2).
(1) Give date when the U.S. business enterprise became a U.S. affiliate of a foreign person.
(2) Give the ending date of the U.S. business enterprise’s fiscal year that ended in calendar year 2017. 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 2018.
(d) This U.S. business enterprise is exempt from filing because its owners are citizens of the United States who are residents abroad as
a result of official employment by the U.S. Government (including the immediate family of such persons), or its owners have been and
expect to be residents abroad for less than one year.
Foreign ownership less than 10%
Liquidated
Dissolved
2
1
2
2
2
3
7012
Foreign ownership less than 10%
Liquidated
Dissolved
2
1
2
2
2
3
7010
Page 2
mm/dd/yyyy
mm/dd/yyyy
mm/dd/yyyy
mm/dd/yyyy
(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 2017 and is (check appropriate box (1) or (2)):
(1) Fully consolidated into the 2017 BE-12 report filed for that U.S. affiliate;
OR
(2) Merged into, and included on the 2017 BE-12 report filed for, that U.S. affiliate.
On the lines below give the name, address, and BE-12 Identification Number of the U.S. affiliate into which this U.S. business
enterprise is fully consolidated or merged.
Name
Street or P.O. Box
City State Zip Code
BE-12 Identification Number of the U.S. affiliate into which this U.S. business enterprise is fully consolidated or merged.
(f) This U.S. business enterprise was identified by BEA as required to file a BE-12A, BE-12B, or BE-12C survey form and ALL of
the following 3 statements apply: 1) The U.S. business enterprise is a private fund; 2) the private fund does not own, directly or
indirectly through another business enterprise, an “operating company” - i.e., a business enterprise that is not a private fund
or a holding company - in which the foreign parent owns at least 10 percent of the voting interest, AND 3) if the foreign parent
owns the private fund indirectly (through one or more other U.S. business enterprises), there are no U.S. “operating companies”
between the foreign parent and the indirectly-owned private fund. Note: The foreign investment in the U.S. private fund may be
required to be reported on Treasury International Capital (TIC) Surveys. Review reporting requirements for TIC surveys at
www.treasury.gov/tic. For more information regarding private funds, visit www.bea.gov/privatefunds.
(g) Other – Specify and include reference to section of regulations or instructions on which claim is based.
Remarks
Supporting Documentation – Please provide supporting documentation when filing the BE-12 Claim for Not Filing. This documentation is useful
in reviewing your claim and may reduce the need for further contact. Section 5(c) of the International Investment and Trade in Services Survey
Act, Public Law 94-472, 90 Stat. 2059, 22 U.S.C. 3101-3108, as amended, provides that this information can be used for analytical and statistical
purposes only and that it must be held strictly confidential. Examples of supporting documentation include, but are not limited to, organizational
chart, registration papers, instrument of incorporation, sales agreement, merger agreement, partnership agreement, shareholders resolution,
members resolution, certificate of merger, certificate of cancellation, statement of dissolution, or court order.
FORM BE-12 Claim for Not Filing (REV 9/2017)
0112 1
2
0200 1 1
0190 1 1
7015 0
0141 0
0150 0
0120 0
0130 0
0140 0
7011 0
Page 3
1
1
FORM BE-12 Claim for Not Filing (REV 9/2017)
Authority – This survey is being conducted under the International Investment and Trade in Services Survey Act (P.L. 94-472, 90 Stat. 2059,
22 U.S.C. 3101-3108, as amended), and the filing of reports is MANDATORY pursuant to Section 5(b)(2) of the Act (22 U.S.C. 3104). The
implementing regulations are contained in Title 15, CFR, Part 801.
Penalties – Whoever fails to report may be subject to a civil penalty of not less than $4,527, and not more than $45,268, 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 an 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-
gestions for reducing this burden, to: Director, Bureau of Economic Analysis (BE-1), U.S. Department of Commerce, 4600 Silver Hill Road,
Washington, DC 20233; and to the Office of Management and Budget, Paperwork Reduction Project 0608-0042, Washington, DC 20503.
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. Per the Cybersecurity Enhancement Act of 2015, your data are protected from cybersecurity risks through
security monitoring of the BEA information systems.
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.
Private fund refers to the same class of financial entities defined by the Securities and Exchange Commission as private funds on Form PF:
“any issuer that would be an investment company as defined in section 3 of the Investment Company Act of 1940 but for section 3(c)(1) or
3(c)(7) of ...[that] Act."
U.S. affiliate means an affiliate located in the United States in which a foreign person or entity has a direct investment.
Page 4
ILLUSTRATION OF FOREIGN PARENT AND ULTIMATE BENEFICIAL OWNER (UBO)
Foreign
United States
Foreign Company X
(UBO)
>50 Percent
Foreign Company Y
(Foreign Parent)
10 to 100 Percent
U.S. affiliate A
Foreign Company Y is the foreign
parent but it is not the UBO
because it is more than 50 percent
owned or controlled by Foreign
Company X. Foreign Company
X is the UBO.
Foreign Company Y directly owns
10 percent or more of the voting rights
of U.S. affiliate A.
U.S. affiliate B is indirectly owned
by Foreign Company Y through
U.S. affiliate A.
NOTE: In the illustration above, if Foreign Company Y does not have at least a 10 percent indirect voting interest in U.S.
affiliate B, then U.S. affiliate B is exempt from filing Form BE-12. In addition, if U.S. affiliate A owns more than 50 percent
of U.S. affiliate B, then the data for U.S. affiliate B should be consolidated on the BE-12 report filed for U.S. affiliate A.
U.S. affiliate B