SURVEY REF NO Date 5 Jan 2015 FORM QSS 2 CONFIDENTIAL For DOS ' Official Use ATTN NAME OF ESTABLISHMENT SSIC QUARTERLY SURVEY OF SERVICES FOURTH QUARTER 2014 Purpose of Survey The purpose of this survey is to obtain up-to-date information for monitoring and analysing the performance of the services sector. The aggregated statistics are used extensively by the government and business community in their policy-making and business planning. The survey findings are available on our website at http://www.singstat.gov.sg/publications/economy.html#services. Confidentiality The survey is conducted under the Statistics Act (Chapter 317) and your completed return will be kept in confidence in accordances with the Statistics Act. A copy of the Statistics Act is available on our website at http://www.singstat.gov.sg/about_us/statistics_act.html Due Date and Mode of Submission We would be grateful if you could return the completed questionnaire by 19 Jan 2015 to our department through internet submission (E-survey) at https://www.biz-esurvey.singstat.gov.sg/IBSS. You can login using either (i) EASY / SingPass or (ii) Survey Ref No (as indicated above) and the one-time survey PIN (which you will receive in a separate letter as an added security measure). Details on EASY / SingPass and submission via E-survey can be found at this website. Alternatively, you may return the completed questionnaire to our Department in the preaddressed envelope or through fax at 68358984 or 68358985. Please make a copy of the completed return for your reference. Assistance If you have any questions pertaining to the survey, or need assistance in completing the questionnaire, please contact the officers-in-charge at Business Statistics Division (operating hours are : Mon-Fri, 8.30 am - 5.00pm): Tel : 6835 8977 / 6835 8979 / 6835 8980 Email : chang-chan_wai_han@singstat.gov.sg You may also refer to our website for a list of frequently asked questions at http://www.singstat.gov.sg/Survey_assistance/business_survey/business_faqs.html Thank you for your co-operation. Wong Wee Kim Chief Statistician Singapore QUARTERLY SURVEY OF SERVICES, 4TH QUARTER 2014 SURVEY REF NO. Name of Establishment REPORTING INSTRUCTIONS (a) As this form will be read using electronic equipment, please take note of the following: - Use black pen and BLOCK LETTERS when completing this form. - Keep each number or tick within the boxes provided. - Leave answer boxes blank when you have no response or data to enter. Do not use `nil', `na', `-` or strike throughout the boxes or page. (b) Explanatory notes can be found on the following page. ESTABLISHMENT INFORMATION IF PRINCIPAL ACTIVITY, ESTABLISHMENT NAME OR ADDRESS HAS CHANGED, PLEASE COMPLETE THIS SECTION New Principal Activity New Name New Address BUSINESS STATISTICS Please provide the following items for the periods stated. Please note that items (1) to (4) are to be provided in nearest Singapore dollars. If actual figures are not yet available, please supply your best estimates. Oct - Dec 2014 1. Operating Receipts [excludes GST] (S$) , , , 2. Other Receipts [e.g. donations, grants/ subsidies, subscriptions, funds raised] (S$) , , , 3. Remuneration (S$) , , , 4. Depreciation (S$) , , , Please explain briefly the factors causing the increase/decrease for items (1) - (4) as compared with the previous quarter and/or the same quarter last year. - 2 - QSS 2 PARTICULARS OF CONTACT PERSON I hereby declare that the information given in this return is complete and correct to the best of my knowledge and belief. Please complete the following information in BLOCK LETTERS. Name (Ms/Mr/Mdm) Signature Designation Date Contact Person (Person filling in the survey form) Name (Ms/Mr/Mdm) Tel 1 Designation Tel 2 E-mail Fax EXPLANATORY NOTES 1 Operating Receipts This generally refers to the fees or income arising from services rendered, commission charges, sales of goods, rental of premises and machinery and equipment. Government subvention/subsidy on healthcare, education and childcare services to patients, students and parents should also be included. Goods & services tax (GST) should be excluded. 2 Other Receipts This refers to gains from sale of fixed assets, realised gain/loss from foreign exchange transactions, hedging gains, donations, grants (excluding subvention), subsidies, subscriptions, interest, dividends, membership fees, funds raised and investment income. 3 Remuneration This refers to total remuneration of employees, crew onboard vessels or aircraft and working directors which includes wages and salaries, commissions, bonuses, overtime pay, CPF contributions and other benefits such as medical benefits, cost of food, accommodation and other benefits in kind provided by employers but excludes gratuities and retrenchment benefits. Remuneration also includes directors' fee, e.g. amount for attending board of directors' meetings. Remuneration of working proprietors and partners are excluded. 4 Depreciation This refers to the value, at current replacement cost, of reproducible fixed assets such as buildings, plants and machinery used during a period of time as a result of normal wear and tear, foreseen obsolescence and the normal rate of accidental damage. - 3 - QSS 2