Survey of Service Industries: Food Services and Drinking Places, 2012 - Full Questionnaire
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For Information onlyThis is an electronic survey example for information purposes only. This is not a working questionnaire.
A - Introduction
If necessary, please make address label corrections in the boxes below.
- 1: Legal name
- 2: Business name
- 3: Title of contact
- 4: First name of contact
- 5: Last name of contact
- 6: Address (number and street)
- 7: City
- 8: Province/territory or state
- 9: Country
- 10: Postal code/ zip code
What is your language of preference?
- 1: English
- 2: French
Purpose
This survey collects the financial and operating data needed to develop national and regional economic policies and programs.
Authority
This information is collected under the authority of the Statistics Act, Revised Statutes of Canada, 1985, Chapter S-19.
COMPLETION OF THIS QUESTIONNAIRE IS A LEGAL REQUIREMENT UNDER THIS ACT.
This document is confidential when completed.
Si vous préférez recevoir ce questionnaire en français, veuillez nous appeler au numéro sans frais suivant : 1-800-972-9692.
Confidentiality
The Statistics Act protects the confidentiality of information collected by Statistics Canada.
Your answers are confidential.
Statistics Canada is prohibited by law from releasing any information it collects which could identify any person, business, or organization, unless consent has been given by the respondent or as permitted by the Statistics Act.
Statistics Canada will use information from this survey for statistical purposes.
Data-sharing agreements
To reduce respondent burden, Statistics Canada has entered into data-sharing agreements with provincial and territorial statistical agencies and other government organizations, which have agreed to keep the data confidential and use them only for statistical purposes. Statistics Canada will only share data from this survey with those organizations that have demonstrated a requirement to use the data.
Section 11 of the Statistics Act provides for the sharing of information with provincial and territorial statistical agencies that meet certain conditions. These agencies must have the legislative authority to collect the same information, on a mandatory basis, and the legislation must provide substantially the same provisions for confidentiality and penalties for disclosure of confidential information as the Statistics Act. Because these agencies have the legal authority to compel businesses to provide the same information, consent is not requested and businesses may not object to the sharing of the data.
For this survey, there are Section 11 agreements with the provincial and territorial statistical agencies of Newfoundland and Labrador, Nova Scotia, New Brunswick, Quebec, Ontario, Manitoba, Saskatchewan, Alberta, British Columbia, and the Yukon.
The shared data will be limited to information pertaining to business establishments located within the jurisdiction of the respective province or territory.
Section 12 of the Statistics Act provides for the sharing of information with federal, provincial or territorial government organizations. Under Section 12, you may refuse to share your information with any of these organizations by writing a letter of objection to the Chief Statistician and returning it with the completed questionnaire. Please specify the organizations with which you do not want to share your data.
For this survey, there are Section 12 agreements with the statistical agencies of Prince Edward Island, the Northwest Territories and Nunavut.
For agreements with provincial and territorial government organizations, the shared data will be limited to information pertaining to business establishments located within the jurisdiction of the respective province or territory.
Record linkage
To enhance the data from this survey, Statistics Canada may combine it with information from other surveys or from administrative sources.
Security of emails and faxes
Statistics Canada advises of the risk of interception by a third party when transmitting information by email or fax. Once we receive your questionnaire, however, Statistics Canada provides a guaranteed level of protection, which covers all information collected under the authority of the Statistics Act. Note: Our online questionnaires are secure, so there is no risk of interception when you respond to our surveys online.
Return procedures
Please return the questionnaire within 30 days.
Please mail the completed questionnaire in the enclosed envelope or fax it to Statistics Canada at 1-888-883-7999.
Lost the return envelope or need help? Call us at 1-800-972-9692 or mail to:
Statistics Canada, Operations and Integration Division, 150 Tunney's Pasture Driveway, Ottawa, Ontario K1A 0T6
Reporting instructions
- Report for business unit(s) specified on the label on the front page.
- Complete only the questions that apply to your business.
- When precise figures are not available, please provide your best estimate.
- Report in Canadian dollars. Dollar amounts and percentages should be rounded to whole numbers.
- Consult the reporting guide at www.statcan.gc.ca/guides-e for further information.
B - Main business activity
B - Main business activity - Question identifier:1.
Please describe the nature of your business.
B - Main business activity - Question identifier:2.
Please check the one main activity which most accurately represents your main source of revenue.
- 1: Full-service restaurant: patrons order while seated and pay after eating
- 2: Limited-service restaurant: patrons order food and beverages at a counter, and/or order by phone and pay before eating
- 3: Food service contractor: supplies food services under contract for a specific period of time
- 4: Social caterer: provides food services for social or business events
- 5: Mobile food service: serves food and beverages, from motorized vehicles or non-motorized carts
- 6: Drinking places (e.g., bars, night-clubs, taverns)
- 7: None of the above - Please call the contact telephone number on the cover page for further instructions.
C - Reporting period information
C - Reporting period information - Question identifier:1.
Please report information for your fiscal year (normal business year) ending between April 1, YYYY and March 31, YYYY. Please indicate below the period covered by this questionnaire.
- 1: Date from (YYYY MM DD) to (YYYY MM DD)
C - Reporting period information - Question identifier:2.
If the reporting period does not cover a full year, please check the reason(s) below:
- 1: seasonal operations
- 2: new business
- 3: change of fiscal year
- 4: change of ownership
- 5: ceased operations
- 6: temporarily inactive
D - Revenue
D - Revenue - Question identifier:1.
Sales of goods and services (e.g., rental and leasing income, commissions, fees, admissions, services revenue) Report net of returns and allowances.
D - Revenue - Question identifier:2.
Grants, subsidies, donations and fundraising
D - Revenue - Question identifier:3.
Royalties, rights, licensing and franchise fees
D - Revenue - Question identifier:4.
Investment income (dividends and interest)
D - Revenue - Question identifier:5.
Other revenue
(please specify):
D - Revenue - Question identifier:6.
Total revenue (sum of questions 1 to 5)
E - Expenses
E - Expenses - Question identifier:1.
Salaries and wages of employees who have been issued a T4 statement
E - Expenses - Question identifier:2.
Employer portion of employee benefits (include employer contributions to pension, medical/life insurance plans, employment insurance, etc.)
E - Expenses - Question identifier:3.
Commissions paid to non-employees
E - Expenses - Question identifier:4.
Professional and business services fees (e.g., legal, accounting)
E - Expenses - Question identifier:5.
Subcontract expenses (include contract labour, contract work and custom work)
E - Expenses - Question identifier:6.
Charges for services provided by your head office
E - Expenses - Question identifier:7.
Cost of goods sold, if applicable (purchases plus opening inventory minus closing inventory)
E - Expenses - Question identifier:8.
Office supplies
E - Expenses - Question identifier:9.
Rental and leasing (include rental of premises, equipment, motor vehicles, etc.)
E - Expenses - Question identifier:10.
Repair and maintenance (e.g., property, equipment, vehicles)
E - Expenses - Question identifier:11.
Insurance (include professional liability, motor vehicles, etc.)
E - Expenses - Question identifier:12.
Advertising, marketing and promotions (report charitable donations at question 22)
E - Expenses - Question identifier:13.
Travel, meals and entertainment
E - Expenses - Question identifier:14.
Utilities and telecommunications expenses (include gas, heating, hydro, water, telephone and Internet expenses)
E - Expenses - Question identifier:15.
Property and business taxes, licences and permits
E - Expenses - Question identifier:16.
Royalties, rights, licensing and franchise fees
E - Expenses - Question identifier:17.
Delivery, warehousing, postage and courier
E - Expenses - Question identifier:18.
Financial services fees
E - Expenses - Question identifier:19.
Interest expenses
E - Expenses - Question identifier:20.
Amortization and depreciation of tangible and intangible assets
E - Expenses - Question identifier:21.
Bad debts
E - Expenses - Question identifier:22.
All other expenses
(please specify):
E - Expenses - Question identifier:23.
Total expenses (sum of questions 1 to 22)
E - Expenses - Question identifier:24.
Corporate taxes, if applicable
E - Expenses - Question identifier:25.
Gains (losses) and other items (see reporting guide)
E - Expenses - Question identifier:26.
Net profit/loss after tax and other items (see reporting guide)
F - Industry characteristics
F - Industry characteristics - Question identifier:1.
Franchise information
F - Industry characteristics - Question identifier:a)
Does this establishment use a trade name authorised by a franchisor?
- 1: yes
- 2: no, go to question 2
F - Industry characteristics - Question identifier:b)
Please specify the trade name:
F - Industry characteristics - Question identifier:c)
Is this establishment owned or operated by the franchisor or the franchisee?
- 1: franchisor
- 2: franchisee
F - Industry characteristics - Question identifier:2.
Estimated average cheque per person (exclude taxes and tips). Please check one only.
- 1: less than $5
- 2: $5 to $9.99
- 3: $10 to $14.99
- 4: $15 to $19.99
- 5: $20 to $29.99
- 6: $30 or more
F - Industry characteristics - Question identifier:3.
Does this establishment have a licence to sell and serve alcohol? Please check one only.
- 1: yes
- 2: no
F - Industry characteristics - Question identifier:4.
Number of seats in this establishment (exclude patio or seasonal seating). If reporting for more than one establishment, please report average number of seats.
F - Industry characteristics - Question identifier:5.
Please report the number of locations (physical place in which business activity is conducted) that you operated in Canada during the reporting period.
F - Industry characteristics - Question identifier:6.
Sales and other revenue
- a): Sales of alcoholic beverages for immediate consumption on the premises
- b): Sales of food and non-alcoholic beverages
- c): Sales of merchandise (e.g., toys, gifts, cigarettes, newspapers)
- d): Fees and Commissions from coin operated machines such as video gambling terminals, video games and vending machines
- e): Other sales (e.g., rentals, cover charge, coat check) (please specify):
- f): Total sales (sum of questions 6a to 6e)
- g): Other revenue (e.g., grants, subsidies, license and franchise fees, investment income, etc.)
(please specify): - h): Total revenue (sum of questions 6f and 6g)
Please indicate if you are reporting in Canadian dollars or percentages.
F - Industry characteristics - Question identifier:7.
Sales of alcoholic beverages for immediate consumption by type of service
- a): Full-table service
- b): Counter service (including bar service)
- c): Take-out
- d): Drive-through
- e): Home delivery
- f): Mobile service (e.g., chip wagon, street vending)
- g): Contract catering (e.g., contracts for a specified period of time, such as contracts with airlines, governments, institutions, etc.). Excludes the sale of alcoholic beverages paid for directly by the consumer.
- h): Social catering (e.g., catering to weddings, business meetings or social events). Excludes the sale of alcoholic beverages paid for directly by the consumer.
- i): Other services
(please specify): - j): Total sales of alcoholic beverages (sum of questions 7a to 7i)
Please provide a breakdown of sales and indicate if you are reporting in Canadian dollars or percentages.
F - Industry characteristics - Question identifier:8.
Sales of food and non-alcoholic beverages by type of service
- a): Full-table service
- b): Counter service (including bar service)
- c): Take-out
- d): Drive-through
- e): Home delivery
- f): Mobile service (e.g., chip wagon, street vending)
- g): Contract catering (e.g., contracts for a specified period of time, such as contracts with airlines, governments, institutions, etc.). Excludes the sale of food and non-alcoholic beverages paid for directly by the consumer.
- h): Social catering (e.g., catering to weddings, business meetings or social events). Excludes the sale of food and non-alcoholic beverages paid for directly by the consumer.
- i): Other services
(please specify): - j): Total sales of food and non-alcoholic beverages (sum of questions 8a to 8i)
Please provide a breakdown of sales and indicate if you are reporting in Canadian dollars or percentages.
F - Industry characteristics - Question identifier:9.
Cost of goods sold
Please indicate if you are reporting in Canadian dollars or percentages.
F - Industry characteristics - Question identifier:a)
Alcoholic beverages
F - Industry characteristics - Question identifier:b)
Food and non-alcoholic beverages
F - Industry characteristics - Question identifier:c)
Merchandise (e.g., gifts, toys, cigarettes, newspapers)
F - Industry characteristics - Question identifier:d)
Total cost of goods sold (sum of questions 9a to 9c)
F - Industry characteristics - Question identifier:10.
Waste management
F - Industry characteristics - Question identifier:a)
Do you pay a contractor or a municipality to collect some or all of your solid or liquid waste and/or recyclable materials?
- 1: Yes
- 3: No, go to section G
F - Industry characteristics - Question identifier:b)
How much did you pay for waste management and/or recycling during the reporting period?
G - Personnel
G - Personnel - Question identifier:1.
Number of partners and proprietors, non-salaried (if salaried, report at question 2 below)
G - Personnel - Question identifier:2.
Paid employees
G - Personnel - Question identifier:a)
Average number of paid employees during the reporting period (see reporting guide)
G - Personnel - Question identifier:b)
Percentage of paid employees (from question 2a) who worked full time
G - Personnel - Question identifier:3.
Number of contract workers for whom you did not issue a T4, such as freelancers and casual workers (estimates are acceptable)
H, I and J - Not applicable
K - Provincial/territorial distribution
K - Provincial/territorial distribution - Question identifier:1.
Please report the number of business units/locations operating in Canada during the reporting period. Business unit is defined as the lowest level of the firm for which accounting records are maintained for such details as revenue, expenses and employment.
K - Provincial/territorial distribution - Question identifier:2.
Do you have business units/locations in more than one province or territory?
- 1: yes, go to question 3
- 2: no, go to section L
K - Provincial/territorial distribution - Question identifier:3.
Please report the following data for the provinces or territories in which you have business units, indicating if you are reporting in Canadian dollars or percentages.
Report for each province: Number of business units (locations); Total revenue; Salaries, wages and employee benefits; Amortization and depreciation of tangible and intangible assets; Total expenses.
- 1: Newfoundland and Labrador
- 2: Prince Edward Island
- 3: Nova Scotia
- 4: New Brunswick
- 5: Quebec
- 6: Ontario
- 7: Manitoba
- 8: Saskatchewan
- 9: Alberta
- 10: British Columbia
- 11: Yukon
- 12: Northwest Territories
- 13: Nunavut
- 14: Total
L - Contact information
Name of person to contact about this questionnaire:
- 1: Mr.
- 2: Mrs.
- 3: Miss
- 4: Ms
- 1: Last name
- 2: First name
- 3: Title
- 4: Telephone number
- 5: Extension number
- 6: Fax number
- 7: E-mail address
- 8: Website address
I certify that the information contained herein is complete and correct to the best of my knowledge.
- 1: yyyy mm dd
M - Comments
We invite your comments below. Please be assured that we review all comments with the intent of improving the survey.
- Date modified: