Company Name:

Mailing Address:

City:

Zip Code:

Phone Number:

Fax Number:

Toll Free Number:

Email Address:

Website:

Senior Official: Name and Title

Export Products Outside the U.S.
(If yes, please complete next question)

Export Official: Name and Title

Product(s) Manufactured:

Targeted Industry:
(Please select all industries that your company may fall under)

Year Business was established in South Dakota:

Headquartered in South Dakota:
(If no, please complete parent company information below)

Parent Company: Name, Address, State or Country

Section 2:
The information provided below will be kept confidential. the only statistics that will be released are the overall totals for staewide new and expanded businesses.

Current Year Full Time Employees: (2011) 

Current Year Part Time Employees: (2011)

2011 Square Foot Increase:

2011 Capital Investment:

*Land: $

*Building: $

*Machinery/Equipment: $

Expansion Completion Date:

Survey Completed by: Name & Title