Please complete and return within 20 days after receipt of this questionnaire
Confidential when completed
Collected under authority of Statistics Act, Revised Statutes of Canada, 1985, Chapter S19.
Completion of this questionnaire is a legal requirement under this Act.
Please correct, if necessary
- Company name
- Operating name
- Care of
- Street address
- City
- Province/Territory
- Postal code
Please read before completing
Purpose of the Survey
To obtain information on the status of energy industries in Canada. The results will be used by industry associations to gauge the size and importance of the industry and by government in establishing informed energy policies. The information may also be useful to individual businesses in decision-making.
Confidentiality
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. The confidentiality provisions of the Statistics Act are not affected by either the Access to Information Act or any other legislation. Therefore, for example, the Canada Revenue Agency cannot access identifiable survey records from Statistics Canada.
An exception to the general rule of confidentiality under the Statistics Act is the disclosure, at the discretion of the Chief Statistician, of identifiable information relating to public utilities, which includes undertakings supplying petroleum or petroleum products by pipeline, and undertakings supplying, transmitting or distributing gas, electricity or steam. This applies to the dissemination of aggregate survey results at the provincial or territorial level where only one or two public utilities may have reported data or where one dominates the industry in a particular province or territory.
Data Sharing Agreement
To reduce respondent burden, Statistics Canada has entered into data sharing agreements with provincial and territorial statistical agencies and other government organizations, which must 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 as well as with Alberta Department of Energy, Natural Resources Canada and Environment Canada.
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 Linkages
To enhance the data from this survey, Statistics Canada may combine it with information from other surveys or from administrative sources.
A. Instructions
Report the most recent fiscal year ending at any time between April 1, 2010 and March 31, 2011.
This report covers the period
- From:
- To:
This schedule is to be completed and returned to Statistics Canada, 150 Tunney’s Pasture Driveway, Ottawa, Ontario, K1A 0T6. If you require assistance in the completion of the questionnaire, contact the Energy Section by telephoning 1-877-604-7828, or by fax at 1-888-883-7999.
Fax or Other Electronic Transmission Disclosure
Statistics Canada advises you there could be a risk of disclosure during the facsimile or other electronic transmission. However, upon receipt of your information, Statistics Canada will provide the guaranteed level of protection afforded to all information collected under the authority of the Statistics Act.
B. Business activity
North American Industry Classification System (NAICS)
Please indicate the primary business activity.
- Providing contract drilling services (NAICS 213111)
- Providing Services, other than contract drilling, to the oil and gas extraction industry (NAICS 213118)
(Please see reporting guide for examples of services) - This company does not provide either of the above listed services. The survey does not apply to this company.
(Please describe briefly this company’s principal business activity and return this form in the envelope provided).
C. Foreign operations
Did this company provide Contract Drillling and/or provide Services to clients outside Canada during the reporting period above?
- No
- Yes
- Report revenues from foreign operations for the latest fiscal year (Thousands of Canadian dollars)
D. Type of organization
Please check your type of organization:
- Individual ownership
- Partnership
- Incorporated Company
- Unincorporated
- Co-operative
E. Canadian operations
Province: Newfoundland (including offshore), Nova Scotia (including offshore), Manitoba, Saskatchewan, Alberta, British Columbia, Northwest Territories, Other Provinces (please specify), Canada
Operating Revenues (in thousands of dollars)
1. Income from contract drilling
2. Income from other services
3. Other operating revenue
4. Total Operating Revenues (Sum of Income from contract drilling, Income from other services and Other operating revenue)
Operating Expenses (in thousands of dollars)
5. Salaries and wages
6. Employer contributions to pension, medical and employment insurance plans
7. Materials and supplies
8. Fuel and electricity
9. Depreciation and amortization
10. Purchased services
11. Other operating expenses
12. Total Operating Expenses (Sum of Salaries and wages, Employer contributions to pension,medical and employment insurance plans, Materials and supplies, Fuel and electricity, Depreciation and amortization, Purchased services and Other operating expenses)
13. Net Revenue from Operations (Total Operating Revenues minus Total Operating Expenses)
F. Reporting Guide
Please report your Canadian operations only in thousands of Canadian dollars.
Operating Revenues:
Income from contract drilling operations:
Report income from the provision of drilling services for crude petroleum and natural gas, building of drilling rigs, repairing and dismantling drilling rigs and derricks, and firefighting operations.
Income from services:
Report income from the provisions of services associated with: acidizing oil and gas wells, cementing oil and gas wells, chemical treating of oil and gas wells, camp services, road building, equipment rental “with operator only”, contract operating, battery operator, tubular testing, wire line and gas testing, maintenance/ repair work at oil and gas well site, pipe fitting, servicing rigs, lease preparation/cleanup, swabbing rigs, pumpjack maintenance/repair, coil tubing, pressure testing, downhole testing and any other activity related to servicing the oil and gas extraction industry.
Other operating revenue:
Report all royalty fee income arising from the use of patents etc., franchise fees, operating subsidies, commissions and any other income not specified above.
Operating Expenses:
Salaries and wages:
Report all salaries and wages (including bonuses and commissions) paid to your own workforce during the reporting period.
Employer contributions to pension, medical and employment insurance plans:
Report all employer contributions to C.P.P., E.I.C., medical plans, dental plans, etc. on behalf of your own workforce.
Materials and supplies:
Report costs associated with drilling mud, acids, drilling bits, cables, lubricants, materials used in repairing rigs, cost of casing and pipe, and all other material costs incurred in the provision of services.
Fuel and electricity:
Report the amount charged to expense of purchased fuel and electricity used in your operations.
Depreciation and amortization:
Report the cost arising from the systematic write-down of fixed assets used in your operation.
Purchased services:
Report the cost of purchased services relating to repair and maintenance, fees paid to sub-contractors, computer services, professional fees, travel and entertainment, etc.
Other operating expenses:
Report all other operating expenses not included above (e.g. general and administrative costs). Exclude costs associated with Debt Financing and Charitable Contributions.
Comments
Please provide an explanation to support reason(s) for a significant increase/decrease in Operating Revenues and/or Operating Expenses compared to the previous year.
Certification
I certify that the information contained herein is complete and correct to the best of my knowledge and belief.
Signature
- Name of signer (please print)
- Official position of signer
- Date
- Name of person to be contacted in connection with this report (please print)
- Telephone
- Fax
- E-mail address