Statistics Canada - Producer Prices Division
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Collected under the authority of the Statistics Act.
Revised Statutes of Canada, 1985, Chapter S19.
Completion of this questionnaire is a legal requirement under this act.
Month
Survey purpose
The prices you report are essential to the production of indexes measuring the movement of prices in the Canadian economy. Your information may also be used by Statistics Canada for other statistical and research purposes.
The reporting form sets out our request for price information for the period shown. We urge you to read the instructions carefully and fill in the requested information.
If necessary, please make address label corrections below.
Company
Attn:
Street
City, Province
A1A 1A1
Statistics Canada, Producer Prices Division, 170, Tunney's Pasture Driveway, Ottawa, Ontario K1A 0T6
Should you require further information with respect to this report, please contact the Producer Prices Division Contact indicated on the reverse side. Please feel free to call collect or call 1-888-951-4550 for general enquiries.
The information and data pre-coded on this form reflects the respondent's preference.
Confidentiality
Statistics Canada is prohibited by law from releasing any information from this survey which would identify a person, business, or organization, unless consent has been given by the respondent or as permitted by the Statistics Act. Statistics Canada will use the information from this survey for statistical purposes.
Record Linkage
To enhance the data from this survey, Statistics Canada may combine it with information from other surveys or from administrative sources.
Fax or other electronic transmission disclosure
Statistics Canada advises you that there could be a risk of disclosure during facsimile or other electronic transmission.
However, upon receipt, Statistics Canada will provide the guaranteed level of protection afforded all information collected under the authority of the Statistics Act.
Respondent:
Contact :
Commodity Specialist
(613) 951-
To complete this Price Report:
1) In Box A enter the transaction price in effect on the 15th of the month indicated.
2) In Box B enter “NS” if no sales occurred and give an estimate in Box A for the transaction prices.
3) If there is any change in the description of product and/or transaction description please amend.
Product ID
- Commodity Description:
- Description of Product:
- Transaction Description:
- C1:
- C3:
- C2:
- C4:
Date of last reported price change :
2010-01
C1 to C4 Transaction description as specified above
Circle reasons for price change
Further explanation of price change
(pertinent market information)
Date:
- A
- B
- C1
- C2
- C3
- C4
- D
- 1
- 2
- 3
- 4
- 5
- 6
- 7
Reasons for price change :
- Material costs
- Labour costs
- Competitive factors
- Physical content
- Terms of sale
- Exchange rate
- Others - describe
General information
Confidentiality
Your answers are confidential.
Statistics Canada is prohibited by law from releasing any information from this survey which would identify a 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 data from Statistics Canada.
These survey data will only be used for statistical purposes and will be published in an aggregate form only.
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 agency 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.
Thank you for completing this questionnaire. Please retain a copy for your records.
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