DateIssued:NameofLicensee/Vendor:Licensee/Vendor#:Region:NameofFactory:Factory#:PhysicalAddress:MailingAddress:Telephone#:Fax#:NameofContact:FacilityName:PhysicalAddress:MailingAddress:Telephone#:Fax#:(Pleasereviewinformationabove,makechangesonformifnecessary.)FACTORY:OwnershipTypeofFactory:JointVenture_____Partnership_____Corporation_____PrivatelyOwned_____ForeignInvestment_____Other________________________________________NameofBroker/Agent(ifapplicable):MailingAddress:Telephone#:Fax#:FACILITY(Note:Completeaquestionnaireforeachfacilitylocation)OwnershipTypeofFacility:JointVenture_____Partnership_____Corporation_____PrivatelyOwned_____ForeignInvestment_____Other_____________________________________________YearFacilityEstablished:NameofPlantManager:Telephone#:Fax#:ArticlesProduced:TotalEmployeesatthisFacility:Contract:Local:Ifcontractworkersemployed,lengthofcontract:StreetAddressofDormitories(ifapplicable):SUBCONTRACTINGFACILITIESORSISTERCOMPANIESName(s)__________________________________________________________________________Location(s)________________________________________________________________________Operationsperformed_______________________________________________________________NUMBEROFMACHINES–Specifythefollowing:NumberofEstimatedEmployeesonMonthlyMachineTypeNumberMachineProductionCuttingMachines_______________________CuttingTables_______________________KnittingMachines_______________________SewingMachines_______________________MakingMachines_______________________LoopingMachines_______________________ProcessingMachines:Permapressingmachines_______________________Dyingmachines_______________________Stonewashingmachines_______________________Other_______________________WeavingMachines_______________________YarnmakingMachines_______________________COMPLETEDBY:Name:Title:Signature:Date:1.Areallemployeesvoluntarilyworkinginthisfacility?YesNoa.Whatproceduresensure/monitorthatallemployeesareworkingvoluntarily?2.Arethereanyworkersinthisfacilitythatareprisoners,havebeenassignedbythemilitary,oranyotherbranchofgovernment?YesNo3.Doemployeeshavefreedomofmovementthatisnotunnecessarilyimpeded?YesNoa.Ifno,explain:4.Areemployeesfreetoleavewhentheirworkshiftends?YesNoa.Ifno,explain:5.Areguardspostedonlyfornormalsecurityreasons?YesNoa.Ifso,whataretheirbasicduties?6.Aredoorsandgatesonthefactorypremiseslockedonlyfornormalbusinesssecuritypurposes?YesNoa.Ifno,explain:7.Whatistheageoftheyoungestworkerinthisfacility?a.Whatistheminimumageallowedbylaw?________________________________________b.Doyouhaveaminimumagepolicydifferentfromlocallaw?YesNoIfyes,explain:c.Doworkersexecuteastatementthattheyareatorabovetheminimumage?YesNoIfyes,isthestatementfiledintheemployees’personnelfiles?8.Arethereanyworkexperienceorapprenticeprogramsforschoolagechildren?YesNoa.Ifyes,explain:9.Arethererestrictionsforworkersunder18?YesNoa.Ifyes,explain:10.Whatproofofagedocumentsareobtainedfromprospectiveemployees?11.Whatproceduresdoesthisfacilityhaveinplacetoverifytheauthenticityofagedocumentation?12.Howareemployeesrecruited(i.e.,newspaperadvertisement,agent,contract)?13.Howdoesmanagementhandlemisconductorpoorperformanceonthepartofanemployee?a.Doesthismanagementofmisconductorpoorperformanceincludefines?YesNoIfyes,explainfactorypolicy.Includeexamples:14.Doyourestrictem...