Nebraska Pre-Audit Questionnaire Form
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Nebraska Pre-Audit Questionnaire
BUSINESS IDENTIFICATION
Legal Name
Federal Identification Number or Social Security Number
Doing Business As
BUSINESS MAILING ADDRESS
ADDRESS WHERE AUDIT WILL BE CONDUCTED
Street or Other Mailing Address
Street Address
City
State
Zip Code
City
State
Zip Code
Name of Person to Contact for Review or Audit
Title
How Long in this Position
Office Hours
Telephone Number
FAX Number
Understanding the nature of the Internet, I accept the risk and the remote possibility of loss of confidentiality. You may provide
information to me via e-mail.
E-mail Address:
BUSINESS INFORMATION
1. Name of parent company, if any:
2. List all related companies (corporations that have at least 50 percent common ownership, and other entities that would be considered
a parent, subsidiary, or brother-sister if they were corporations). Please enclose a copy of your most recent annual report.
3. List all Web site addresses:
4. Has the parent or any related company applied for a tax incentive program?
YES
NO
5. Type of ownership:
Sole Proprietorship
Partnership
S Corporation
C Corporation
LLC
LLP
Government
Other:
6. List addresses for ALL NEBRASKA locations, including offices, warehouses, manufacturing facilities, etc.
Street Address
City
Within City Limits?
YES
NO
YES
NO
YES
NO
YES
NO
YES
NO
YES
NO
7. Are multiple locations reported on the same sales tax return?
YES
NO
8. List all applicable Nebraska ID Numbers used for reporting Nebraska taxes and fees:
Not licensed
Sales ________________________
Cigarette __________________________
Litter Fee ______________________
Use _________________________
Waste Reduction and Recycling Fee _____
Tobacco Products _______________
Withholding __________________
Lodging ___________________________
Financial Institutions ____________
Corporate Income ______________
Exemption for Sales and Use Tax _______
Tire Fee _______________________
Partnership ___________________
6-2010
7-243-1996 Rev.
Supersedes 7-243-1996 Rev. 2-2008
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