Business Activity Questionnaire Form - New Hampshire (Page 2 of 2) in pdf

14. Do company employees/independent contractors convey inventory information, authorize credits against or pick up

damaged, defective or obsolete merchandise in NH previously sold to or returned by NH customers?

15. Do company employees/independent contractors check inventories or inspect goods after they have been delivered

to NH customers?

16. Do company employees/independent contractors make "on the spot" sales of any item(s) carried by them or fill

orders from a stock of goods maintained in a location in NH?

17. Does your company have display merchandise in leased space in NH for more than 14 days?

18. Do company employees/independent contractors accept deposits on customer orders?

19. Does your company extend credit to, or place loans with, customers in NH?

20. Does your company foreclose on any property located in NH?

21. Have you utilized the NH Court System in the last three years to enforce a contract or to collect unpaid accounts?

If yes, provide details:___________________________________________________________________________

22. Does your company transport goods, merchandise or equipment to or from NH location in company owned or leased

vehicles?

23. Does your company, either in owned or leased vehicles, back-haul from NH locations?

24. Does your company conduct training courses or hold seminars in NH for customers?

If yes, enter how many per year:____________________________________________________

25. Is your company involved in any type of construction projects in NH or does it perform engineering functions in NH or

for projects in NH?

26. Have you applied for any building permits or executed any contracts in NH?

If yes, where? (attach list if necessary)_______________________________________________________

27. Does your company have any affiliates that conduct business in NH that keep any property at NH locations or perform

any services in NH for your company?

If yes, describe the services provided and/or list the property and the location where it is kept on an attached sheet.

28. Do any of your NH employees use their NH residence for offices?

29. Do any of your NH employees using their NH residence for offices receive reimbursement for this use, receive

business callers, store inventory, or list it as a business address? If yes, state address:________________________

30. Is your company listed in any NH telephone book, NH building directory or Internet website indicating a NH location?

31. Do you file in and apportion sales to any other jurisdictions in which you have similar activity to that conducted

in NH? (If yes, identify jurisdictions)_________________________________________________________________

32. Provide a list of the job titles and attach a job description for each NH employee.

33. Provide the dollar amount of everywhere sales, New Hampshire destination sales and/or income earned from New Hampshire

sources, New Hampshire payroll and New Hampshire property for the applicable tax years.

TAX YEAR END

EVERYWHERE SALES

NH SALES

NH PAYROLL

NH PROPERTY

__________________

___________________

____________________

__________________

___________________

____________________

__________________

___________________

____________________

__________________

Under penalties of applicable law, I declare that I have examined this questionnaire including accompanying statements, and to the

best of my knowledge and belief it is true, correct and complete.

SIGNATURE OF OFFICER

DATE

PRINT NAME OF OFFICER

PRINT TITLE OF OFFICER

NH Department of Revenue Contact:

RETURN THIS COMPLETED FORM WITHIN THIRTY (30) DAYS. FAILURE TO RETURN THIS FORM MAY RESULT IN THE

DEPARTMENT ISSUING A NOTICE OF ASSESSMENT FOR THE TAX PERIODS COVERED BASED ON THE BEST

INFORMATION AVAILABLE.

AU-15

Revised 4/2009

Business Activity Questionnaire Form - New Hampshire Page 2

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