Ap-223 12/07 - Bank Nexus Questionnaire - State Of Texas
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1
2AP-223
STATE OF TEXAS
(12-07)
PRINT FORM
CLEAR FIELDS
BANK NEXUS QUESTIONNAIRE
for Savings and Loans, State Banks, Federal Banks, Savings Banks and Foreign Country Banks
Texas taxpayer number
File number
under Chapters 552 and 559,
You have certain rights
Government Code, to review, request and correct
information we have on file about you. Contact us at the
address or toll-free number listed on this form.
1.
2.
Entity name
Federal employer identification number (FEIN)
3.
Mailing address (if different than above address)
City
State
ZIP code
4.
5.
Contact person
Contact phone (Area code and number)
6.
Bank entity type
State bank
Federal bank
Federal savings and loan
(FO)
(FJ)
(FN)
State savings bank
Federal savings bank
Foreign country bank
(FH)
(FK)
(FR)
State savings and loan
(FA)
month
day
year
7.
Formation date
In what state or country was this entity formed?
8. If this entity is registered with the Texas Secretary of State, please provide the file number.
9.
Please provide the entity's North American Industry Classification System (NAICS) code.
(NAICS codes are available at )
10. Please list any tax permits or licenses issued to this entity by the Texas Comptroller.
Type of permit or license
Taxpayer number for permit or license
If included in a combined group Texas Franchise Tax Report,
provide the reporting entity's Texas taxpayer number
11. Please describe this entity's business activities:
START DATE
12.
Please check the items pertaining to this entity in Texas during the last seven years.
month
day
year
Place of business
(maintaining a place of business, manufacturing plant, office, warehouse or retail outlet, owned or leased)
Performance of a contract
(with own employees, local labor or contractors)
Delivering
(items sold and delivered into Texas in company vehicles)
Warranty work
(with own employees or third party)
Real property in Texas
(hold, acquire, lease or dispose of)
Personal property
(hold, acquire, lease, install, erect, modify, maintain, repair or dispose of personal property used or located in Texas)
General partner
(in a general or limited partnership that is doing business in Texas)
Shows
(staging of or participation in shows, theatrical performances, sporting events or other events in Texas)
(continued on back)
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