Form Otr 40 - Questionnaire For Determining Responsibility For Corporate Taxes

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GOVERNMENT OF THE DISTRICT OF COLUMBIA
OFFICE OF THE CHIEF FINANCIAL OFFICER
OFFICE OF TAX AND REVENUE
QUESTIONNAIRE FOR DETERMINING
RESPONSIBILITY FOR CORPORATE TAXES
District of Columbia Code Sections 1530, 1812.9 and 2011 hold corporate officers or employees responsible for paying corporate taxes personally liable for the
payment of the taxes. This questionnaire is designed to help determine who is personally responsible for payment.
Please forward the completed questionnaire to: Office of Tax and Revenue, Collection Division, P.O. Box 37559, Washington, D.C. 20013
SECTION 1 – BACKGROUND INFORMATION
Name
Address
Home Telephone Number
Office Telephone Number
Social Security Number
Corporation Registration Number
Taxpayer (Corporation) Name
Address
Incorporation (Date)
State Where Incorporated
Has the state revoked the corporation franchise?
If so, when?
□
□
Yes
No
Has the corporation ever filed bankruptcy?
If so, when?
□
□
Yes
No
How were you associated with this corporation?
Form OTR 40 (Rev. 5/98)

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