Form St-10v - Vessel Dealer Sales And Use Tax Exemption Report For A Foreign Corporation - 1999

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ST-10V

STATE OF NEW JERSEY

DEPARTMENT OF THE TREASURY

SUPPLEMENT 1

DIVISION OF TAXATION

(11-99, R-5)

VESSEL DEALER SALES AND USE TAX EXEMPTION REPORT

FOR A FOREIGN CORPORATION

(See Reverse Side for Instructions and Privacy Act Notification)

Name

Telephone

Federal Identification Number

_______________________________________________________________________________________________________________________

Address (Number and Street or Rural Route)

State of Incorporation

_______________________________________________________________________________________________________________________

City, Town or Post Office and State

Zip Code

Date of Incorporation

_______________________________________________________________________________________________________________________

(a) Does this corporation have a registered agent? . . . . . ¨ Yes

¨ No

Name

Address

Telephone

If yes, ______________________________________________________________________________________________________________

(b) Is the stock of this corporation publicly held? . . . . . . . ¨ Yes

¨ No

Name of Exchange

Symbol

If yes, ______________________________________________________________________________________________________________

Number of shares outstanding ________________________________

Is the stock of this corporation closely held? . . . . . . . ¨ No

(c)

Yes - Number of shares ____________________________

If yes, Part IV must be completed.

(a) Principal type of business ______________________________________________________________________________________________

(b) Location of principal office ______________________________________________________________________________________________

Does this corporation have an office in New Jersey? . . . . . . ¨ No

¨ Yes - Address ____________________________________________

(c)

(d) Does this corporation:

1. Own or lease real property? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ¨ Yes

¨ No

2. Own or lease tangible or intangible personal property? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ¨ Yes

¨ No

3. Employ any other assets in a business, trade, profession or occupation? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ¨ Yes

¨ No

4. Own merchandise or other property for sale? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ¨ Yes

¨ No

5. Own assets which are leased to others? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ¨ Yes

¨ No

6. Perform any construction, erection, installation or repair work or other services? . . . . . . . . . . . . . . . . . . . . . . . . . . ¨ Yes

¨ No

7. Receive payments from persons for the sale of services or property? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ¨ Yes

¨ No

(e) Do any of the above activities take place in New Jersey? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ¨ Yes

¨ No

If yes, state details. (Use separate sheet if necessary.) _______________________________________________________________________

___________________________________________________________________________________________________________________

III

Names of Principal Officers

Title and Social Security Number

Address

Telephone

_______________________________________________________________________________________________________________________

To be completed only by a corporation answering “Yes” to question (c), Part I.

Names of Major Stockholders

Address