Form Tr-0412 - Self-Examination Questionnaire Page 4
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58. Which company officials have the authority to remove payroll or commission checks from
the abandoned property list?
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
9. Approximately what percentage of payroll is on a direct deposit? Total __________________
Quantity in Tennessee _________________
10. Approximately how many employees does the company have?
Total __________________
Quantity in Tennessee _________________
11. How many locations do you have in Tennessee? __________________ (Please attach a list of
operating locations.)
EQUITY
1. If this is a stock company, is the stock publicly traded?
Yes
No
2. Who is the registrar and dividend-paying agent? _______________________________________
3. How are unpresented dividend checks identified?
__________________________________________________________________________________
__________________________________________________________________________________
4. Are any shares undelivered because the owner is unlocated?
Yes
No
5. How are shares and unpaid dividends, etc. reported to Tennessee?
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
ACCOUNTS RECEIVABLE CREDIT BALANCES AND CREDIT MEMOS
1. Where merchandise is returned and/or adjustment is made, is a credit memo issued?
Yes
No
2. If yes, will the credit memo appear in accounts receivable?
Yes
No
3. Where a credit balance exists in accounts receivable and the customer does no further
business, what becomes of the credit balance?
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
(4)
TR-0412
RDA 2128
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Parent category: Financial