Form Ftb 4684a - Demand For Tax Return - Questionnaire - 2013 Page 2
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4Reply to FTB
C
Provide the following information
Entity ID Number:
To determine if your entity must file for the tax year specified, you must complete and return this
questionnaire. If we cannot determine your entity's filing status, we may issue a Notice of Proposed
Assessment.
1.
Describe the nature of your business and indicate the activities you conduct in California or which are conducted
in California on behalf of your entity for the year specified on this notice. Attach a separate sheet if necessary.
2.
Your entity's share of the property, payroll, and sales:
Total within and
Factors
outside California
Total within California
Property
Beginning of tax year
$
___________________________
$
____________________________
Ending of tax year
$
___________________________
$
____________________________
Annual rent expense
$
___________________________
$
____________________________
Payroll
$
___________________________
$
____________________________
Sales
$
___________________________
$
____________________________
YES
NO
3.
Did your entity hold an interest in or own a California business entity?......................................
If yes, provide the business entity's account number (FEIN): ...............................
Business entity name:
4.
Did your entity have an office, agency, liaison, warehouse, or other place of business in
YES
NO
California?..................................................................................................................................
If yes, provide the company name, location, dates, and nature of activities:
5.
Did your entity hold title to or own personal or real property located or used in California
(e.g., merchandise inventory, motor vehicles, office, industrial equipment, ownership
YES
NO
interest or intellectual property, etc.)?........................................................................................
If yes, provide the location and cost of such property:
6.
Did your entity lease or rent from or to others, any personal or real property in California
(e.g., warehouse space, motor vehicles, office space, housing space, or industrial
YES
NO
equipment, ownership interest or intellectual property, etc.)?....................................................
If yes, provide the dates, description of property, and amount of rental or lease payments made:
7.
Was your entity listed in a California telephone directory or did it use a California
YES
NO
answering service?....................................................................................................................
If yes, provide telephone numbers:
YES
NO
8.
Does your business entity advertise in California? (Provide details.).......................................
Continued on next page
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FTB 4684A (REV 07-2013) C3 PAGE 4
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Parent category: Financial