Form Ftb 4684a - Demand For Tax Return - Questionnaire - 2013 Page 4
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4Reply to FTB
C
Continued from previous page
Entity ID Number:
20. Engaged in collection activity, including notifying customers or clients of past due accounts
YES
NO
or assignment of accounts to third parties.................................................................................
YES
NO
21. Secured deposits or collected the balance due on sales of merchandise.................................
YES
NO
22. Inspected products for, or offered technical assistance about, product use or utility................
23. Provided training courses, lectures, or other instructions for personnel other than
YES
NO
those involved only in solicitation..............................................................................................
24. Picked up or verified destruction of damaged or returned merchandise from customers in
YES
NO
California...................................................................................................................................
25. Unpacked, inspected, or installed a company product either by doing the actual work
YES
NO
themselves or by supervising the unpacking/installing done by others.....................................
YES
NO
26. Solicited sales for delivery from California inventory or approved customer orders..................
YES
NO
27. Authorized credit adjustments or repairs...................................................................................
YES
NO
28. Advised customers or distributors on removal of obsolete, damaged, or dated inventories......
YES
NO
29. Solicited orders for the sale of services or for the sale of California real estate........................
30. Used their California homes or offices, listed their California homes as a business address,
received business calls there, received reimbursement of rent for use of their homes, or
YES
NO
stored inventory in their homes or garages...............................................................................
D
Signature
Under penalty of perjury under the laws of the State of California, I declare the above information is true,
correct, and complete to the best of my knowledge and belief. If prepared by a person other than an
officer of the business entity, his or declaration is based on all information of which he or she has
knowledge and has reasonably attempted to secure and verify.
(
)
Signature: _______________________________________
Daytime telephone number: ________________________
(
)
Print name: ______________________________________
Fax number: _____________________________________
Declarant's relationship to the
business: ________________________________________
Website address: _________________________________
468401071336
FTB 4684A (REV 07-2013) C3 PAGE 6
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Parent category: Financial