Form R-4310 - Questionnaire To Assist In Determining Liability For Corporation Income Tax Or Corporation Franchise Tax Page 2

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B. Public Law 86-272 Questionnaire—To be completed by companies with sales into Louisiana
1.
Does this company:
❏ ❏ Yes
❏ ❏ No
a.
Maintain an office or warehouse in Louisiana?
b.
Maintain stocks of merchandise, inventories, or samples, including samples used by
❏ ❏ Yes
❏ ❏ No
sales personnel, in Louisiana?
❏ ❏ Yes
❏ ❏ No
c.
Ship merchandise into Louisiana on consignment?
d.
Provide or reimburse for office space and related expenses for sales
❏ ❏ Yes
❏ ❏ No
personnel in Louisiana?
❏ ❏ Yes
❏ ❏ No
e.
Furnish automobiles for use by sales personnel?
2.
Do your Louisiana sales personnel:
❏ ❏ Yes
❏ ❏ No
a.
Work in states other than Louisiana?
If so, what is the approximate percentage of their time in
Louisiana and outside Louisiana?
❏ ❏ Yes
❏ ❏ No
b.
Assist your customers or users with warranty or damage claims?
c.
Assist in the installation or operation of your
❏ ❏ Yes
❏ ❏ No
products actually or in a supervisory capacity? (Sales or technical personnel)
❏ ❏ Yes
❏ ❏ No
d.
Collect delinquent accounts?
If no, how are they collected?
3.
What is the number of sales personnel in Louisiana each year?
❏ ❏ Yes
❏ ❏ No
a.
Are any sales personnel residents of Louisiana?
b.
What is the total annual compensation paid to sales personnel
in Louisiana in each of the past three years?
❏ ❏ Yes
❏ ❏ No
4.
Is any merchandise shipped into Louisiana by company-owned or leased vehicles?
If yes, how often?
5.
Describe the products your company provides to Louisiana customers.
6.
What is the amount of gross sales of products to Louisiana
customers for each of the past three years?
7.
Does your company provide any services or conduct any other trade or business in Louisiana other than
❏ ❏ Yes
❏ ❏ No
the sale of tangible personal property?
Name of person completing the questionnaire
Title
Signature
Date (MM/DD/YYYY)
Telephone Number
Email address

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