Form 1353 - Michigan Department Of Treasury Nexus Questionnaire - 2012 Page 2
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31353, Page 2
4. Do agents, representatives, independent contractors, brokers or others acting on your behalf do any of the following: own, lease, use or maintain an
office or other establishment in Michigan which is significantly associated with your ability to establish or maintain a market in Michigan? (See Table 2
on page 4) If Yes, identify the year(s).
Yes, enter year(s):
No
“Representative” means any individual or entity, including but not limited to agents, corporate or other business entities, whether related or unrelated
to the other business, and independent contractors, that conducts business activity in the taxing state on behalf of another. The term does not include
employee. The term includes, without any limitation on the foregoing, agents, corporate or other business entities, related or unrelated to the other
business, and independent contractors. A representative may be a resident or nonresident of the taxing state. The term also includes
sub-representatives. “Sub-representative” means a person to whom a representative delegates authority to perform some duty, or the whole of
the business, relating to their representation, or to assist in transacting the affairs of their principal. A sub-representative is a person appointed by a
representative empowered to do so, to perform functions undertaken by the representative for the principal, but for whose conduct the representative
agrees with the principal to be primarily responsible. Such person may be: an under-representative; a substituted representative; or one person
appointed by one who is a representative. But a mere servant of a representative is not a “sub-representative.”
5. How are goods delivered to Michigan purchasers?
Common Carrier
Contract Carrier
Vehicles owned, leased, used or maintained by your company
By a Related Party
By a Representative
Other:
“Related Party” means any individual or entity that qualifies or would qualify as (i) an affiliated group or a controlled group of corporations
under section 1563 of the internal revenue code or (ii) an entity under common control under internal revenue code regulation 1.414(c)-2
provided that “50 percent” shall be substituted for “80 percent” in determining when an individual or entity is part of an affiliated group, a
controlled group of corporations, or an entity under common control.
6. For Transportation Companies only:
Company doesn’t enter Michigan
Company drives through, picks up or drops off in Michigan, enter year(s):
7. Do your employees, agents, representatives, independent contractors, brokers or others (both Michigan residents and nonresidents) conduct
business activity in Michigan on your behalf? If Yes, for each activity listed below enter the applicable tax year(s) and indicate the number of days
activities were performed in Michigan during the 12-month taxable year. Attach additional sheets if necessary.
Yes
No
Last Four Completed
Number of Days During the 12-Month Taxable Year
Tax Year(s)
Activity Conducted in Michigan
(MM/DD/YY)
0
1
2 or more
Yr 1
Physical presence within Michigan soliciting sales through
Yr 2
employees, agents, representatives, independent contractors or
Yr 3
others acting on your behalf.
Yr 4
Yr 1
Yr 2
Make repairs or provide maintenance or service to property sold or
to be sold to Michigan customers.
Yr 3
Yr 4
Yr 1
Collect on current or delinquent accounts through assignment or
Yr 2
otherwise. This does not include financial institutions or banks
Yr 3
unless they make sales of tangible personal property.
Yr 4
Yr 1
Yr 2
Install or supervise installation at or after shipment or delivery.
Yr 3
Yr 4
Yr 1
Conduct
training
for
employees,
agents,
representatives,
Yr 2
independent contractors, brokers or others acting on your
Yr 3
company’s behalf.
Yr 4
.
Continued on page 3
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