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REV-986 CT (07-10)

9860010101

CORP TAX

TAX YEAR

CORPORATION NAME _______________________________ ACCOUNT ID _____________________ ENDING

SCHEDULE TO SUPPORT CLAIM OF EXEMPTION FROM

CORPORATE NET INCOME TAX UNDER P.L. 86-272

Did the taxpayer make repairs or provide maintenance or service to the product sold? . . . . . . . . . . . . . . . . . . . . . . .Yes

Did sales personnel have the authority to collect payment for current or delinquent accounts? . . . . . . . . . . . . . . . . .Yes

Did the taxpayer install or supervise the installation of the product? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Yes

Did the taxpayer conduct training courses or seminars in Pennsylvania for personnel other than personnel

involved in solicitation? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Yes

Did the taxpayer provide any technical assistance or service including, but not limited to, engineering assistance

or design service, when one of the purposes thereof is other than the facilitation of the solicitation of orders? . . . . . .Yes

Did the sales personnel investigate, handle or otherwise assist in resolving customer complaints, other than direct

customer complaints in relation to the solicitation of sales? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Yes

Did the sales personnel have the authority to accept and approve orders? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Yes

Did the sales personnel repossess property? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Yes

Did the sales personnel secure deposits on sales? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Yes

10. Did the sales personnel pick-up or replace damaged or returned property? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Yes

11. Did the taxpayer hire, train or supervise personnel, other than personnel involved only in solicitation? . . . . . . . . . . .Yes

12. Did the sales personnel use agency stock checks or any other instrument or process by which sales are made

within Pennsylvania by sales personnel? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Yes

13. Did the taxpayer maintain a sample or display room in excess of two weeks at any one location in Pennsylvania? . . .Yes

14. Did the sales personnel carry samples from which sales, exchanges or distributions were made in any

manner or consideration or other value? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Yes

15. Did the taxpayer own, lease, use or maintain any of the following facilities or property in Pennsylvania:

A) Any kind of office other than an in-home office located within the residence of the employee that is not

publicly attributed to the company. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Yes

B) Meeting place for directors, officers or employees. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Yes

C) Stock of goods other than samples for sales personnel or that are used entirely ancillary to solicitation. . . . . . . .Yes

D) Telephone answering service that is publicly attributed to the company or to employees of the company . . . . . . .Yes

E) Mobile stores, i.e., vehicles with drivers who are sales personnel making sales from the vehicles

. . . . . . . . . . . .Yes

16. Did the taxpayer consign stocks of goods or other tangible personal property to any person, including an

independent contractor, for sale? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Yes

17. Did the taxpayer maintain a telephone listing or other public listing within Pennsylvania for the company or for

an employee as a means of contact? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Yes

18. Did the taxpayer enter into a franchise or licensing agreement in Pennsylvania? . . . . . . . . . . . . . . . . . . . . . . . . . . .Yes

A complete description of all Pennsylvania business activities must be included. Taxpayers reporting property owned and/or rented in Pennsylvania and also claim-

ing exemption from corporate net income tax under P.L. 86-272 must provide a description of this property below:

9860010101