Nexus Investigation Questionnaire Form
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2NEXUS INVESTIGATION QUESTIONNAIRE
Page One
Case Number: ________________
Auditor:
__________________
Please answer the following questions to the best of your ability. The answers should be based on your
company’s business activities since the date of inception. This form must be signed by a corporate officer.
1. How is your business organized?
( ) C Corporation
( ) Partnership
( ) S Corporation
( ) Joint Venture
( ) Sole Proprietorship
( ) Other _________________
2. What was your principal business activity? ______________________________________________
SIC code: _______________
OR
NAICS code: _____________________________
3. Do you have a physical location in Florida (e. g., retail store, sales office, factory or warehouse)?
( ) Yes
( ) No
Comment: __________________________________________
4. Do you make sales to customers in Florida?
( ) Yes
( ) No
Comment: __________________________________________
5. Does your company provide services in Florida (consulting, training, pest control, security, burglar protection,
cleaning, etc.)?
( ) Yes
( ) No
Type: ______________________________________________
6. How are your Florida sales solicited? (Check all that apply)
( ) Salesman
( ) Agent
( ) Manufacturer Representative
( ) Internet
( ) Independent Contractor
( ) Tradeshows – held in Florida
( ) Catalog
( ) Tradeshows – held outside Florida ( ) Walk-in
( ) Telephone
( ) Other (please specify): ______________________________________________________
7. How are the goods delivered into Florida? (Check all that apply)
( ) Common Carrier (e.g., UPS)
( ) Own truck
( ) Leased Truck
( ) Other ______________________________
8. Do you have an inventory of materials or goods in Florida?
( ) On consignment
( ) in public warehouses
( ) I have no inventory of materials or goods in Florida
9. What are your average yearly sales to Florida customers?
( ) Less than $5,000/year
( ) $5,000 – 50,000/year
( ) $50,000 – 100,000/year
( ) $100,000 – 250,000/year
( ) Over $250,000/year
10. Do you have at least one employee living or working in Florida?
( ) Yes
( ) No
Please Explain: ___________________________________________
11. Please provide your company’s website address? _______________________________________
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