Questionnaire: Nexus Activities In Iowa For Sales Or Use Tax Purposes Page 3

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Date Hired/Date
Name/Address of the soliciting individuals or businesses
Terminated
a.
b.
c.
d.
e.
13. Does the company (check all that apply):
a. Have an office, agency, warehouse, or any other place of business in Iowa?
Yes
No
b. Own or retain title to tangible personal property or real property located or used in Iowa? Do not include
employee vehicles.
Yes
No
c. Ship products into Iowa in returnable containers?
Yes
No
d. Deliver its products in company owned or leased vehicles?
Yes
No
14. While in Iowa, did company employees (check all that apply):
YES
NO
If yes, how often?
become involved in
Monthly
Yearly
Other
warranty matters?
Quarterly
Install, assemble or repair
Monthly
Yearly
Other
products?
Quarterly
Sell items in their
Monthly
Yearly
Other
possession?
Quarterly
Replace merchandise or
Monthly
Yearly
Other
products with items in their
Quarterly
possession?
Remove or destroy any
Monthly
Yearly
Other
merchandise or products,
Quarterly
for any reason?
Pick up merchandise,
Monthly
Yearly
Other
products, or other company
Quarterly
property from anyone
located in Iowa?
15. Please provide the names, addresses, titles and telephone numbers of all employees who helped complete
this questionnaire or provided information for the questionnaire.
16. Please provide the name, title, e-mail and telephone number of the employee we should contact for further
information.

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