Business Activity Questionnaire Form Page 3

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BUSINESS ACTIVITY QUESTIONNAIRE
12.
Has the company or an affiliate ever maintained a bank account in New Mexico?
q YES
q NO
If yes, where and for what years:
PART II: GENERAL OPERATIONS
Please give detailed answers in the spaces indicated. If the space is inadequate, please submit
separate detailed explanations. If a document answers the question, please submit a copy of
the document.
1.
Does the company derive income in, into or from the transaction of any business in
New Mexico?
q YES
q NO
If yes, describe the source of income:
DATE ACTIVITIES BEGAN:
2.
Does the company and/or affiliate have employees that perform activities in New
Mexico?
q YES
q NO
If yes, please provide the frequency and time periods of performance.
3.
Does the company and/or affiliate have representatives that perform activities in New
Mexico?
q YES
q NO
If yes, describe the activities of the representatives within New Mexico, including the
frequency and time periods of performance.
DATE ACTIVITIES BEGAN:
A - 4

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