Business Activity Questionnaire Form Page 9
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9BUSINESS ACTIVITY QUESTIONNAIRE
PART IV: COMPETITOR LIST
Please list your five largest competitors in and around New Mexico. Include addresses and telephone numbers.
Name
Address
ADDITIONAL COMMENTS:
ENCLOSE A COPY OF YOUR ANNUAL REPORT, FEDERAL FORM 10K
AND A LIST OF YOUR AFFILIATES.
PART V: SIGNATURE AND VERIFICATION
I declare that the information furnished in response to this questionnaire is to the best of my
knowledge and belief, true, correct and complete.
SIGNATURE OF OFFICER OR AUTHORIZED REPRESENTATIVE OF TAXPAYER
Signature
Title
Date
- OR -
SIGNATURE OF PARTNER OR OWNER
Signature
Title
Date
A - 10
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