Form St101 - Minnesota Business Activity Questionnaire For Determining Sales Tax Nexus Page 5
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5Section E—Affiliated companies
1 Does your business own more than 50 percent of another business? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Ye s
No
2 Does another business own more than 50 percent of your business? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Ye s
No
If yes to either question 1 or 2, list the names, addresses, and FEINs of the businesses below.
Attach additional sheets if necessar y.
3 Check all activities that affiliated companies perfor m. If checked, enter the names of the affiliated companies that perfor m
the activities, Minnesota tax ID number s, and dates activities were performed. Attach additional sheets if necessar y.
File income tax in Minnesota.
Name
Minn. ID
From
to
Name
Minn. ID
From
to
File sales tax in Minnesota.
Name
Minn. ID
From
to
Name
Minn. ID
From
to
File withholding (payroll) tax in Minnesota.
Name
Minn. ID
From
to
Name
Minn. ID
From
to
Make mail-order sales to Minnesota customer s.
Name
Minn. ID
From
to
Name
Minn. ID
From
to
Have destination sales in, or receipts from, Minnesota.
Name
Minn. ID
From
to
Name
Minn. ID
From
to
Solicit, distribute or ser vice products in Minnesota of other member s of affiliated group.
Name
Minn. ID
From
to
Name
Minn. ID
From
to
Perform services or provide facilities for affiliated companies in Minnesota.
Name
Minn. ID
From
to
Name
Minn. ID
From
to
Sign here
I declare that the information furnished in this report, including accompanying statements, contracts, and schedules, is to the best of
my knowledge and belief, true, correct and complete.
Signature
Date
Name of person who prepared questionnaire
Title
Daytime phone
(
)
Enclose a copy of your most recent annual report.
Mail or fax to: Minnesota Department of Revenue Nexus Unit 2711 West Superior St. Suite 200 Duluth, MN 55806
Questions: Call 218-723-4626
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Minnesota Business Activity Questionnaire—Sales Tax Nexus
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