Business Activities Questionnaire - Pa Department Of Revenue - 2002
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2REV-203 CM (03-02)
BUSINESS ACTIVITIES
QUESTIONNAIRE
PA DEPARTMENT OF REVENUE
Please Print or Type
A. GENERAL INFORMATION
Federal EIN
1.
Legal Name:
1b. Doing Business As:
2.
3.
Address
City
State
Zip Code
Type of Business entity. (Check one)
Corporation
Non-profit Corporation
Subchapter “S” Corporation
4.
Limited Liability Co.
Partnership
Individual (Proprietorship)
Trust
(Attach list of S Corp shareholders, LLC members, or Partnership partners, with Federal ID #’s if applicable)
The entity was incorporated ______ / ______ / ______ under the laws of
5.
6.
The entity’s Pennsylvania Corporation Tax File (Box) Number is:
7.
The entity files federal corporation returns on a Tax Year Ending _________________________________ basis.
8.
List the corporations that are related by ownership along with their Federal ID Numbers and their addresses (include parent, subsidiary and affiliate corporations):
9.
List the entity’s Pennsylvania Sales & Use Tax License Number:
10. List the entity’s Unemployment Compensation Account Number:
Describe the activities performed in Pennsylvania by employees for whom Unemployment Compensation contributions are remitted to Pennsylvania:
11. List all other taxes and tax ID Numbers under which the entity remits taxes to Pennsylvania:
(a) Tax
Tax #
(b) Tax
Tax #
12. If the entity is an LLC, is the entity classified as a corporation or as a partnership by the Internal Revenue Service?
As a corporation
As a partnership (submit a copy of the first page of your federal corporation or partnership filing).
13. If you are a non-profit entity, please submit a copy of the IRS letter granting you 501 status.
B. PENNSYLVANIA BUSINESS ACTIVITIES – PART I
1.
Describe the principal business activities of the entity in Pennsylvania:
2.
Describe the principal business activities of the entity elsewhere:
3.
Indicate the date that the entity’s activities in Pennsylvania first occurred: ______ / ______ / ______ .
4.
List the date that employees or individuals operating on your behalf first offered technical assistance, training or other
services to customers in Pennsylvania ______ / ______ / ______ .
5.
List the date that the entity first leased or owned an office in Pennsylvania: ______ / ______ / ______ .
6.
List the date that the entity first owned or was lessor or lessee of any real tangible personal property
in Pennsylvania: ______ / ______ / ______ .
Owned
Leased
7.
List the date that the entity first brought equipment or tangible personal property into Pennsylvania to conduct
business activities: ______ / ______ / ______ .
8.
List the date that the entity first had inventories in Pennsylvania: ______ / ______ / ______ .
9.
If the entity performs a service in Pennsylvania, please describe:
10. List the date that the entity first delivered its product to Pennsylvania customers ______ / ______ / ______ .
11. List the date that the entity first had interest(s) in partnership(s) which have any activities, operations, or real estate ownership in
Pennsylvania ______ / ______ / ______ . [Provide name, address, Federal ID Number of partnership(s)].
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