Business Activities Questionnaire - Pa Department Of Revenue

C. PENNSYLVANIA BUSINESS ACTIVITIES – PART 2

Answer the following questions based on the entity’s activities in Pennsylvania. If the business is a corporation, responses should also reflect the activities of

a partnership or similar association in which the corporation has an interest.

CUSTOMER SERVICE AND DELIVERY:

Check the different ways in which the entity’s personal property is delivered in Pennsylvania:

Motor carrier

US mail

Your agent

Company vehicle

Not Applicable

Check the different advertising media you use to reach Pennsylvania customers:

Internet

Telephone solicitations

Catalogs placed in outlets

Other/Describe:

Does the entity participate in trade fairs or shows in PA? If so, are products sold directly to the customer or are orders taken and sent back to the home

office for approval?

For each of the following activities performed by any of your employees or independent representatives, indicate the dates during which the activities were

performed in Pennsylvania:

Start Date

End Date

______ / ______ / ______

______ / ______ / ______ Occasional or regular visits to Pennsylvania to create a demand for your personal property or service

______ / ______ / ______

______ / ______ / ______ Solicitation of orders within Pennsylvania

______ / ______ / ______

______ / ______ / ______ Approval of orders within Pennsylvania

______ / ______ / ______

______ / ______ / ______ Repair, servicing, or warranty servicing of personal or real property within Pennsylvania

______ / ______ / ______

______ / ______ / ______ Installation or assembly of products within Pennsylvania

______ / ______ / ______

______ / ______ / ______ Construction related activities

______ / ______ / ______

______ / ______ / ______ Training personal

______ / ______ / ______

______ / ______ / ______ Collections or credit activities within Pennsylvania. Please explain.

D. INDEPENDENT REPRESENTATIVES

Are you a manufacturer’s representative?

Yes

If you have a contract with a manufacturer’s representative(s) to market your product or service to Pennsylvania customers, please attach a list of the

name(s) and address(es) of each.

If you are a manufacturer’s representative, please attach a list of the names and addresses of each business entity you represent in Pennsylvania.

E. AFFIRMATION

I hereby affirm under penalties prescribed by law that this questionnaire has been examined by me, and to the best of my knowledge and belief is true,

correct, and complete. If prepared by a person other than the taxpayer, statements are based on all information of which preparer has knowledge. The

preparer also must complete the information below.

(

)

Date

Print Name of Owner/Officer/Partner

Signature

Telephone Number

Fax Number

(

)

Date