Page 3
Please give detailed answers to all remaining questions. If needed, attach additional explanation sheets. If a
document answers the question, submit the document.
Answers will apply to each tax period indicated on page one. Employees who are most familiar with activities
described by each question should complete this questionnaire. It is important that all people helping to
answer this questionnaire are listed in question 19.
12. Does your company solicit sales by (please select Yes or No for all that apply):
Yes
No
a. Company employee(s) traveling in Iowa on company business?
______
______
b. Telephone or telemarketing?
______
______
c. Mail order (catalog or publications)?
______
______
d. Participating in Iowa trade shows?
______
______
e. Independent representative(s)?
______
______
f. Independent dealer(s)?
______
______
g. Independent contractor(s)?
______
______
h. Other
______
______
If yes to items e - h, complete the following and provide a copy of any hiring agreements:
Name & Mailing Address
__________________________________________________________
Or Company (for e,f,g,h)
________________________________________________________
Type of the soliciting individuals _____________________________________________________
Date Hired ______________________
Date Ended ______________________________
Name & Mailing Address
__________________________________________________________
Or Company (for e,f,g,h)
________________________________________________________
Type of the soliciting individuals _____________________________________________________
Date Hired ______________________
Date Ended ______________________________
Name & Mailing Address
__________________________________________________________
Or Company (for e,f,g,h)
________________________________________________________
Type of the soliciting individuals _____________________________________________________
Date Hired ______________________
Date Ended ______________________________
13. Did the company have an office, agency, warehouse, or any other place of business in Iowa? ___ Yes ___No
If yes, please provide dates and addresses:
21-006c(03/28/11)