Form 21-006e - Questionnaire 21-006 Service Activies In Iowa For A Corporation, Partnership Or Llc Page 4

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14. Did the company own or retain title to tangible personal property or real property located or used in Iowa
other than employee vehicles? ___Yes
___ No
Year
Property Type & Location
Owned / Rented
____
____________________________________________________________
________
____
____________________________________________________________
________
____
____________________________________________________________
________
____
____________________________________________________________
________
15. Does the company have any franchises or licensing agreements or receive payments for the use of
trademarks or trade names in Iowa? ___Yes
___ No
If yes, please provide a copy of the agreements.
16. Does the company pay for the use of trade names or trade marks used in its Iowa business? ___Yes ___ No
If yes, please provide a copy of the agreements.
“Employees” means all people entering Iowa on company business regardless of domicile or office location.
If no employees travel in Iowa, go to question 19.
17. For all present and former employees who have entered Iowa, please complete the following (include copies
of the employees’ job descriptions and that of his/her immediate supervisor):
Name, Title line 1 /Address line 2
Home Phone
Division/Subsidiary
Date
Date
Hired
Ended
1.________________________________
_____________
_______________
_____
_____
2. __________________________________________________________________________________
1.________________________________
_____________
_______________
_____
_____
2. __________________________________________________________________________________
1. ________________________________
_____________
_______________
_____
_____
2. __________________________________________________________________________________
18. While present in Iowa, what activities have company employees performed? Please explain any activity,
including how often this activity occurred.
21-006d(04/25/11)

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