Nexus Questionnaire - Montana Department Of Revenue
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5Montana Department of Revenue
Nexus Questionnaire
Business Tax and Valuation
Telephone: (406) 444-6900
Sam W. Mitchell Building
Fax: (406) 444-2900
P.O. Box 5805
Helena, MT 59604-5805
1. Legal Name of Business:
Phone:
d/b/a name:
Street Address:
City:
State:
Zip Code:
2. Federal Employer Identification No.:
3. State of Incorporation:
4. Date of Incorporation:
5. Date Qualified to do business in Montana:
6. Type of Corporation (C corporation, S corporation, LLC):
7. Nature of business and description of property and/or services sold:
8. Have you ever filed Corporate License Tax returns with Montana? If yes, enter date of last return and name under which
return was filed:
Date:
Name:
9. List names and addresses of your three largest customers in Montana:
a)
b)
c)
10. Amount of sales for the last three years:
Tax Year Ended
Total Everywhere
Total Montana
______/______/______
$ ______________________________
$ ______________________________
______/______/______
$ ______________________________
$ ______________________________
______/______/______
$ ______________________________
$ ______________________________
11. Net income (before net operating loss and special deductions, i.e. Line 28) on federal tax return for last three years:
20_____
$________________
20____ ____
$________________
20_____
$________________
12. List all states your corporation conducts business activities in:
13. List all subsidiaries, divisions, or parent corporations operating within Montana:
Name
Relationship
Address
(a) ____________________________
____________________
_____________________________________________
(b) ____________________________
____________________
_____________________________________________
(c) ____________________________
____________________
_____________________________________________
(d) ____________________________
____________________
_____________________________________________
14. If your company is owned over 50% by another entity, list the parent's name and FEIN:
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