Minnesota Business Activity Questionnaire Form Page 2
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53. Has your business made Minnesota retail sales of products?
Yes
No
4. Has your business made sales of products to end users located in Minnesota?
Yes
No
5. Has your business made mail order sales of your products to Minnesota consumers?
Yes
No
6. Does your business have a regional office serving Minnesota?
Yes
No
If yes, list office location and the states it serves.
_______________________________________________________________________________________________________
7. Is the business listed in a Minnesota telephone directory?
Yes
No
City: ______________________________________________ Phone number: ( ______ ) ______________________________
8. Date any employee first worked for your business in Minnesota. _____________________________________________________
9. Date your business began marketing/shipping your product/service in Minnesota: _______________________________________
10. List states from which Minnesota destination sales are shipped or delivered:
_______________________________________________________________________________________________________
11. Have products been sent to Minnesota in returnable containers?
Yes
No
Does your business retain ownership of the containers?
Yes
No
Does your business charge a deposit on the containers?
Yes
No
12. Does your business perform any of the following activities using vehicles that are owned or leased by your business:
a) Deliver to Minnesota locations
Yes
No
b)Pick up own merchandise for return to out of state location
Yes
No
c) Pick up products owned by another business
Yes
No
d)Pick up merchandise from one Minnesota location for delivery to another Minnesota location
Yes
No
e) Sales made by vehicle driver or passenger(s)
Yes
No
If yes, what years and how frequently? ________________________________________________________________________
13. Does your business own or lease any terminals or fuel facilities in Minnesota?
If yes, where? _______________________________________________________________________________ Yes
No
14. Names, addresses and phone numbers of the 3 largest Minnesota customers.
A. _____________________________________________________________________________________________________
B. _____________________________________________________________________________________________________
C. _____________________________________________________________________________________________________
15. Amount of Minnesota destinations
Amount of total company sales (sales,
Net Income (before net operating loss
sales (sales, gross earnings, or
gross earnings, or receipts) for the
deduction) on the federal income tax
receipts) for the past three years:
past three years:
return for the past three years:
year/mo
year/mo
year/mo
___/___ $______________________
___/___ $______________________
___/___ $______________________
___/___ $______________________
___/___ $______________________
___/___ $______________________
___/___ $______________________
___/___ $______________________
___/___ $______________________
MBAQ WEB-PAGE 2
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