Tax Return Questionnaire – CNF-120/SPF-100
NaME
FEIN
CHECK ALL THAT APPLY
short period return
Change of accounting period
Change of name
Change of entity type
Change of address
FINAL AND/OR SHORT-PERIOD RETURN – CHECK ALL THAT APPLY
Ceased operations in West Virginia
Change in filing status
Change of ownership
Merger
successor to previous business
other ___________________________________
Technical Termination
Taxpayer continue to file future returns under this FEIN
PLEASE PROViDE AN ExPLANATiON FOR BOxES CHECKED ABOVE
1. If this is the entity's initial return or if the entity did not file a return under the same name and same federal I.D. number for the preceding year,
indicate whether: (a) new WV business; (b) successor to previously existing business; or (c) was included on a WV return filed under
a different FEIN. Please explain: ____________________________________________________________________________________
_______________________________________________________________________________________________________________
_______________________________________________________________________________________________________________
2. are Q-subs included in this return? Yes
No. If yes, list name and federal I.d. number of each Q-sub and the name and FEIN of their
parent. _________________________________________________________________________________________________________
_______________________________________________________________________________________________________________
_______________________________________________________________________________________________________________
_______________________________________________________________________________________________________________
_______________________________________________________________________________________________________________
3. are disregarded entities included in this return? Yes No. If yes, list name and federal I.d. number of each disregarded entity and the
name and FEIN of their parent. Please submit additional pages if required. _________________________________________________
_______________________________________________________________________________________________________________
_______________________________________________________________________________________________________________
_______________________________________________________________________________________________________________
4. (a) Was the entity a partner or member in a pass-through entity doing business in West Virginia? Yes No. If yes, list name and federal
I.d. number of the pass-through entity(ies). _____________________________________________________________________________
_______________________________________________________________________________________________________________
_______________________________________________________________________________________________________________
_______________________________________________________________________________________________________________
5. (b) Was the entity doing business in West Virginia other than through its interest held in a pass-through entity doing business in West Virginia?
Yes No
6. did the entity at any time during the taxable year do business in West Virginia and own 80 percent or more of the voting stock of another
corporation doing business in West Virginia? Yes No. If yes, list name, address and federal I.d. number of each entity. ___________
_______________________________________________________________________________________________________________
_______________________________________________________________________________________________________________
7. Was 80 percent or more of the corporation's voting stock owned by any corporation doing business in West Virginia at any time of the year?
Yes No. If yes, list name, address and federal Id number of each entity. _________________________________________________
_______________________________________________________________________________________________________________
_______________________________________________________________________________________________________________
8. The federal tax return attached to this West Virginia return is: a proforma federal tax return a copy of the federal tax return filed with the
Internal Revenue service
9. Is the entity currently under audit by the Internal Revenue service? Yes No
If yes, enter years under audit ____________________________________
If the Internal Revenue Service has made final and unappealable adjustments to the entity's taxable income which have not been reported
to the department, check here and file an amended return. Attach a copy of the final determination to each amended return.
–24–