Form 1902(B) - Delaware Information Return Holding Company I Investment Company - 2011 Page 2
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PART III - QUESTIONS RELATING TO EXEMPT ACTIVITIES
If the answer to any of the following is “YES”, it would be an indication that the corporation is exempt from Delaware corporat e tax under
Section 1902(b)(8), 30
DEL C. (If yes, please provide a brief description.)
1.
Did the corporation directly or indirectly receive income from any one of the following sources? Please check the appropriate box for
each source of income and, for each “yes” response where the income received is in excess of $1 million, provide a description of the
activity performed in Delaware with regard to such income.
a.
Interest on notes secured by real estate mortgages.
YES / NO
b.
Interest on all other debt obligations.
YES / NO
YES / NO
c.
Dividends.
d.
Patents, patent applications, trademarks, trade names and know-how.
YES / NO
YES / NO
e.
Gain on the sale of intangible investments.
YES / NO
f.
Rental income from real property located outside of Delaware.
g.
Rental income from tangible personal property located outside of Delaware.
YES / NO
2.
Is the corporation engaged in business activities outside of Delaware other than described
YES / NO
in Question 1 above? (If yes, please describe.)
PART IV - ADDITIONAL INFORMATION
YES / NO
Did the corporation have any source of income other than the sources of income described in Parts II
and III above? (If yes, please describe the source of income and the activity in Delaware relating to it.)
Under penalties of perjury, I declare that I have examined this return and statements, and believe it is true, correct and comp lete.
Signature
Title
Date
(Revised 11/21/11)
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