Form C101 - Minnesota Business Activity Questionnaire
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5C101
Minnesota Business Activity Questionnaire
Legal name of business
Federal employer ID number (FEIN)
Date income year ends
Home office mailing address
Phone
Fax
City
State
Zip code
Web address
Email address
Type of business
State/year of incorporation or organization
Year of subchapter S election
Corporation
S corporation
Partnership
Other
If S corporation or partnership, enter:
Number of shareholders or partners
Percentage ownership of the partner/shareholder owning the largest share
%
Prior business names and dates of incorporation or organization, if any
Principal product or service
Brand names of products or services
States or countries from where products/services are marketed or shipped
Answer all questions with regard to the business listed above. Attach additional sheets if necessary to explain your answers.
Enclose a copy of your most recent annual report.
Section A
1 Check the tax types for which your business has filed a Minnesota return. Enter the years filed and FEIN if different from above.
Corporation franchise tax . . . . . . . . . .
.
From
to
FEIN
S corporation tax . . . . . . . . . . . . . . . .
.
From
to
FEIN
Partnership tax . . . . . . . . . . . . . . . . . .
.
From
to
FEIN
Sales/use tax . . . . . . . . . . . . . . . . . .
.
From
to
FEIN
Withholding tax/unemployment tax . . .
.
From
to
FEIN
2 Has your business made Minnesota retail sales of products or services? If yes, what types of products
or services have you sold? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Yes
No
3 Does your business have a regional office serving Minnesota? If yes, enter the office location and the
states it serves . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Yes
No
Location
State(s)
4 Is your business listed in a Minnesota phone directory? If yes, enter city and phone number . . . . . . . . . . . . .
Yes
No
City
Phone
5 Enter the date your business began marketing or shipping your products/services in Minnesota . . . . . .
/
/
6 Does your business have a distribution center located in Minnesota? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Yes
No
7 Have products been sent to Minnesota in returnable containers? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Yes
No
If yes:
a. Does your business retain ownership of the containers? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Yes
No
b. Does your business charge a deposit on the containers? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Yes
No
Continued
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(Rev. 3/13)
Minnesota Business Activity Questionnaire
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Parent category: Financial