41A800 (12-15)
Page 4
f.
Do you lease motion picture films to movie theaters and television stations in
Kentucky?
¨
¨
YES
NO
If yes, explain: __________________________________________________________
________________________________________________________________________
________________________________________________________________________
g. Are you a member of a single member limited liability company that is doing
business in Kentucky and is disregarded for federal income tax purposes?
¨
¨
YES
NO
If yes, provide the name, identification number and address of each:
________________________________________________________________________
________________________________________________________________________
h. Are you a shareholder, partner, or member of a pass-through entity doing
business in Kentucky?
¨
¨
YES
NO
If yes, provide the name, identification number and address of each:
________________________________________________________________________
________________________________________________________________________
i.
Do you receive income from intangible personal property that has acquired a
Kentucky situs? (See 103 KAR 16:240 for definition of situs)
¨
¨
YES
NO
If yes, explain: ___________________________________________________________
________________________________________________________________________
________________________________________________________________________
j.
Are you a professional service provider (such as a law firm, accounting firm,
etc.) providing services in Kentucky?
¨
¨
YES
NO
If yes, provide dates in Kentucky: _________________________________________
________________________________________________________________________
________________________________________________________________________
12.
Do you derive income from or attributable to sources within this state
including deriving income directly or indirectly from a trust doing business in
this state?
¨
¨
YES
NO
If yes, provide the name, identification number and address of each:
________________________________________________________________________
________________________________________________________________________