Form 6401-Hmc - Application And Election For A Headquarters Management Corporation Business License

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FORM 6401-HMC
APPLICATION AND ELECTION FOR A
HEADQUARTERS MANAGEMENT CORPORATION
Print Form
BUSINESS LICENSE
STATE OF DELAWARE
Division of Revenue
REVENUE CODE 0101-01
P.O. Box 8750
Wilmington DE 19899-8750
GROUP CODE 712
PART A - APPLICANT’S NAME, ADDRESS AND IDENTIFICATION NUMBER
Federal Employer Identification Number
Name of Corporation
Address
Zip Code
PART B - EXISTING ACTIVITIES OF APPLICANT:
1.
Date of election to be taxed as a Headquarters Management Corporation.
/
/
Month / Day
/ Year
2.
Prior to the date of this application,
(a) Did the Applicant conduct any business or investment activities in Delaware?
Yes
No
(b) If the answer to question 2(a) is yes, did those activities include anything other than ‘investment activities’,
as defined in 30 Del. § 6401(c)?
Yes
No
(c) Was the Applicant affiliated with any other entity that ever performed any non ‘investment activities’
in Delaware?
Yes
No
3.
If the answers to question 2. (a), (b), and (c) are ‘No’ skip to Part C.
4.
If the answer to question 2. (a) is ‘Yes’ and (b) and (c) are ‘No’ skip to Part D.
5.
If the answer to question 2. (b) or (c) is ‘Yes’ skip to Part E.
PART C - NEW BUSINESS ACTIVITIES OF APPLICANT WITH NO DELAWARE AFFILIATES:
1. Describe the Headquarters Services, as defined in 30 Del. § 6401(b), Applicant will perform in Delaware.
2. Describe the intangible investments Applicant will manage and/or maintain and the investment activities it will perform
in Delaware.
3. Go to and Complete Part F.
*DF42813019999*

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