SCHEDULE N
NEXUS-IMMUNE ACTIVITY DECLARATION
(03-10, ct,)
For Periods Beginning On or After January 1, 2002
For taxable year beginning ______________________, _________ and ending ______________________, _________
Corporation Name
Federal ID Number
Read the instructions on the reverse side before completing this schedule
Did this corporation, during the period covered by this return, perform any of the following activities in New Jersey:
Yes No
1.
Own, lease or rent any real property in New Jersey?
Yes No
2.
Lease tangible property to others for use in New Jersey?
Yes No
3.
Own or lease vehicles registered in New Jersey which are provided to people who are not sales people?
4.
Own, lease or rent any type of property located in New Jersey (consignments, inventory, drop shipments, or like transactions)?
Yes No
5.
License the use of any intangible rights from which royalties, licensing fees, etc., are derived from the use of these rights in
Yes No
New Jersey (for example without limitations, software licenses, trademarks)?
Yes No
6.
Solicit in New Jersey for services through the use of employees, officers, agents and/or independent contractors or
representatives?
7.
Perform any type of service in New Jersey (other than solicitation) such as constructing, erecting, installing, repairing,
Yes No
consulting, training, conducting seminars or meetings or administering credit investigations through the use of employees,
agents, sub- contractors and/or independent contractors or representatives?
8.
Provide any technical assistance or expertise which is performed in New Jersey through the use of employees, agents, sub-
Yes No
contractors and/or independent contractors or representatives?
Yes No
9.
Perform any detail work in New Jersey without limitations such as taking inventory, stocking shelves, maintaining displays,
arranging delivery through the use of employees, agents, sub-contractors and/or independent contractors or representatives?
Yes No
10. Carry goods, merchandise, inventory, or other property including samples into New Jersey for direct sale to customers in New
Jersey?
11. Pick-up and/or replace damaged, returned or repossessed goods from New Jersey customers with company owned vehicles or
Yes No
through contract carriers?
12. Does this company make pick-up or deliveries to points in New Jersey with company owned vehicles or through contract
Yes No
carriers for any other company other than itself?
13. Provide any type of maintenance program which is performed in New Jersey by either this entity or an independent contractor?
Yes No
14. Have sales representatives who have the authority to accept or approve sales orders from customers located in New Jersey in
Yes No
which acceptance/approval takes place in New Jersey and not from an out-of-state location?
Yes No
15. Have employees, independent contractors or representatives with in-home offices in New Jersey for which they are reimbursed
for expenses other than telephone or travel or have employees working from home telecommuting on a regular basis for the
convenience of the taxpayer?
Yes No
16. Own an interest in either a partnership or LLC doing business in New Jersey? If yes, identify the name and address of the
partnership or LLC.
Yes No
17. Secure deposits for sales or payment for sales and/or deliveries?
Yes No
18. Allow catalog or on-line sales to be returned or picked up at an in-store location of a related or affiliated company?
Yes No
19. Collect delinquent accounts directly or indirectly or repossess property?
Yes No
20. Maintain a display at a single location for more than two weeks?
AFFIRMATION OF INFORMATION BY AN OFFICER/RESPONSIBLE INDIVIDUAL
I hereby certify that this schedule, including any accompanying riders, is to the best of my knowledge a true, correct and complete report.
Name: _________________________________________________ Title: ________________________________________________
Signature: ________________________________________________ Date: ________________________________________________
Questions or inquiries can be directed to the Nexus Audit Group at (609) 984-5749