Form Tc-51 - Nexus Questionnaire Page 3
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316. List names and addresses of employees or representatives, the territory they cover, and designate whether they are employees or independent
contractors. Use additional sheets if necessary.
Yes
No
17. Do any of the sales agents in Utah represent your corporation only? .............................................................................................
Other Information
Other Information
18. List the company's three (3) major Utah customers:
19. Are there other types of activities in Utah? Please explain:
Signatures
Signatures
Under penalties of perjury, I declare that the information furnished in this questionnaire is, to the best of my knowledge and belief, true, correct and
complete. If prepared by a person other than an officer of this corporation, this declaration is based on all information of which you have knowledge.
Name of officer
Title of officer
Signature of officer
Date
Remember to sign and date this form after printing it.
Officer's mailing address
City
State
Zip code
Officer's phone number
Name of preparer
Signature of preparer
Date
Remember to sign and date this form after printing it.
Preparer's mailing address
City
State
Zip code
Preparer's phone number
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Parent category: Financial