Form 41a800 - Corporation And Pass-Through Entity Nexus Questionnaire

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41A800 (12-11)
Commonwealth of Kentucky
CORPORATION AND PASS-THROUGH ENTITY
DEPARTMENT OF REVENUE
NEXUS QUESTIONNAIRE
The term “you” is defined to mean the taxpayer or an agent of the taxpayer.
Please explain all “YES” answers in detail and attach additional information, if necessary.
1.
Legal Name of Corporation or Pass-through Entity:
________________________
________________________________________________________________________
FEIN: __________________________________________________________________
Kentucky Corporation/LLET Account Number: _____________________________
2.
Home Office Mailing Address:
___________________________________________
________________________________________________________________________
________________________________________________________________________
3.
Location of Books and Records:
__________________________________________
________________________________________________________________________
________________________________________________________________________
4.
Principal Product or Service in Kentucky:
__________________________________
________________________________________________________________________
________________________________________________________________________
5.
Give State and Year of Incorporation or Organization:
________________________________________________________________________
6.
Date of Tax Year End:
_____________________________________________________
7.
Is your business registered with the Kentucky Secretary of State to do
business in Kentucky?
YES
NO
If yes, give date: _________________________________________________________
8.
a. Is Kentucky the commercial domicile of your business?
YES
NO
(Commercial domicile means the principal place from which the trade or
business of the corporation or the pass-through entity is managed.)
If yes, provide address: ___________________________________________________
________________________________________________________________________
________________________________________________________________________

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