Form 41a800 - Corporation And Pass-Through Entity Nexus Questionnaire Page 11
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1141A800 (12-11)
Page 11
d. Do you receive income from a contract between your company and a related
corporation doing business in Kentucky?
YES
NO
If yes, provide the name, identification number and address of each:
________________________________________________________________________
________________________________________________________________________
e. Is your corporation essentially a shell corporation which has no economic
purpose other than tax planning?
YES
NO
If yes, explain: ___________________________________________________________
________________________________________________________________________
________________________________________________________________________
f.
Have you entered into any franchising or licensing agreements and received
income from franchising or licensing agreements that have acquired a
Kentucky business situs?
YES
NO
If yes, explain: ___________________________________________________________
________________________________________________________________________
________________________________________________________________________
The above responses apply to the period from _______________ to _______________. (Please give details
of any changes in the nature of the entity’s activity in Kentucky and specify the tax periods involved.)
PROVIDE ANY ADDITIONAL INFORMATION WHICH MAY BE USEFUL IN DETERMINING
WHETHER YOU HAVE A FILING REQUIREMENT FOR TAXES IN KENTUCKY.
Person completing questionnaire: __________________________________________
Title: ___________________________________________________________________
Telephone: ______________________________________________________________
Email address:___________________________________________________________
Date: ___________________________________________________________________
Please return this completed questionnaire to:
ATTN:
Division of Corporation Tax
Kentucky Department of Revenue
P . O. Box 181, Station 52
Frankfort, Kentucky 40602-0181
Telephone: 502-564-8139
Fax: 502-564-0058
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