Form 60-0126 - Report To Determine Liability

Reference Guide to Completing Item 12: Nature of Primary Business Activity in Iowa

(09-06)

Please read the statements below for your particular business activity. In the business activity box, list your business activity (e.g., trade, manufactur-

ing, services) and follow the instructions for that business activity to specifically describe your business activity in the space provided to give details.

If engaged in AGRICULTURE, FORESTRY, FISHING activities.

Examples: General crop farming, cattle ranching, turkey production, corn and soybean farm, crop dusting and tree farm.

List each type of crop grown; crop service, livestock raised, forestry work and related services.

If crops, list where grown (e.g., field, greenhouse) and primary crop grown (e.g., soy beans, apples)

If livestock, list purpose for which raised (e.g., meat, dairy, or egg production).

If engaged in COMMUNICATIONS activities.

Examples: Telephone line leasing, cable television, cellular telephone service, paging and TV and radio broadcasting.

List types of services you provide. Describe any distinctive or unusual features of these activities.

If engaged in CONSTRUCTION activities.

Examples: Single-family house building, industrial building, road construction, plumbing, excavation, carpentry and roofing.

List types of projects or structures for which you have full responsibility (e.g. apartment buildings, roads). Or

List type of trade or trade specialty (e.g. masonry, electrical, painting, HVAC) and if the work is done primarily on residential or commercial

structures.

If engaged in FINANCE, INSURANCE, REAL ESTATE activities.

Examples: Banking and credit institutions, securities, insurance carriers and agents, real estate operations and investments.

List main activities, services or products.

If financial institution, list type (e.g., bank, mortgage broker) and charter (e.g., State, National or Federal).

If insurance, list type(s) sold and whether underwriter or agent.

If residential building operator, list number of housing units and whether you own property or operate it for others.

If engaged in MANUFACTURING activities.

Examples: Food processing, textile productions, electronic appliance production, apparel jobbing and machine shops.

List types of products manufactured (e.g., plastic bottles, electroplating, book printing, and ice cream). List if product is part of a larger item

(e.g., automobile exhaust systems, pharmaceuticals).

For each product list (1) type of plant; (2) most important manufacturing processes; (3) principal materials or products used; (4) source of

materials (i.e. purchased from others, transferred from within your company, or produced as intermediate products at this location).

If engaged in MINING, QUARRYING, OIL and GAS EXTRACTION activities.

Examples: Coal mining, metallic ore extraction, crude petroleum and natural gas and mining services activities.

List mineral, product or service (e.g., gold mining, underground bituminous coal mining, oil well drilling).

If coal mining, list whether surface or underground mining.

If mining service, list service and mineral involved. Note whether you have full responsibility for site operation.

If engaged in PRIVATE HOUSEHOLD activities.

Examples: Employing a maid, gardener, nanny, cook in your home.

If engaged in SERVICES activities.

Examples: Auto repair, business services, education, health services, janitorial, lodging and beauty or barber shop.

List main services your business provides or main activities of your business.

List if services are for the general public or only for members of a specific organization.

List if services are offered mainly to individuals, groups or businesses.

If engaged in TRADE (including eating and drinking places) activities.

Examples: Drug stores, grocery stores, convenience stores, restaurants, bars, computer stores, and new or used car dealers.

List types of products or merchandise sold.

List (1) approximate percentage of each product (e.g., sport shoes 65%, athletic wear 35%); (2) whether the merchandise is new or used;

(3) whether seller owns the merchandise or is a broker/agent; (4) whether sales are made from a store or only by an indirect method (e.g.,

Catalog, door-to-door, warehouse sales, or internet).

If department store, if purchases are paid for in each department or in a check out area.

If eating place, list whether service is full-service, limited-service, or special food service (e.g., caterers, mobile food cart).

If engaged in TRANSPORTATION, WAREHOUSING activities.

Examples: Airline, pipeline, and truck transportation, railroad passenger service, travel agency, warehousing and storage.

List type of transportation and services provided.

If transportation, list whether service is scheduled or not and if local or long distance.

If warehousing, list types (e.g. general, refrigerated, farm products).

If transportation-related service, list type of service (e.g., travel agency, shipping agent).

If engaged in UTILITIES, SANITARY SERVICES activities.

Examples: Electric power generation. Natural gas transmission and distribution refuse systems and water and sewer systems.

List main activities and types of services provided (e.g., natural gas pipelines, trash hauling, irrigation, snowplowing).

If engaged in OTHER activities.

Example: anything that does not seem to fit in any other category (e.g., professional services, health care, and entertainment).

List main activities and type and level of service provided.

If additional assistance is desired please call (800) 532-1249 (in Iowa) or (515) 281-8415 (outside Iowa).

Form 60-0126 - Report To Determine Liability - 2006 Page 4

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