Fillable Form Tc-51 - Nexus Questionnaire (Page 3 of 3) in pdf

Form Tc-51 - Nexus Questionnaire Page 3

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16. 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

17. Do any of the sales agents in Utah represent your corporation only? .............................................................................................

Other Information

18. List the company's three (3) major Utah customers:

19. Are there other types of activities in Utah? Please explain:

SST Voluntary Seller

You are a voluntary seller in Utah under the Streamlined Sales Tax Agreement (see Article IV of SSUTA) if you have met ALL of the following conditions

for at least 12 MONTHS PRIOR to registering with Utah:

1. You have had no fixed place of business in Utah for more than 30 days.

2. Less than $50,000 of your property* in located in Utah.

3. Less than $50,000 of your payroll occurs in Utah.

4. Less than 25 percent of your total property* or total payroll*are in Utah.

5. You do not collect sales or use tax in Utah as a condition for you or an affiliate to qualify as a supplier of goods or services to Utah.

6. You are not required to register and collect sales or use tax in Utah as a statutory requirement for yourself or an affiliate to be able to sell, ship

or deliver a particular type of product into Utah.

*As defined in the contract between Streamlined Sales Tax Governing Board, Inc and the contractor.

Yes

20. Based on the criteria above, are you a voluntary Streamlined Sales Tax seller?...............................................................................

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 questionnaire.

Officer's mailing address

City

State

Zip code

Officer's phone number

Name of preparer

Signature of preparer