Nexus Questionnaire -Utah
Utah State Tax Commission
210 N 1950 W • SLC, UT 84134 • www.tax.utah.gov
Nexus Questionnaire
Company Information
Exact business name
Federal ID number
Street address of principal office
Contact person
City
State
Zip code
Contact phone number
Type of business
Corporation
Sole Proprietor
L.L.C.
Partnership
Other:
_________________________________
First date that business in Utah began, or that
If no longer doing business within Utah,
income was derived from sources within Utah:
_______________________________
indicate date business activity ceased:
_______________________________
Nature of business and description of property and/or services sold. Attach additional sheets if necessary.
Who are the company's customers? (check all that apply)
Resellers
Final consumers
Do you now or have you ever filed Utah Corporation Franchise/Income Tax Returns? If yes, complete (a), (b) and (c) below.
Yes
No
(a)
Date first return filed:
_____________________________
(b)
Date last return filed:
_____________________________
(c)
Business name under which last return was filed:
___________________________________________________________________________________________
What was the company's total sales to customers in Utah and the total sales to all customers during the last three (3) years?
Year Utah Sales Total Sales
_______________ $__________________ $__________________
_______________ $__________________ $__________________
_______________ $__________________ $__________________
Nexus Questions
Answer "Yes" or "No" to the following questions. For answers that require additional information, include that information on a separate sheet, and
reference the question number.
1. Does the company have an office, agency, warehouse or other place of business in Utah? If YES, list company name,
...............
Yes
No
location and nature of activities on a separate sheet.
2. Does the company regularly solicit orders in Utah, whether or not those orders are accepted in Utah?
.........................................
Yes
No
3. Does the company hold title to tangible personal or real property located in Utah, i.e., merchandise inventory, motor
..................
Yes
No
vehicles, office or industrial equipment, etc.? If YES, list owner, location and description of such property on a
separate sheet.
4. Does the company rent or lease to others or has it at any time in the last three (3) years rented/leased property to
.....................
Yes
No
others who then use the property in Utah? If YES, list lessee's name, location and description of property on a
separate sheet.
5. Does the company rent or lease from others or has it at any time leased or rented from others any tangible personal
.................
Yes
No
property located and/or used in Utah, i.e., warehouse space, motor vehicles, office space, housing space or
industrial equipment, etc.?
6. Does the company have a Utah telephone number or use a Utah answering service?
...................................................................
Yes
No
7. Does the company have or has it at any time maintained or consigned stocks or goods in Utah (i.e. distribution
..........................
Yes
No
warehouse)?
8. Does the company deliver to a Utah location by using company owned or leased vehicles?
..........................................................
Yes
No
9. Are contracts or similar agreements executed in Utah?
...................................................................................................................
Yes
No
TC-51
Rev. 9/02
Who are the company's customers? (check all that apply)
Who are the company's customers? (check all that apply)
Page 1/3
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