Rev. 05/06 

                                                                                          Agent/Auditor 

                                            Nexus Questionnaire                                                                                          
                        Corporation Franchise Tax and Pass-Through Entity Tax 
Note: Please refer to the department information release concerning nexus by visiting our Web site at tax.ohio.gov. 
Entity’s legal name 
DBA (if different than above name) 
Mailing address (number and street) 
City, state, ZIP 
Business Web site address 
Type of entity              LLC               LLP                    C corporation        S corporation                                          Partnership 
(check all that apply)      Business trust   Sole proprietorship    Other (specify) 

State or country of incorporation, formation or origination and date 
Federal business activity code (NAICS code)                      Federal employer identifi cation number 

I. Has this entity ever fi led with this department any of the following tax returns? If yes, indicate the year of the most 
    recently fi led return. 

                               No  Yes  Year (If Yes)                                            No  Yes  Year (If Yes) 
Corporation franchise tax                                        Highway use/motor fuel tax                                                         
Sales or use tax                                                 Employer withholding tax                                                           
Pass-through entity tax                                          Personal property tax                                                              
Commercial activity tax                                          Other (please indicate)                                                            
                                                                                                                                                     
II. Do any “related members” (defined     at the bottom of page 2) of this entity file any of the tax returns listed above? No                          Yes
    If yes, please list entity name(s), FEINS and the type(s) of tax returns filed (attach additional sheet(s) if necessary).

III.Does this entity, directly or through others acting on behalf of the out of state business, 
    conduct any of the following activities in Ohio? 
                                                                                                                                                  No  Yes  Year (If Yes) 
       
    1.  Solicit sales and/or solicit loans ............................................................................................  
    2.  Make repairs or provide maintenance or warranty service ...................................................                                   
    3.  Collect current or delinquent accounts .................................................................................                      
    4.  Transport passengers or property for hire in or through this state ........................................                                   
         If yes, please check the method(s) of delivery: 	    owned or leased trucks; 
             delivery agent or salesperson;              customer pickup;          common carrier .........                                           

   5.  Install or supervise installation of property ............................................................................        
   6.  Provide technical assistance, training and/or consulting services, including, but not limited 
         to, engineering assistance, design services, quality control, product inspections or similar 
         services, to your customers, your own employees, your related members’ employees or 
    others ....................................................................................................................................   

                                                                                                                                                  No  Yes  Year (If Yes) 

   7.  Investigate, handle or otherwise provide assistance to resolve customer complaints ..........                                               
   8.  Having one or more employees or others conducting business activity in this state ............ 
   9.  Sell, lease, rent, license to use (for your use/consumption or for others’ use/consumption) 
      or consign to others real property and/or tangible or intangible personal property ...............                                           
   10.  Have employees, agents, representatives, independent contractors, brokers or others 
      who  own, rent, lease, use or maintain an office   or other establishment if this property(i) is 
      used in the representation of the out-of-state business in this state and (ii) is significantly
      associated with the business’s ability to establish and maintain a market in this state ........
   11.  Have a direct or indirect ownership interest in a pass-through entity having nexus with
      this state. If “yes”, please indicate the name and FEIN of the pass-through entity (attach 
          additional sheet(s)) ................................................................................................................
   12.  Hold a certificate of compliance authorizing the out-of-state business to transact business
       in this state ............................................................................................................................ 
   13.  Hire, train or supervise personnel .........................................................................................               
   14.  Is this business the survivor of a merger with another business that was formerly an 
      Ohio taxpayer? If “yes”, please indicate the name and the FEIN of the surviving and non-
      surviving business and the year of the merger (attach additional sheet(s)) .........................
   15.  Does the business and/or any one or more of its related members conduct in this state 
      any activity that exceeds the protection of P.L. 86-272? If “yes,” please indicate the 
      complete name, address and federal ID number for each entity (attach additional 
   sheet(s)) ................................................................................................................................ 
                                                                                                                                 
   Signature of officer, general partner, 
        proprietor, member or manager

                 Print name and title

 Telephone

 E-Mail address 

                                 Date 

                                         Please return this completed questionnaire to: 
                                             Ohio Department of Taxation
                                             Pass-Through Entity Tax Unit
                                             Corporation Franchise Tax Unit
                                                        P.O. Box 2476 
                                             Columbus, OH 43216-2476
         
Defi nition: “Related    Member”  means a person that, with respect to the out-of-state business, is any of the following during 
all or any portion of the taxable year: (i) a “related entity” as defi ned in division (I)(12)(c) of Ohio Revised Code (R.C.) section 
5733.04, or (ii) a “component member” as defi ned in Internal Revenue Code (I.R.C.) section 1563(b), or (iii) a person to whom 
or from whom there is attribution of stock ownership in accordance with I.R.C. section 1563(e) except that “twenty percent” 
shall be substituted for “5 percent” wherever “5 percent” appears in I.R.C. section 1563(e). See R.C. 5733.042.