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                                                       Utah State Tax Commission                             Clear form
                                                210 N 1950 W • SLC, UT 84134 • tax.utah.gov                                                                                     TC-51
                                                                                                                                                                                Rev. 8/21
                                                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 were the company's total Utah sales, number of Utah customer transactions, and total sales to all customers during the last three years?
                                     Number of Utah
     Year           Utah Sales       Transactions              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.   In either the previous or the current calendar year, did the company sell tangible personal property, products transferred ............                                    Yes  No
     electronically or services for storage, use or consumption in Utah that generated revenues of more than $100,000; or did 
     the company make 200 or more separate transactions in Utah during that period?
2.   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.
3.   Does the company regularly solicit orders in Utah, whether or not those orders are accepted in Utah?..........................................                             Yes  No
4.   Does the company hold title to tangible personal or real property located in Utah, i.e., merchandise inventory, motor vehicles,.....                                       Yes  No 
     office or industrial equipment, etc.? If YES, list owner, location and description of such property on a separate sheet.
5.   Does the company rent or lease to others or has it at any time in the last three (3) years rented/leased property to others ...........                                    Yes  No 
     who then use the property in Utah? If YES, list lessee's name, location and description of property on a separate sheet.
6.   Does the company rent or lease from others or has it at any time leased or rented from others any tangible personal property....                                           Yes  No 
     located and/or used in Utah, i.e., warehouse space, motor vehicles, office space, housing space or industrial equipment, etc.?
7.   Does the company have a Utah telephone number or use a Utah answering service?....................................................................                         Yes  No
8.   Does the company have or has it at any time maintained or consigned stocks or goods in Utah (i.e. distribution............................                                 Yes  No
     warehouse)?
9.   Does the company deliver to a Utah location by using company owned or leased vehicles?...........................................................                          Yes  No
10.  Are contracts or similar agreements executed in Utah?....................................................................................................................  Yes  No



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11.  Does the company engage in any activity in connection with the leasing or servicing of property located in Utah? ........................                                             Yes  No
12.  Does the company have or has it ever had a security interest in any real or personal property sold or located in Utah? ................                                               Yes  No
13.  Does the company have any employees, commissioned agents, independent contractors or other representatives.......................                                                     Yes  No
 residing, selling, soliciting or performing services in Utah? If YES, list on a separate sheet the year(s) in which your 
 employees or other representatives began performance of these activities in Utah.

  Employee and Contract Agent Information
The following questions pertain to the type of activities performed by the employees or independent contract agent(s) within Utah.
14.  Does the company have any employees, sales representatives, commission agents or independent contractors 
 that carry out or that are responsible for any of the following activities in Utah?
 a. Making repairs or providing maintenance .................................................................................................................................              Yes  No
 b. Collecting current or delinquent accounts .................................................................................................................................            Yes  No
 c. Investigating credit worthiness ..................................................................................................................................................     Yes  No
 d. Installing or supervision of installation.......................................................................................................................................       Yes  No
 e. Conducting training courses, seminars or lectures ...................................................................................................................                  Yes  No
 f. Providing any kind of technical assistance or service when a purpose of that assistance or service is something..................                                                      Yes  No
    other than the facilitation or solicitation of orders
 g. Handling customer complaints ..................................................................................................................................................        Yes  No
 h. Approving or accepting orders ..................................................................................................................................................       Yes  No
 i. Repossessing property.............................................................................................................................................................     Yes  No
 j. Securing deposits on sales .......................................................................................................................................................     Yes  No
 k. Picking up or replacing damaged or returned property.............................................................................................................                      Yes  No
 l. Hiring, training or supervising personnel, other than personnel involved only in solicitation.....................................................                                     Yes  No
 m.  Using agency stock checks or any other instrument by which sales are made within Utah by sales personnel.......................                                                       Yes  No
 n. Maintaining sample or display room in excess of two weeks (14 days) during the year ...........................................................                                        Yes  No
 o. Carrying samples for sale, exchange or distribution in any manner for consideration or other value .......................................                                             Yes  No
 p. Owning, leasing, maintaining or otherwise using any of the following facilities or property in state of Utah
    1. Repair shop.......................................................................................................................................................................  Yes  No
    2. Parts department...............................................................................................................................................................     Yes  No
    3. Any kind of office other than an in-home office .................................................................................................................                   Yes  No
    4. Warehouse........................................................................................................................................................................   Yes  No
    5. Meeting place for directors, officers or employees............................................................................................................                      Yes  No
    6. Stock of goods...................................................................................................................................................................   Yes  No
    7. Telephone answering service............................................................................................................................................             Yes  No
    8. Mobile stores, i.e., trucks with driver salesmen.................................................................................................................                   Yes  No
    9. Real property or fixtures of any kind .................................................................................................................................             Yes  No
 q. Consigning tangible personal property to any person, including an independent contractor....................................................                                           Yes  No
 r. Maintaining, by either an in-state or an out-of-state resident employee, an office or place of business of any.........................                                                Yes  No
    kind other than an in-home office
 s. Entering into franchising or licensing agreements.....................................................................................................................                 Yes  No
15.  Does the company have a standard form or written agreement with employees, sales representatives, commissioned .................                                                      Yes  No
 agents or independent contractors? If YES, enclose a sample copy.
16.  Are commissioned agents/independent contractors forbidden (by contractual agreement or otherwise) from selling or..................                                                   Yes  No
 promoting your competitors' products?



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17.  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.

18.  Do any of the sales agents in Utah represent your corporation only?...............................................................................................  Yes  No

  Other Information
19.  List the company's three (3) major Utah customers:

20.  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.
21.  Based on the criteria above, are you a voluntary Streamlined Sales Tax seller?..............................................................................        Yes  No

  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                                                                                     Date 
Remember to sign and date this form after printing questionnaire.
Preparer's mailing address 

City                                                                               State Zip code         Preparer's phone number






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