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 CBA-1             
 (03-10, R-4, ct) 
                                                           STATE OF NEW JERSEY 
                                                           DIVISION OF TAXATION 
                                              NOTICE OF BUSINESS ACTIVITIES REPORT 
                                                     by a FOREIGN CORPORATION 
                                                      (Incorporated other than in New Jersey) 
                                                              (P.L. 1973, c. 171) 
                   
                                                       FOR CALENDAR YEAR                              
 
          or taxable year beginning                           ,                          and ending                     ,     
 
 DUE DATE:  File on or before the fifteenth day of the fourth month after the close of the calendar or fiscal year.                            
 
          Name                                                                           Federal Identification No. 

          Address (Number and Street or Rural Route)                                     State of Incorporation 

          City, Town or Post Office and State                    Zip Code                Date of Incorporation 

 Principal Type of Business                                                                                                                   
 
 Location of Principal Office                                                                                                                 
 
 Offices and Other Places of Business in New Jersey: 
 Location                                                                                            Nature of Activity 
 
 Officers, Employees, Agents and Representatives in New Jersey (attach fully descriptive 
 duty statement for each officer and each class of employee, agent or representative) 
 
 Title                                                                                               Number of Persons 
 
                                                           GENERAL INFORMATION 
 
 1. Chapter 171 Laws of 1973 (N.J.S.A. 14A:13-14, et seq.) provides that every foreign corporation except corporations exempt pursuant 
       to paragraph 2, must file a Notice of Business Activities Report on Form CBA-1 if: 
 
          (a) Such corporation has not obtained a certificate of authority to do business in New Jersey and is not "doing business" in this 
                   State in the traditional franchise tax sense, but, nevertheless, is deriving income from sources within this State; or is engaged 
                   in any type of activity or interrelationships within this State. 
          (b) Such corporation disclaims liability for the Corporation Business Tax and any obligation to obtain a certificate of authority to 
                   do business in this State. 
 
 2. A foreign corporation is exempt from the requirement of filing a Notice of Business Activities Report if: 
 
          (a) By the end of its accounting period for the preceding calendar or fiscal year it had received a certificate of authority to do 
                   business in New Jersey issued by the Division of Revenue; 
                   or 
          (b) Files a timely return under the Corporation Business Tax Act for such calendar or fiscal year. 
 
          NOTE:   The failure of a foreign corporation to file a timely report may prevent the use of the courts in this State for all contracts 
                      executed and all causes of action that arose at any time prior to the end of the last accounting period for which the 
                      corporation failed to file a required timely report. 
 
                                              ANSWER ALL QUESTIONS ON THIS FORM

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Corporate Name

Federal ID# ________________________________________________ F/Y/E __________ / __________ / __________

Answer All Questions (See Instructions for Explanations):

DID THIS CORPORATION, now or ever, conduct any of the following activities in New Jersey:

If "YES" insert first date (month and year) in yes box. YES NO
If "NO" insert "X" in no box Month/Year X

1. Conduct any type of activity or engage in any interrelationships within New Jersey? ............................
2. Derive Income from sources located in New Jersey?
If yes, specify: Type Approximate amount $ # of transactions
3. Solicit sales in New Jersey? If yes, specify:

For product By In-State Reps., etc. Internet or Electronic Means
For services By mail or phone only …………………………....…………
4. If you have in-state solicitation of product is sales acceptance and/or approval:

By salesman at New Jersey customer
At corporate office located outside of New Jersey …………………………………….………
5. If you have in-state salespeople with in-home offices in New Jersey, do you reimburse them for the
expense of maintaining such space in their home? If yes, submit copies of vouchers .........……….….
6. Own, rent or lease any type of property located in New Jersey either for your own or other use? ..……

7. Do you license the use of intangible rights to clients located in New Jersey? ………………………….

8. Provide any type of continuous maintenance program(s) which is/are performed in New Jersey by this
entity or by any sub-contractor or independent contractor? .………………………………….………..

9. Deliver goods to points in New Jersey? Your own trucks Common Carrier
If delivered in your own truck, do you assist in set-up, installation or pick up of damages, returned or
replaced goods? ………………………………………………………………………………………….

10. Perform any type of service in New Jersey, not related to solicitation of sales? ......................................

11. Do you own or lease any vehicles which are registered in New Jersey? If yes, are they assigned to:
Salespeople only Salespeople and others Others ……………….
12. Is this corporation deriving income as a partner/member of any Partnership or LLC located or doing
business in New Jersey? If yes, describe this corporation's involvement:

In conclusion, is this corporation otherwise subject to tax under either the Corporation Business Tax Act
(N.J.S.A. 54:10A-1, et seq.) …………………………………………………………………………………… YES NO
or
have any obligation to obtain a certificate of authority to do business in this State. (as qualified and issued by
the Division of Revenue, Commercial Recording Bureau ………………………………………………………… YES NO

CERTIFICATION OF AN AUTHORIZED OFFICER OF THE CORPORATION
SUBMIT COMPLETED FORM
I hereby certify that this report, including any attachments, is to the best of my knowledge and belief, a true, TO:
correct and complete report. NJ DIVISION OF TAXATION FFICEO
AUDIT BRANCH
3 John Fitch Way 2nd Floor
PO BOX 269
TRENTON, NJ 08695‐0269

Signature of Officer Title Date

CBA-1 (03-10, R-4, ct) Pg 2

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CORPORATION BUSINESS ACTIVITIES REPORTING ACT
INSTRUCTIONS (by Question)

(1) Includes the maintenance of an office or other place of business; maintenance of personnel, including the presence
of employees, agents, representatives or independent contractors in connection with the corporation's business,
even though not regularly stationed in New Jersey.

(2) Receive payments from persons, business, etc. located in New Jersey regardless of any other connection with New
Jersey.

(3) Have customers located in New Jersey from which you derive sales receipts. You must indicate whether for product
or services and whether solicitation is physically in‐state.

(4) Does the salesman have this authority or are orders required to be approved at the corporation's office out of state.

(5) Examples of expenses include (but are not limited to) mortgage or rent, electricity, gas, oil, telephone, other
utilities, travel and entertainment. Please include copies of appropriate expense vouchers.

(6) Examples of corporate property include (but are not limited to) real estate, inventories, office equipment, office
space, storage space, other equipment, etc. that is used by the corporation or that is rented, leased, etc. to others,
in which the corporation retains title.

(7) Examples include (but are not limited to) software licensing agreements with end users in New Jersey; the use of
patents, trademarks, logos, goodwill, or any other items that result in the payment of royalties and the location of
franchises in New Jersey.

(8) Is there a contractual obligation to perform continuing maintenance services? You must submit copies of said
agreements.

(9) If you deliver goods (that you sell), does the corporation, at point of delivery, perform any other services that go
beyond merely unloading of goods, merchandise or inventory, such as set‐up, installation , moving, etc. or picking
up damaged, returned or replaced goods?

(10) Services include: repairs, maintenance, construction, installation, supervision, consulting, technical assistance,
training, collection of accounts, taking inventory, maintaining displays, conducting meetings/seminars (for other
than sales personnel), transport of the goods of others, etc.

(11) If there are corporate owned or leased vehicles in New Jersey, answer accordingly.

(12) This must be answered if the corporation has a partnership interest in a partnership or LLC doing business or
located in New Jersey. In addition, submit a rider detailing the partnership or LLC name and mailing address as well
as same for all other partners.

The final two (2) questions dealing with subjectivity to Corporation Tax and the necessity to qualify as a Foreign Corporation
are to be answered to the best ability of the respondent.

Please note that the Business Activities Report will be rejected and returned to the corporation as unfiled for the following
reasons:
• Calendar or fiscal year has not yet ended
• Report does not include calendar or fiscal year covered
• Report covers a period in excess of one year
• Report has not been signed
• Federal Identification Number is missing
• Form is incomplete (all questions must be answered)

For further information, contact the Office Audit Branch, Nexus Group, phone number (609) 984‐5749.

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