NEAR FINAL DRAFT 8/1/24

2024 M4R, Minnesota Business Activity Report
Corporations are required to file Form M4R if they obtain any business from within Minnesota during the tax year. If you are registered with the Minnesota 
Secretary of State’s Office to do business in this state, you are not required to file Form M4R. 

For Calendar Year             Or fiscal year (enter beginning/ending dates)
                              Begins                       Ends 
Name of Corporation                                                                FEIN                            Minnesota Tax ID

Mailing Address                                                                    Are you a member of a           Do you make retail
                                                                                   unitary business?               sales in Minnesota?
City                                                  State  ZIP Code                              Yes      No        Yes              No

Principal Office in Minnesota                                                      Principal Type of Business

Street Address                                                                     Principal Product or Service

City                                                  State  ZIP Code              Amount of Minnesota Sales (wholesale or retail) or Receipts 
                                                                                   $

Offices and other places of business in Minnesota. (Attach additional sheets if you need more room.)
Location                                                                                         Nature of Activity

Officers, employees, agents and representatives with activity in Minnesota.  
(Attach a brief job description for each officer and class of employee.)
Title                                                                                            Number of Persons

On a separate sheet, explain all “yes” answers below in detail. During the period covered by the report, did the corporation:
                                                                                                                                Yes     No
  1   Own or lease tangible or intangible personal property or real property in Minnesota?                          1                      

  2   Employ or own any other assets in Minnesota?                                                                  2                      

  3   Own or consign any merchandise located in Minnesota?                                                          3                      

  4   Own assets located in Minnesota that are leased to others?                                                    4                      

  5   Perform or contract any training, installation or repair work in Minnesota?                                   5                      

  6   Perform or contract any warranty work in Minnesota?                                                           6                      
  7   Derive any revenues from services performed by employees or entities  
    for persons or businesses located in Minnesota?                                                                 7                      
  8   Derive income from any source within Minnesota, including income from activities 
    conducted by subsidiaries, affiliated entities or partnerships?                                                 8                      
I certify that this report, including any accompanying material, is true, correct and complete to the best of my knowledge and belief.
Signature                            Title                                                       Date              Direct Phone

Signature of Preparer                PTIN                                                        Date              Direct Phone 

         Mail to: Minnesota Department of Revenue, Mail Station 5130, 600 N. Robert St., St. Paul, MN 55146-5130
                                                                           9995