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                                                            New Jersey Nexus Audit Group Questionnaire

               (10/23)  
You must answer all questions and provide a detailed explanation when requested.  If more room is needed, you may attach separate pages as necessary. 

General Information 
Legal Name of Business                                                                                                                                      Federal Employer ID Number (FEIN) 

Business or Trade Name                                                             NJ State Corporation Number                                                          Fiscal Year End 

Street Address 

City                                                              State Zip Code                                             Website Address 

Contact Person                     Telephone Number                     Fax Number                                                                    Email Address 

Type of Business Entity (Check One) 
                        State of Incorporation                                                                               Date of Incorporation 
      Corporation 
                        If the entity is a member of a New Jersey unitary group, provide the Managerial Member name and NU#. 

      Partnership       List all Partners, FEIN, Social Security Number, and addresses on separate attachment. 
                        Owner Name                                                                                           Owner Social Security Number 
      Proprietorship 
                        List Type (e.g., LLC, LLP, Single Member)                                                            Indicate Which Form You File with the IRS (e.g., 1120, 1065) 
      Limited Liability 

                        • If you file Form 1065, list all members with FID or SSN and address on a separate attachment. 
                        • If you are a Disregarded Entity, list owner(s) with FEIN or SSN and addresses on a separate attachment. 

      Tax Exempt/       Attach IRS documentation. 
      Non-Profit 

Certificates, Registrations, Licenses, Authorizations, etc. List all certificates, registrations, licenses, and authorizations issued by any New Jersey State Agency and date issued.  
Complete even if certificates, etc. have expired.  In such cases, indicate the ending date.  If none, write none. 

Did your business, currently, or at any time, have any agents, independent representatives, subcontractors, third parties, etc., who worked on your behalf in New 
Jersey? 

If yes, state the names, addresses and dates worked in New Jersey, of all agents, independent representatives, sub-contractors, third parties,                          Yes                   No 
etc. who worked on your behalf in New Jersey, on a separate attachment. 
Provide the Address Where the Books and Records of the Business are Located 
Street Address 

City                                                                               State                                                           Zip Code 

Contact Person                     Phone Number                         If the books and records are in New Jersey, provide the date that the location was established. 

Provide the Address Where the Actual Seat of Management and Control is Located 
Street Address 

City                                                                               State                                                           Zip Code 

Contact Person                     Phone Number                         If located in New Jersey, provide the date that the location was established. 

New Jersey Division of Taxation Nexus Audit Group Questionnaire                                                                                                                           Page 1

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Is this entity related to any other company (parent, subsidiary, internet seller, etc.) with business activities in New Jersey?
If yes, provide the complete name and address of each related company, the way it is related, and the type of business conducted in New Yes No
Jersey. Also, if this entity has or had at any time, any activity at any related company's New Jersey address, please describe, in detail, any
inter-company transactions. Provide the information on a separate attachment.

Is this entity a partner in a partnership or LLC doing business in or deriving income from New Jersey?
If yes, provide the name and address of each partnership or LLC and all partners on a separate attachment. Also indicate the date that this entity Yes No
became a partner, and when the partnership or LLC commenced business in or began deriving income from New Jersey.

Status of Business
Active Dormant, Inactive Dissolved
(Attach Certificate of Dissolution)
Non-Survivor of Merger Other
(Provide date of merger, name, address, and FEIN of surviving entity) (Provide details on separate attachment)

Total Gross Revenue for Past Four Years as Reported to IRS
Tax Year Gross Revenue Tax Year Gross Revenue

Tax Year Gross Revenue Tax Year Gross Revenue

Total Gross Revenue from New Jersey for Past Four Years
Tax Year Gross Revenue Tax Year Gross Revenue

Tax Year Gross Revenue Tax Year Gross Revenue

Total Number of NJ Transactions for Past Four Years (Including Any Marketplace Sales)
Tax Year Tax Year Tax Year Tax Year

Number of Transactions Number of Transactions Number of Transactions Number of Transactions

Business Activities
Nature of Business Activity Conducted Everywhere Federal Business Activity Code

Nature of Business Activity Conducted in New Jersey

Did the company now or ever conduct any of the following activities in New Jersey? Month/Year
If yes, insert month and year where indicated.
a. Do any business or conduct any type of activity in New Jersey? Yes _____ No
b. Derive any type of income from sources located in New Jersey (sales receipts, fees for services, franchise fees, Yes No
royalties, licensing fees, management fees)? Specify type:
c. Have employees, officers, agents and/or independent representatives working in New Jersey on behalf of the Yes No
company?
d. Solicit sales in New Jersey? If yes, indicate the date that each type of solicitation began: Yes No
For tangible personal property By in-state employees, agents, reps., etc. For services
For intangible property By mail, phone, publication, internet, etc. Other. Explain on a separate attachment
e. Sell any type of goods, property or services to customers located in New Jersey? If yes, check all that apply:
Tangible personal property to resellers Tangible personal property to customers Services performed in New
Jersey. Services performed outside New Jersey Yes No
f. Does the business have employees, representatives, related entities, agents, or independent contractors who
perform the following activities in New Jersey? If yes, when was the first date that each activity first occurred in Yes No
New Jersey? Identify all that apply.

Make repairs or provide maintenance, service Collect current or delinquent Investigate credit Approve or accept customer orders.
or replace faulty or damaged goods. accounts. worthiness.
Repossess property or accept sale returns. Secure deposits on sales. Install, supervise, or Conduct training.
inspect installation.
Give technical assistance. Resolve customer complaints and Carry samples for sale or Have goods on consignment.
credit disputes. exchange.
Have a display at a New Jersey location in Use agency stock checks. Hire or train personnel. Pick up or replace damaged or returned
excess of 14 days. property.

g. Lease tangible property to others for use in New Jersey? If yes, attach a copy of the lease agreement. Yes No

New Jersey Division of Taxation Nexus Audit Group Questionnaire Page 2

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h. License the use of any type of intangible right from which royalties, licensing fees, etc., are derived from the use Yes No
of these rights in New Jersey (e.g. software licenses, trademarks, etc.)? Provide the type of intangibles used in
New Jersey and begin date. ________________________________________________
i. Offer, solicit, sell, accept, or buy digital assets such as virtual currency or non-fungible tokens (NFTs) to New Yes No
Jersey residents?
j. Offer services involving the purchase, sale, processing, or virtual storage of digital assets to New Jersey Yes No
residents?
k. Perform any type of service in New Jersey (other than for solicitation of sales) such as constructing, erecting, Yes No
installing, repairing, consulting, training, conducting seminars or meetings, credit investigations by employees,
agents, subcontractors, and/or independent representatives?
l. Provide any technical assistance or expertise in New Jersey by employees, agents, subcontractors, and/or Yes No
independent representatives?
m. Perform any detail work by employees, agents, representatives and/or subcontractor, such as taking inventory, Yes No
stocking shelves, maintaining displays, arranging delivery, etc.?
n. Carry goods, merchandise, inventory, etc., into New Jersey for sale to customers in New Jersey? Yes No
o. Performs any of the following in New Jersey: Make deliveries, pick-up and/or replacement of goods? Yes No
With Common Carriers (submit name and address) With company owned vehicles With Contract Carriers (submit name and address)
p. Provide any type of maintenance program which is performed in New Jersey by either this entity or a hired Yes No
independent contractor?
q. Have employees, independent contractors, and/or other representatives with in-home office in New Jersey for Yes No
which they are reimbursed for expenses other than telephone or travel?
r. Have the use of any office or any type of facility in New Jersey (whether owned or leased)? Yes No
s. Have the use of any property located in New Jersey (whether owned or leased)? Yes No
t. Have a telephone listing in New Jersey? If yes, provide phone number and address? Yes No
u. Own or lease equipment or vehicles registered in New Jersey, which are provided to employees, agents, Yes No
representatives, subcontractors, and/or independent contractors. If "yes", please provide full details on separate
attachment?
v. Have any type of property located in New Jersey (whether owned, leased or rented, real estate, consignments, Yes No
inventory (including inventory stored in a New Jersey marketplace facilitator’s warehouse), computer servers,
merchandise, display racks etc.)?
w. Offer, sell, provide maintenance, or perform such duties under a warranty or extended warranty service contract Yes No
for the performance of services under the contract through any means, whether in person or through the internet?
x. Contract with a marketplace facilitator to facilitate the sale of the taxpayer’s products on the facilitator’s online Yes No
marketplace?
y. If yes, does the marketplace facilitator maintain the taxpayer’s products at fulfillment centers in this State? Yes No
z. Transmit code or electronic instructions through the internet to repair or upgrade products as part of a service Yes No
subscription purchased by the customer or as part of a warranty (or extended warranty) service contract
purchased by the customer?
aa. Place software or ancillary data (e.g., apps or “internet cookies”) on computers and devices in New Jersey to Yes No
gather market or product research that is packaged and sold to data-brokers or other third parties?
bb. Sell internet advertising services to New Jersey business customers where the taxpayer provides targeted Yes No
advertising to specific New Jersey individuals using information the taxpayer mined from software or ancillary
data (e.g., apps or “internet cookies”) that was placed on computers and devices in New Jersey by the taxpayer
on individuals’ devices?
cc. Provide certain types of post-sales assistance through an electronic chat, email, or application that customers Yes No
access through the company’s website. Some examples include but are not limited to: chat rooms for
troubleshooting problems, complaint resolution, or an internet help desk for technical support whereby the
customer can talk to a service representative who may conduct repair services remotely?
dd. Collect and/or remit New Jersey Gross Income Tax withholding from employees at any time? Yes No
ee. Collect and/or remit New Jersey Sales Tax at any time? Yes No
ff. Enter into agreements with representatives in New Jersey who refer customers to the business by a link on an Yes No
internet website or otherwise?
gg. Receive income such as interest, fees or annual charges on any loans, credit cards, mortgages, etc. from New Yes No
Jersey residents?
hh. Make personal loans, car loans, or mortgages to New Jersey residents? Yes No
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ii. Purchase or sell mortgage loans secured by real estate in New Jersey? Yes No
jj. Provide checking, savings, money market accounts, payment services, or lines of credit? Yes No
kk. Offer certificates of deposit, debit and/or credit cards, mortgages or loans? Yes No
ll. Offer investment advice and services, derivatives, and/or custody services? Yes No
mm. Participate as an exhibitor at a trade show or take orders at a trade show in New Jersey? Yes No
nn. Is the business related to a company utilizing intangible assets in New Jersey? Yes No
oo. Own, lease or maintain in-state facilities such as a warehouse or answering service? Yes No
pp. Perform construction contracts in New Jersey? Yes No
qq. Perform as a subcontractor in New Jersey? Yes No
rr. Executed contracts in New Jersey? Yes No
ss. Did the company cease operations in NJ? If so, when? Yes No

Affirmation: I declare, under penalty of perjury, that the information provided in the questionnaire and any attachments is, to the best of my knowledge, true, correct, and
complete. If prepared by a person other than an officer, partner or owner of the business, this declaration is based on all information on which you have knowledge.
Signature Date

Print Name Title

Return this by regular mail to: By Courier, other than USPS Express: Phone: 609-984-5749
New Jersey Division of Taxation New Jersey Division of Taxation Fax: 609-633-6201
Nexus Audit Group Nexus Audit Group Email: nexusauditgroup.taxation@treas.nj.gov
PO Box 269 3 John Fitch Plaza
Trenton, NJ 08695-0269 Trenton, NJ 08611

New Jersey Division of Taxation Nexus Audit Group Questionnaire Page 4

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