637 Form 637 Questionnaires A

Name:	EIN:
Address:	Registration No:
City, State, Zip

"A" QUESTIONNAIRE (Revision 02-01-2006)

Manufacturer of gas guzzler automobiles, sport fishing equipment (including fishing rods and fishing poles), fishing tackle boxes, bows, quivers, broadheads, points, arrow shafts, taxable tires, or vaccines.

Review Form 637, "Application for Registration" for any updates or changes. This includes Part I, II, and III. Attach the updates or changes to questionnaire. Notate if no updates or changes have been made since last visitation.

1. Who is responsible for the preparation and filing of Form 720 and/or Form 8849? From what address are they filed? _______________________________________________________________________________________________________________________________________________________________________________________________________________

2. Does the company, related company, or any of its owners incur any liability for excise tax? If so, name the type of tax. __________________________________________________________________________________________________________________________________________

3. Does the company sell or plan to sell any taxable articles to a related company? If so, describe the arrangements.

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4. Has the company's excise, employment, or income tax returns been examined by the State or IRS during the previous five years? If so, what were the results of the examination?

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5. List all articles manufactured and explain the company’s manufacturing process. Enclose advertising brochures, if available.

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6. List the name and address of organizations or businesses to which you sell or will sell articles tax-free.

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7. List the monthly volume of tax-free articles you intend to sell. Also list the monthly volume of taxed articles you intend to sell.

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8. Do you export? Are you the exporter, or do you sell to a buyer for subsequent export? What records are maintained to verify that the products are subsequently exported?

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8. List your primary competitors.

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