Name: |
EIN: |
Address: |
Registration No: |
City, State, Zip |
|
“E” QUESTIONNAIRE (Revision 02-01-2006)
Buyer (other than state or local government) of gas guzzler automobiles for ambulance, law enforcement, or firefighting.
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.
Who is responsible for the preparation and filing of Form 720 and/or Form 8849? From what address are they filed? _______________________________________________________________________________________________________________________________________________________________________________________________________________
Does the company, related company, or any of its owners incur any liability for excise tax? If so, name the type of tax. __________________________________________________________________________________________________________________________________________
Does the company sell or plan to sell any gas guzzler automobiles to a related company? If so, describe the arrangements.
_______________________________________________________________________________________________________________________________________________________________________________________________________________
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?
_______________________________________________________________________________________________________________________________________________________________________________________________________________
List the make, model, GVW, and fuel economy rating of the gas-guzzler automobiles that you will be buying for use and used as an ambulance, in law enforcement, or in fire fighting.
______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
List the name, and address of your suppliers of gas-guzzler automobiles purchased for use and used as an ambulance, in law enforcement, or in fire fighting.
_______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
TIN - DATE -
| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
| File Title | "E" QUESTIONNAIRE |
| Author | National Office Excise |
| File Modified | 0000-00-00 |
| File Created | 2021-01-30 |