Form 637 A Questionnaire OMB_Rev_Feb_2022

Name:		EIN:
Address:		637 Reg No.:
City, State, Zip:		OMB No.:	1545-1835

In addition to the Form 637 General Questionnaire, please answer the following questions specific to this activity. (Attach additional sheets, if needed.)

Activity Letter A - 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.

Registration allows a manufacturer of a taxable article(s) subject to tax under Chapter 32 to make certain tax-free sales under IRC 4221 and IRC 4064(b)(1)(C). The term “manufacturer” means manufacturer, producer, or importer.

Registration for “A” activity is required when the manufacturer engages in a tax-free sale (buyer must be registered unless buyer is exempt from registration).

"A" QUESTIONNAIRE

1. Does your business qualify for the Form 637 “A” Registration?

☐ Yes ☐ No

• If yes, please complete questions below and return this form.

• If no, please sign the statement below, date, and return this form.

I request my Form 637 _“A_” Registration be denied or revoked as I am no longer engaged in this activity.

____________________________________ __________________

Printed Name Title

____________________________________ __________________

Signature Date

Note: This request must be signed by a person with authority to bind the applicant or registrant. Refer to Form 637, Application for Registration (For Certain Excise Tax Activities), General Instructions, under the Signature section for additional guidance.

1. 
   
   

   
   
   

   
   
   

   
   
   

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

2. List the name and address of organizations or businesses to which your business sells or will sell articles tax-free.

3. 
   
   

   
   
   

   
   
   

   
   
   

   
   
   

   
   
   

   List the monthly volume of tax-free r business sells or intends to sell.

4. 
   
   

   
   
   

   List the monthly volume of taxed articles your business sells or intends to sell.

5. 
   
   

   
   
   

   Does your business export?

☐Yes ☐No

7. If your business exports, is your business the exporter, or does your business sell to a buyer for subsequent export?

8. 
   
   

   
   
   

   
   
   

   If your business exports, what records are maintained to verify that the products are subsequently exported?

9. 
   
   

   
   
   

   
   
   

   List your business’s primary competitors.

   Name	Address

10. List the name and phone number of a person whom we can contact about this application/registration.

Form 637 A Questionnaire 2 Revised Feb 2022