Dtf 17 1 Form PDF Details

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QuestionAnswer
Form NameDtf 17 1 Form
Form Length2 pages
Fillable?No
Fillable fields0
Avg. time to fill out30 sec
Other namesCEO, LLP, dtf 17 1 fill in form, LLCs

Form Preview Example

Department of Taxation and Finance

DTF-17.1

 

Business Contact and

(5/15)

Responsible Person Questionnaire

 

Retain a copy of this form for your records for each business contact or responsible person.

Who should complete this questionnaire

Any oficer, partner, member, shareholder, or employee who is considered a business contact of the business applying for a sales tax Certiicate of Authority should complete the Business contact information section below. Also, a business contact who is a responsible person should also complete the Responsible person information section on page 2.

Responsible person

Aresponsible person generally includes anyone who does any of the following:

• is actively involved in operating the business on a daily basis

• is involved in deciding which inancial obligations are paid

• is involved in personnel activity (such as hiring or iring employees)

• has check signing authority

• prepares tax returns

• has authority over business decisions

• is a tax manager or general manager

In addition, certain owners, oficers, partners, and members of LLCs are automatically considered responsible persons. To determine who is considered a business contact or responsible person, see the table below.

Entity type

Business contacts

Responsible persons?

 

 

 

 

Individual (sole proprietor)

Owner

Yes

 

 

 

 

 

Partnership, LP, or LLP

All general partners

Yes

 

 

 

 

 

Any limited partner who:

Yes, if the limited partner does any of the following:

 

• actively runs the business, or

• is actively involved in operating the business on a daily

 

• has at least 20% ownership or proit distribution

basis

 

percentage

• is involved in deciding which inancial obligations are

 

 

paid

 

 

• is involved in personnel activity (such as hiring or iring

 

 

employees)

 

 

• has check signing authority

 

 

• prepares tax returns

 

 

• has authority over business decisions

 

 

• is a tax manager or general manager

LLC

All members

Yes

 

 

Appointed manager (if a manager-managed LLC)

 

 

 

 

 

Corporation

CEO

Yes, if the corporate oficer or shareholder does any of

 

CFO

the following:

 

• is actively involved in operating the business on a daily

 

 

 

President

basis

 

Vice President

• is involved in deciding which inancial obligations are

 

paid

 

 

 

Treasurer

• is involved in personnel activity (such as hiring or iring

 

Secretary

employees)

 

• has check signing authority

 

 

• prepares tax returns

 

 

• has authority over business decisions

 

 

• is a tax manager or general manager

 

Any shareholder who has at least 20% ownership or proit

Yes, if the shareholder:

 

distribution interest.

• does any of the following (regardless of the amount of

 

 

ownership or proit distribution interest):

 

 

is actively involved in operating the business on a

 

 

 

daily basis

 

 

is involved in deciding which inancial obligations are

 

 

 

paid

 

 

is involved in personnel activity (such as hiring or

 

 

 

iring employees)

 

 

has check signing authority

 

 

prepares tax returns

 

 

has authority over business decisions

 

 

is a tax manager or general manager

 

 

• owns more than 50% of the voting stock of the

 

 

corporation

 

 

 

 

Page 2 of 2 DTF-17.1 (5/15)

Business contact information

Name (irst, middle initial, last, sufix)

 

 

 

 

 

Business title

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Home address (number and street; not a PO Box)

 

City

 

U.S. state/Canadian province

ZIP/Postal code

Country

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Home phone number

 

Ownership percentage except for

 

 

 

 

 

Proit distribution percentage, if different

(

)

 

government entities, trusts, and estates:

 

than ownership percentage:

 

E-mail address

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Are you a responsible person?

Yes

 

 

No

 

 

If you are a responsible person, complete the Responsible person

 

 

 

 

information section.

 

 

 

 

 

 

Responsible person information

SSN

Country of residence

 

Effective date of assuming

 

 

 

 

 

 

 

 

 

 

 

 

 

responsibility

/

/

 

 

 

 

 

 

 

 

 

 

 

Partnerships, LPs, LLPs, and LLCs: Have you been designated as a tax matters partner or as the person responsible for

 

 

tax issues?

 

 

 

Yes No

Manager-managed LLC: Are you the appointed manager?

Yes

No

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Will you be actively involved in operating this business on a daily basis?

Yes

No

Will you be involved in deciding which inancial obligations are paid?

Yes

No

Will you be involved in personnel activity (such as hiring or iring)?

Yes

No

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Primary duties - You must check YES for at least one of the business duties listed below:

 

 

 

Will you have check signing authority?

Yes

No

• Will you prepare tax returns?

 

 

 

Yes

No

Will you have authority over business decisions?

Yes

No

Are you a tax manager or general manager?

Yes

No

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Do you have any open, unsatisied judgments, injunctions, or liens in effect today?

Yes

No

Do you have any felony, misdemeanor, and/or administrative charges currently pending?

Yes

No

At any time within the last ive years, have there been any judgments, injunctions, or liens issued against you?

Yes

No

At any time within the last ive years, have you had any permit, license, concession, franchise, or lease terminated for

 

 

cause or revoked for any reason?

 

 

 

Yes

No

At any time within the last ive years, have you been investigated by any governmental or quasi-governmental agency,

 

 

including but not limited to federal, state, and local regulatory agencies?

Yes

No

At any time within the last ive years, have you been convicted of a misdemeanor and/or found in violation of any

 

 

administrative, statutory, or regulatory provisions?

Yes

No

At any time within the last ive years, have you had any sanction imposed as a result of a judicial, regulatory, or

 

 

administrative proceeding with respect to any license, permit, concession, franchise, or lease?

Yes

No

At any time within the last ive years, have you failed to ile any applicable federal, state, or New York City tax return by

 

 

the applicable due date?

 

 

 

Yes

No

At any time within the last ive years, have you failed to pay any applicable taxes or assessed government charges by

 

 

the applicable due date?

 

 

 

Yes

No

At any time within the past seven years, has any bankruptcy proceeding been initiated by or against you?

Yes

No

At any time within the last ten years, have you been convicted of a felony and/or any crime related to truthfulness and/or

 

 

business conduct?

 

 

 

Yes

No

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Retain a copy of this form for your records for each business contact or responsible person.