Exhibit [1.3] 32-3 (08/19/98)
Documentation of State Data
1. |
State: |
2. Date: |
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3. |
Responsible State Agency: |
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4. |
Name of File, Record or Source: |
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5. |
Description of the Record's
Content: |
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6. |
Storage Medium: |
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7. |
Approximate Number of Cases
on Record: |
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8. |
Is the following information
on the record: |
Yes No |
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a. |
Social Security Number |
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b. |
Employer Identification Number |
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c. |
Name (Individual) |
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d. |
Name (Business) |
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e. |
Name (Doing Business As) |
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f. |
Address (Residence) |
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g. |
Address (Business) |
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9. |
Is this file, record or source
available to the IRS? |
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a. |
If yes, describe procedures
for requesting the data: |
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b. |
If no, explain reason(s): |
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10. |
Comments Regarding Usefulness
of This Data to IRS: |
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11. |
Information To Complete This
Data Sheet Was Provided By: |
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a. |
Name |
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b. |
Title |
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c. |
Phone No. |
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12 |
Person to contact for further
information (if different from above). |
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a. |
Name |
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b. |
Title |
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c. |
Phone No. |
Explanation and Instructions
for Completing the State Data Identification
Sheet |
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The "State Data Identification
Sheet"
which follows
is designed to secure only the essential information
necessary
to conduct a preliminary assessment of the
utility of a given state source
for tax compliance
purposes. The questionnaire is a major element in
the
overall procedures drafted to identify, evaluate
and utilize State information
with compliance potential.
The purpose is to document information about
the nature
and content of the State file but not to acquire copies
of the
actual data. |
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The following instructions
explain the items on the
data sheet. Answers would
be continued on the back of the data sheet if
additional
space were needed. |
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Item 1: |
Provide the name of the State
in question. |
Item 2: |
Enter the date the data sheet
was completed. |
Item 3: |
Record the full name of the
State agency responsible for maintaining the
file,
record or source. |
Item 4: |
Provide the official name of
the file, record or source. If no formal name
exists,
supply an informal name that sufficiently identifies
the type of
record, file or source in question. |
Item 5: |
Describe the content of the
record, file or source, including: |
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a. references to the kinds
of entities on the file; |
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b. the circumstances which
cause an entity to be included on the
record; |
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c. the age of the record
information; |
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d. when the data are updated; |
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e. if the data are updated,
how often; and |
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f. any other details which
help to precisely identify the makeup
of the state
source. |
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The answer to this question
is crucial in assessing the potential utility
of a
given State record, therefore, it is better to provide
too much detail,
than too little. The followinig paragraph
is offered as a model answer. |
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Example:
This register
contains a list of all sole-proprietors, partnerships
and
corporations licensed to do business in the State.
State law (Section XX
of State Code) requires every
business within its jurisdiction to obtain
a license
before operating a for profit enterprise. The license
expires
after two years and must be renewed. New license
issuances are recorded
on the register (and obsolete
record purged) on a quarterly basis. Businesses
with
less than $5,000 gross profit a year are exempt from
the provisions
and are not listed on the register. |
Item 6: |
Provide a description of the
physical means by which the information is
retained
(i.e., storage media). For example, whether the state
data are
on microfilm, magnetic tape, small index
cards, etc. Also, if possible,
include the computer
manufacturer and machine type when the information
is stored on automated equipment (e.g., IBM 370-168,
etc.). |
Item 7: |
Enter the estimated number
of records on the State file. Be sure to properly
identify what exactly your estimate is counting (e.g.,
1,000 corporations,
5,000 individual permits, 250
property transfers, etc.). |
Item 8: |
Check the appropriate column
for each yes-no question. If the answer is
unknown,
write "UNK"
next to that question. |
Item 9: |
Provide information on the
availability of the State data to the IRS. |
Item 10: |
This question is intended to give the respondent (usually
a State official)
an opportunity to provide his/her evaluation of the use
of this State file
for IRS compliance programs. If the respondent cannot provide
an assessment,
"no comment"
should be entered. However,
if the State official is aware of certain
aspects of a file that render it
of little use for compliance purposes
(e.g., the State requires a particular
type of registration but doesn't
enforce the provisions, and most entities
in the State do not register),
the respondent's observations about the file
in question would be extremely
helpful. |
Item 11: |
Enter the name, job title and phone number of the data
sheet respondent. |
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Note:
Include any additional comment the
respondent may have on the back of
the data sheet. Label such information "Additional Comments"
. |