or taxable year beginning __________________________, ________ and ending __________________________, ________
DUE DATE: File on or before the fifteenth day of the fourth month after the close of the calendar or fiscal year.
Principal Type of Business ___________________________________________________________________________________________________
Location of Principal Office __________________________________________________________________________________________________
Offices and Other Places of Business in New Jersey:
Location Nature of Activity
Officers, Employees, Agents and Representatives in New Jersey (attach fully descriptive
duty statement for each officer and each class of employee, agent or representative)
Title Number of Persons
1. Chapter 171 Laws of 1973 (N.J.S.A. 14A:13-14, et seq.) provides that every foreign corporation except corporations exempt pursuant
to paragraph 2, must file a Notice of Business Activities Report on Form CBA-1 if:
(a) Such corporation has not obtained a certificate of authority to do business in New Jersey and is not "doing business" in this
State in the traditional franchise tax sense, but, nevertheless, is deriving income from sources within this State; or is engaged
in any type of activity or interrelationships within this State.
(b) Such corporation disclaims liability for the Corporation Business Tax and any obligation to obtain a certificate of authority to
do business in this State.
2. A foreign corporation is exempt from the requirement of filing a Notice of Business Activities Report if:
(a) By the end of its accounting period for the preceding calendar or fiscal year it had received a certificate of authority to do
business in New Jersey issued by the Division of Revenue;
(b) Files a timely return under the Corporation Business Tax Act for such calendar or fiscal year.
NOTE: The failure of a foreign corporation to file a timely report may prevent the use of the courts in this State for all contracts
executed and all causes of action that arose at any time prior to the end of the last accounting period for which the
corporation failed to file a required timely report.
City,TownorPostOfficeandState ZipCode DateofIncorporation
ANSWER ALL QUESTIONS ON THIS FORM
(03-10, R-4, ct)