VD Application

All questions are required. Complete every question below, then click Next. To go back to a previous set of questions, click Previous or use the buttons on the left side of the screen.

Have you ever filed a return or registered with the Minnesota Department of Revenue?

Yes No

Have you been contacted by the Minnesota Department of Revenue about a tax audit or compliance issue? If Yes, please explain.

Yes No

Are you currently under review or being audited by the Minnesota Department of Revenue or any other tax agencies? If Yes, please include the return type and periods.

Yes No

Did you knowingly fail to correctly file or pay taxes in Minnesota? If Yes, please explain.

Yes No

Please explain why you did not file or pay taxes in Minnesota.

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What type of corporate returns do or will you file?

Separate Combined

When does your fiscal year end for federal income tax purposes?

When did you begin taxable business activities in Minnesota?

Do you file as a member of a federal consolidated group?

Yes No

Do you have any affiliated business entities that file in Minnesota?

Yes No

Are you part of a single unitary business?

Yes No

Estimate the tax due by filling out the following table. If no tax is due, enter an earlier year under Year and '0' under Estimated Tax Due.

Year	Estimated Tax Due

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For what years will you file or amend individual income tax returns?

Do you owe any other Minnesota back taxes?

Yes No

What was your residency status for these tax years? (select all that apply)

Full-Year Resident
Part-Year Resident
Nonresident

Estimate the tax due by filling out the following table. If no tax is due, enter an earlier year under Year and '0' under Estimated Tax Due.

Year	Estimated Tax Due

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Describe the MinnesotaCare services or activities that you provide in Minnesota.

When did you begin activities in Minnesota?

Have you charged MinnesotaCare Taxes on your billing invoices?

Yes No

Estimate the tax due by filling out the following table. If no tax is due, enter an earlier year under Year and '0' under Estimated Tax Due.

Year	Estimated Tax Due

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What type of entity is ultimately responsible for paying the income tax due?

C Corporation
Individuals (partners, shareholders, or beneficiaries)
Other (specify)

When does your fiscal year end for federal income tax purposes?

When did you begin taxable business activities in Minnesota?

How many partners, shareholders, or beneficiaries does the PTE have?

How many partners, shareholders, or beneficiaries are applying for voluntary disclosure?

Estimate the tax due by filling out the following table. If no tax is due, enter an earlier year under Year and '0' under Estimated Tax Due.

Year	Estimated Tax Due

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Have you filed any Minnesota sales or use tax returns? If Yes, list the returns and filling periods.

Yes No

When did you start making taxable sales or purchases in Minnesota?

Have you collected, but not submitted, Minnesota sales tax? If Yes, enter the date you started collecting the tax.

Yes No

How much estimated sales and use tax is due?

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What taxable unrelated business activities - activities that produce income and are not related to your tax-exempt mission - do you conduct in Minnesota?

When does your fiscal year end for federal income tax purposes?

When did your taxable business activities start?

Describe your charitable (tax-exempt) mission.

Estimate the tax due by filling out the following table.

Year	Estimated Tax Due

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What year did you start conducting business in Minnesota?

For what years will you file withholding tax returns?

For how many workers did you underreport or fail to report withholding tax?

Did you withhold Minnesota income tax from the workers?

Yes No

Did you issue the workers a Form W-2 reporting the correct amount of Minnesota income?

Yes No

Did you issue the workers a Form 1099-MISC reporting the correct amount of Minnesota income?

Yes No

Did the workers perform services or attend training in Minnesota? If Yes, please explain.

Yes No

Do you reasonably expect the workers to have a Minnesota individual income tax obligation? If Yes, please explain.

Yes No Not Sure

Estimate the tax due by filling out the following table. If no tax is due, enter an earlier year under Year and '0' under Estimated Tax Due.

Year	Minnesota Wages	Estimated Tax Due

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Provide any additional information or comments below. (optional)

You must agree to the following statement before submitting this application. We will send a confirmation email to the address you provide and attach a copy of the application for your records.

By selecting Submit Application, I understand that I am electronically signing and applying for the Voluntary Disclosure Program ("the program"). I certify that:
● I am the taxpayer or authorized to file this application on the taxpayer's behalf with the Minnesota Department of Revenue ("the department").
● The information provided on this application is true and complete.
● If approved for the program, I will
○ disclose my or my business's identity if applying anonymously.
○ sign and return the department's Voluntary Disclosure Agreement ("the agreement").

I understand my application will be denied, and any signed agreement will become null and void, if the department finds that I omitted or misrepresented any facts on this application.

I agree.

Application submitted succesfully.

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