Form Boe-400-Spa - Application For Seller'S Permit - 2010
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2BOE-400-SPA REV. 4 (FRONT) (3-10)
STATE OF CALIFORNIA
APPLICATION FOR SELLER’S PERMIT
BOARD OF EQUALIZATION
1. PERMIT TYPE:
Regular
Temporary
(check one)
FOR BOE USE ONLY
2. TyPE OF OwNERShIP (check one)
* Must provide partnership agreement
TAX
IND
OFFICE
PERMIT NUMBER
S
Sole Owner
Married Co-ownership
Limited Liabilit
y Compan
y (LLC)
Corporation
NAICS CODE
BUS CODE A.C.C.
REPORTING BASIS
TAX AREA CODE
Unincorporated Business Trust
General Partnership
Limited Liability Partnership (LLP)*
RETURN TyPE
Limited Partnership (LP)*
(Registered to practice law, accounting or architecture)
(1) 401-A
(2) 401-EZ
PROCESSED By
PERMIT ISSUE
DATE
Registered Domestic Partnership
VERIFICATION
DL
PA
Other
___ / ___ / ___
Other (describe)
3. NAME OF SOLE OwNER, CORPORATION, LLC, PARTNERShIP, OR TRUST
4. STATE OF INCORPORATION OR ORGANIZATION
5. BUSINESS TRADE NAME/ “DOING BUSINESS AS” [DBA] (if any)
6. DATE yOU wILL BEGIN BUSINESS ACTIVITIES (month, day, and year)
7. CORPORATE, LLC, LLP OR LP NUMBER FROM CALIFORNIA SECRETARy OF STATE
8. FEDERAL EMPLOyER IDENTIFICATION NUMBER (FEIN)
CHECK ONE
Owner/Co-Owners
Partners
Registered Domestic
Corp. Officers
LLC Officers/Managers/
Trustees/
Partners
Members
Beneficiaries
Use additional sheets to include information for more than three individuals.
9. FULL NAME (first, middle, last)
10. TITLE
11. SOCIAL SECURITy NUMBER (corporate officers excluded)
12. DRIVER LICENSE NUMBER (attach copy)
13. hOME ADDRESS (street, city, state, zip code)
14. hOME TELEPhONE NUMBER
(
)
15. NAME OF A PERSONAL REFERENCE NOT LIVING wITh yOU
16. ADDRESS (street, city, state, zip code)
17. REFERENCE TELEPhONE NUMBER
(
)
18. FULL NAME OF ADDITIONAL PARTNER, OFFICER, OR MEMBER (first, middle, last)
19. TITLE
20. SOCIAL SECURITy NUMBER (corporate officers excluded)
21. DRIVER LICENSE NUMBER (attach copy)
22. hOME ADDRESS (street, city, state, zip code)
23. hOME TELEPhONE NUMBER
(
)
24. NAME OF A PERSONAL REFERENCE NOT LIVING wITh yOU
25. ADDRESS (street, city, state, zip code)
26. REFERENCE TELEPhONE NUMBER
(
)
27. FULL NAME OF ADDITIONAL PARTNER, OFFICER, OR MEMBER (first, middle, last)
28. TITLE
29. SOCIAL SECURITy NUMBER (corporate officers excluded)
30. DRIVER LICENSE NUMBER (attach copy)
31. hOME ADDRESS (street, city, state, zip code)
32. hOME TELEPhONE NUMBER
(
)
33. NAME OF A PERSONAL REFERENCE NOT LIVING wITh yOU
34. ADDRESS (street, city, state, zip code)
35. REFERENCE TELEPhONE NUMBER
(
)
36. TyPE OF BUSINESS (check one that best describes your business)
37. NUMBER OF SELLING LOCATIONS
(if 2 or more, see Item No. 66)
Retail
wholesale
Mfg.
Repair
Service
Construction Contractor
Leasing
38. whAT ITEMS wILL yOU SELL?
39. ChECK ONE
Full Time
Part Time
40. BUSINESS ADDRESS (street, city, state, zip code) [do not list P.O. Box or mailing service]
41. BUSINESS TELEPhONE NUMBER
(
)
42. MAILING ADDRESS (street, city, state, zip code) [if different from business address]
43. BUSINESS FAX NUMBER
(
)
44. BUSINESS EMAIL ADDRESS
45. BUSINESS wEBSITE ADDRESS
46. DO yOU MAKE INTERNET SALES?
www.
yes
No
47. NAME OF BUSINESS LANDLORD
48. LANDLORD ADDRESS (street, city, state, zip code)
49. LANDLORD TELEPhONE NUMBER
(
)
50. PROJECTED MONThLy GROSS SALES
51. PROJECTED MONThLy TAXABLE SALES
52. ALCOhOLIC BEVERAGE CONTROL LICENSE NUMBER (if applicable)
___ ___ - ___ ___ ___ ___ ___ ___
$
$
53. SELLING NEw TIRES AT RETAIL?
54. SELLING COVERED ELECTRONIC DEVICES?
55. SELLING TOBACCO AT RETAIL?
yes
No
yes
No
yes
No
(continued on reverse)
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