Form Boe-400-Mcr - Application For Certificate Of Registration - Use Tax Account
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2BOE-400-MCR (S2F) REV. 6 (11-99)
STATE OF CALIFORNIA
APPLICATION FOR CERTIFICATE OF
BOARD OF EQUALIZATION
REGISTRATION — USE TAX ACCOUNT
FOR BOARD USE ONLY
SECTION I: OWNERSHIP INFORMATION
TAX
OFFICE
NUMBER
1. PLEASE CHECK TYPE OF OWNERSHIP
SC
Photocopy of
Sole Owner
Husband/Wife Co-ownership
Driver's License and
BUSINESS CODE
AREA CODE
Corporation
Limited Liability Co. (LLC)
Social Security Card
Partnership
is required
PREPARER
VERIFICATION:
See instruction number 6
Other
SSN
DL
Other
2. IF CORPORATION, ENTER FULL CORPORATE NAME. IF LIMITED LIABILITY CO. (LLC), ENTER FULL LLC NAME.
3. FEDERAL EMPLOYER IDENTIFICATION NUMBER (FEIN)
4. CORPORATE OR LLC NUMBER/STATE OF INCORPORATION OR ORGANIZATION
Please check appropriate title and use additional sheet to include information about additional co-owners or members.
OWNER
PARTNER
CO-OWNER
PARTNER
PARTNER
SECRETARY
PARTNER
TREASURER
PRESIDENT
MANAGER
VICE-PRESIDENT
MANAGER
MEMBER
MANAGER
MEMBER
MEMBER
MANAGER
MEMBER
5. FULL NAME
(incl. mid. name)
6. ADDRESS
(residence)
7. TELEPHONE
(
)
(
)
(
)
(
)
(residence)
8. DAYTIME
(
)
(
)
(
)
(
)
TELEPHONE
9. SOCIAL
SECURITY NO.
10. DRIVER’S
LICENSE NO.
11. SIGNATURE
SECTION II: BUSINESS INFORMATION
1. BUSINESS NAME
BUSINESS TELEPHONE
(
)
2. BUSINESS ADDRESS (do not list P.O. Box or mailing service)
CITY
STATE
ZIP CODE
3. MAILING ADDRESS (if different from No. 2 above)
CITY
STATE
ZIP CODE
4. DESCRIPTION OF BUSINESS
Retail
Wholesale Manufacturing
Service/Repair
Other
5. WHAT WILL YOU SELL
6. DATE SALES STARTED IN CALIFORNIA (month, day & year)
7. DO YOU MAKE INTERNET SALES?
8. WEBSITE ADDRESS
Yes
No If yes, answer 8
9. NAME OF BANK / OTHER FINANCIAL INSTITUTION AND LOCATION (checking and savings accounts)
ACCOUNT NUMBER
10. LOCATIONS IN CALIFORNIA (attach separate schedule if necessary)
11. FUNCTION (sales office, warehouse, etc.)
12. REPRESENTATIVES IN CALIFORNIA AND THEIR ADDRESS (attach separate schedule if necessary)
TELEPHONE
(
)
(
)
Continued on Reverse
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Parent category: Financial