Form Boe-345-Qp - Qualified Purchaser - Registration Update

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bOe-345-Qp (4-10)
state Of califOrnia
Qualified purchaSer—reGiStration update
bOard Of eQualiZatiOn
boe
uSe
Ownership name
accOunt number (example: su kh xxx-xxxxxx)
tin #
business trade name [dba] (if any)
business tYpe
cOrpOrate, llc, llp Or lp number (if applicable)
federal emplOYer identificatiOn number (fein) (if applicable)
Section i: type of ownerShip (check one)
limited partnership (lp)
unincorporated business trust
(Registered to practice law, accounting, or architecture)
registered domestic partnership
married co-ownership
General partnership
sole Owner
limited liability company (llc)
limited liability partnership (llp)
corporation
Other (describe)
Section ii: update name, add a partner/co-owner, drop a partner/co-owner
tin #
Use additional sheets to include information for more than three individuals.
Check One
  update
  add
  drOp
full name (first, middle, last)
title
sOcial securitY number (corporate officers excluded)
driver license number
state
email
hOme address (street, city, state, zip code)
hOme telephOne number
(
)
tin #
Check One
  update
  add
  drOp
full name (first, middle, last)
title
sOcial securitY number (corporate officers excluded)
driver license number
state
email
hOme address (street, city, state, zip code)
hOme telephOne number
(
)
tin #
Check One
  update
  add
  drOp
full name (first, middle, last)
title
sOcial securitY number (corporate officers excluded)
driver license number
state
email
hOme address (street, city, state, zip code)
hOme telephOne number
(
)
Section iii: addreSS chanGeS and contact information
new califOrnia business address (street, city, state, zip code) (do not list PO Box or mailing service)
business telephOne number
(
)
new mailinG address (street, city, state, zip code) (do not list PO Box or mailing service)
business fax number
(
)
name Of primarY cOntact (include title)
cOntact telephOne number
(
)
business email (to receive email reminders to efile)
business web address
Section iv: Sell/cloSe out
date clOsed
was the business sOld?
if Yes, buYer name and telephOne number
  Yes
  nO
Section v: completed by
printed name
title
telephOne number
(
)
siGnature
email
date
mail to: Your local bOe field office.
a listing is located on our website under
“field Office”
at
CLEAR
PRINT

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