Form Boe-400-Csu - Application For Consumer Use Tax Account - 2005
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2BOE-400-CSU (FRONT) REV. 1 (10-05)
STATE OF CALIFORNIA
APPLICATION FOR CONSUMER USE TAX ACCOUNT
BOARD OF EQUALIZATION
* Must provide partnership agreement
1. TYPE OF OWNERSHIP (check one)
FOR BOARD USE ONLY
Husband/Wife Co-ownership
Sole Owner
TAX
IND
OFFICE
ACCOUNT NUMBER
Limited Liability Company (LLC)
Corporation
SU
(Must provide Articles of Incorporation or
Operating Agreement)
General Partnership
NAICS CODE
BUSINESS
A.C.C.
AREA CODE
Unincorporated Business Trust
CODE
Limited Partnership (LP)*
(Must provide Trust Agreement)
REPORTING BASIS
Limited Liability Partnership (LLP)*
Registered Domestic
PROCESSED BY
CERTIFICATE FOR
(Registered to practice law, accounting, or
PERMIT ISSUE
Partnership
VERIFICATION
architecture)
DATE
DL
PA
Other
Other (describe)
___ / ___ / ___
2. NAME OF SOLE OWNER, CORPORATION, LLC, PARTNERSHIP, OR TRUST
3. STATE OF INCORPORATION OR ORGANIZATION
4. BUSINESS TRADE NAME [DBA] (if any)
5. DATE PURCHASES BEGAN OR WILL BEGIN IN CALIFORNIA
(month, day, and year)
6. CORPORATE, LLC, LLP OR LP NUMBER FROM CALIFORNIA SECRETARY OF STATE
7. FEDERAL EMPLOYER IDENTIFICATION NUMBER (FEIN)
CHECK ONE
Owner/Co-Owners
Partners
Registered Domestic
Corp. Officers
LLC Officers/
Trustees/
Use additional sheets to include information for more than two individual
s .
Partners
Managers/Members
Beneficiaries
8. FULL NAME (first, middle, last)
9. TITLE
10. SOCIAL SECURITY NUMBER (corporate officers excluded)
11. DRIVER LICENSE NUMBER (attach copy)
12. HOME ADDRESS (street, city, state, zip code)
13. HOME TELEPHONE NUMBER
(
)
14. NAME OF A PERSONAL REFERENCE
15. ADDRESS (street, city, state, zip code)
16. TELEPHONE NUMBER
(
)
17. FULL NAME (first, middle, last)
18. TITLE
19. SOCIAL SECURITY NUMBER (corporate officers excluded)
20. DRIVER LICENSE NUMBER (attach copy)
21. HOME ADDRESS (street, city, state, zip code)
22. HOME TELEPHONE NUMBER
(
)
23. NAME A PERSONAL REFERENCE
24. ADDRESS (street, city, state, zip code)
25. TELEPHONE NUMBER
(
)
26. TYPE OF BUSINESS (check one that best describes your business)
Retail
Wholesale
Mfg.
Repair
Service
Construction Contractor
Leasing
27. TYPES OF ITEMS PURCHASED
28. BUSINESS WEBSITE ADDRESS
www.
29. CALIFORNIA BUSINESS ADDRESS (street, city, state, zip code) [do no list PO Box or mailing service]
30. BUSINESS TELEPHONE NUMBER
(
)
31. MAILING ADDRESS (street, city, state, zip code) [if different from business address]
32. BUSINESS FAX NUMBER
(
)
33. NAME OF PERSON MAINTAINING YOUR RECORDS
34. ADDRESS (street, city, state, zip code)
35. TELEPHONE NUMBER
(
)
36. NAME OF BUSINESS LANDLORD
37. ADDRESS (street, city, state, zip code)
38. LANDLORD TELEPHONE NUMBER
(
)
39. PROJECTED GROSS MONTHLY PURCHASES IN CALIFORNIA
40. PROJECTED MONTHLY TAXABLE PURCHASES IN CALIFORNIA
$
$
41. NAME OF BANK OR OTHER FINANCIAL INSTITUTION (note whether business or personal)
42. BANK BRANCH LOCATION
43. NAME OF MERCHANT CREDIT CARD PROCESSOR (if you accept credit cards)
44. MERCHANT CARD ACCOUNT NUMBER
45. NAMES OF MAJOR SUPPLIERS
46. ADDRESSES (street, city, state, zip code)
47. PRODUCTS PURCHASED
(attach additional sheets, if required)
(continued on reverse)
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