Form Boe-400-Mcr - Application For Certificate Of Registration Use Tax Account - 2002
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2BOE-400-MCR (FRONT) REV. 8 (4-02)
STATE OF CALIFORNIA
APPLICATION FOR CERTIFICATE OF REGISTRATION
BOARD OF EQUALIZATION
USE TAX ACCOUNT
Use additional sheets to include information for more than two individuals.
SECTION I: OWNERSHIP INFORMATION
FOR BOARD USE ONLY
1. PLEASE CHECK TYPE OF OWNERSHIP/ENTITY
TAX
IND
OFFICE
NUMBER
Sole Owner
Husband/Wife Co-ownership
SC
Limited Liability Partnership (LLP)
Corporation
(registered to practice law, accounting
Limited Partnership (LP)
or architecture) Provide documents if filed
BUSINESS CODE
AREA CODE
Provide documents if filed with
with Secretary of State.
Secretary of State.
Limited Liability Company (LLC)
General Partnership
APPLICATION PROCESSED BY
VERIFICATION:
Unincorporated Business Trust
Other (describe)
DL
Other
2. ENTER FULL NAME OF CORPORATION, LP, LLP, LLC, PARTNERSHIP, OR UNINCORPORATED BUSINESS TRUST
3. FEDERAL EMPLOYER IDENTIFICATION NUMBER (FEIN)
4. CORPORATE, LP, LLP, OR LLC NUMBER FROM CALIFORNIA SECRETARY OF STATE
5. STATE OF INCORPORATION OR ORGANIZATION
CHECK ONE
Officer
Manager
Member
Trustee
Beneficiary
Partner
Sole Owner or Co-Owner
6. FULL NAME (first, middle, last)
7. TITLE
8. SOCIAL SECURITY NUMBER (corporate officers excluded)
9. DRIVER LICENSE NUMBER (attach verification)
10. RESIDENCE ADDRESS (street, city, state, zip code)
11. RESIDENCE TELEPHONE NUMBER
(
)
CHECK ONE
Officer
Manager
Member
Trustee
Beneficiary
Partner
Co-Owner
12. FULL NAME (first, middle, last)
13. TITLE
14. SOCIAL SECURITY NUMBER (corporate officers excluded)
15. DRIVER LICENSE NUMBER (attach verification)
16. RESIDENCE ADDRESS (street, city, state, zip code)
17. RESIDENCE TELEPHONE NUMBER
(
)
SECTION II: BUSINESS INFORMATION
18. BUSINESS NAME [DBA] (complete if different than entity name)
19. DID YOU INCLUDE A COPY OF YOUR PARTNERSHIP AGREEMENT?
Yes
No
20. BUSINESS ADDRESS (street, city, state, zip code) [do not list P.O. Box or mailing service]
21. BUSINESS TELEPHONE NUMBER
(
)
22. MAILING ADDRESS (street, city, state, zip code) [if different from business address]
23. BUSINESS FAX NUMBER
(
)
24. TYPE OF ITEMS SOLD OR LEASED
25. DATE SALES OR LEASES STARTED IN CALIFORNIA (month, date & year)
26. TYPE OF BUSINESS (check one)
Retail
Wholesale
Mfg.
Repair
Service
Construction Contractor
Leasing
27. OWNERSHIP CHANGES
Are you buying an existing business?
Yes
No If yes, complete items 28 and 29 below.
Are you changing from one type of business organization to another (for example, from a sole owner to a corporation or from a
partnership to a limited liability company, etc.)?
Yes
No If yes, complete items 28 and 29 below.
Other:
28. FORMER OWNER’S NAMES
29. FORMER OWNER’S PERMIT NUMBER
30. DO YOU MAKE INTERNET SALES?
31. WEBSITE ADDRESS
Yes
No
If yes, answer 31
32. NAME & LOCATION OF BANK OR OTHER FINANCIAL INSTITUTION (note whether business or personal)
33. ACCOUNT NUMBER(S)
Continued on Reverse
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