Form Boe-400-Fco - Supplier And/or Ultimate Vendor Fuel Tax License Application - Board Of Equalization - California Page 2
Download a blank fillable Form Boe-400-Fco - Supplier And/or Ultimate Vendor Fuel Tax License Application - Board Of Equalization - California in PDF format just by clicking the "DOWNLOAD PDF" button.
Open the file in any PDF-viewing software. Adobe Reader or any alternative for Windows or MacOS are required to access and complete fillable content.
Complete Form Boe-400-Fco - Supplier And/or Ultimate Vendor Fuel Tax License Application - Board Of Equalization - California with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.
Some fillable PDF-files have the option of saving the completed form that contains your own data for later use or sending it out straight away.
ADVERTISEMENT
1
2BOE-400-FCO (BACK) REv. 5 (11-07)
SECTION III: BUSINESS INFORMATION
1. CURRENTLY DOING BUSINESS AS [DBA] (write none if not applicable) Partnerships complete if business name different than name of partnership.
2. BUSINESS ADDRESS (do not list P.O. Box or mailing service) If two or more locations, please attach a list. DAYTIME TELEPHONE NUMBER
FAx NUMBER
(
)
(
)
3. MAILING ADDRESS (if different from above) (street, city, state, zip code)
4. WEBSITE ADDRESS
5. ADDRESS WHERE BOOKS AND RECORDS ARE MAINTAINED (street, city, state, zip code)
DAYTIME TELEPHONE NUMBER
FAx NUMBER
(
)
(
)
6. NAME OF PERSON TO CONTACT REGARDING ALL LICENSING ACTIvITIES
DAYTIME TELEPHONE NUMBER
E-MAIL ADDRESS
(
)
7. NAME OF PERSON TO CONTACT REGARDING TAx REPORTING ACTIvITIES
DAYTIME TELEPHONE NUMBER
E-MAIL ADDRESS
(
)
8. NAME OF BANK OR FINANCIAL INSTITUTION HOLDING PRIMARY BUSINESS ACCOUNT
ACCOUNT NUMBER
9. BANK OR FINANCIAL INSTITUTION ADDRESS (mailing address, city, state, zip code)
TELEPHONE NUMBER
FAx NUMBER
(
)
(
)
10.DO YOU OWN, OPERATE OR OTHERWISE CONTROL A TERMINAL?
Yes
No If yes, state the number of terminals:
and complete the following information for each terminal location. (If more than
one location, please attach a list.)
TERMINAL LOCATION ADDRESS (street, city, state, zip code)
CAPACITY OF TANKS
11. DO YOU HAvE A LETTER OF REGISTRATION (FORM 637) FROM THE IRS?
Yes (attach a copy)
No (please explain)
12. DO YOU HAvE OTHER BOARD OF EQUALIZATION ISSUED LICENSES OR PERMITS?
Yes
No If yes, please list the account numbers.
13. ARE YOU BUYING A BUSINESS?
No If yes, please list seller’s name and fuel tax account number(s) if known.
Yes
14. ARE THERE UNDERGROUND STORAGE TANK(S) AT A CALIFORNIA BUSINESS LOCATION?
Yes
No If yes, are you the owner?
Yes
No
If yes, please provide your account number TK MT 44
-
. If no, please provide the name and address of the owner of the
tank.
15. ESTIMATED AvERAGE MONTHLY GALLONS
Motor Vehicle Fuel
Diesel Fuel
Total removals, entries, or sales
gallons
Total removals, entries, or sales
gallons
Minus exempt removals, entries, or sales
gallons
Minus exempt removals, entries, or sales
gallons
Total taxable removals, entries, or sales
gallons
Total taxable removals, entries, or sales
gallons
SECTION IV: CERTIFICATION
I certify and declare, under penalty of perjury, that the information contained herein is correct to
the best of my knowledge and that I am authorized to sign and certify this application.
NAME (typed or printed)
TITLE
SIGNATURE
DATE
-
Return Application to: Board of Equalization, Fuel Taxes Division
P.O. Box 942879, Sacramento, CA 94279-0030, 916-322-9669
FOR BOARD USE ONLY
SECURITY REvIEW
RETURNS
PUBLICATIONS
BOE-598 $
No Security
FURNISHED TO TAxPAYER
License Issued Date
PUB 6-A
PUB 19
REPORTING BASIS
PUB 70
EFT 89-T
Monthly
Yearly
Monthly Prepay
Quarterly
BY
APPROvED BY
CLEAR
PRINT
ADVERTISEMENT
0 votes
Related Articles
Related forms
Form Boe-501-nu - Natural Gas Surcharge Return For Public Utility Gas Corporations - Board Of Equalization - California
Financial
Form Boe-400-dc - California Interstate User Diesel Fuel Tax License Application For Corporations/limited Liability Companies/organizations
Financial
Form Boe-400-di - California Interstate User Diesel Fuel Tax License Application For Individuals/partnerships
Financial
Form Boe-531-a - Schedule A - Computation Schedule For District Tax Form - Board Of Equalization - California
Financial
Related Categories
Parent category: Financial