Form Boe-400-Ld - Application For Retailer'S Cigarette And Tobacco Products License
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6BOE-400-LD (S1) REV. 2 (7-07)
STATE OF CALIFORNIA
BOARD OF EQUALIZATION
APPLICATION FOR DISTRIBUTOR'S CIGARETTE AND TOBACCO PRODUCTS LICENSE
BOARD USE ONLY
RA-B/A
AUD
REG
FILE
RR-QS
REF
YOUR ACCOUNT NO.
[
]
FOID
EFF
BOARD OF EQUALIZATION
EXCISE TAXES DIVISION
PO BOX 942879
SACRAMENTO CA 94279-0056
READ INSTRUCTIONS
BEFORE PREPARING
CALIFORNIA CIGARETTE AND TOBACCO PRODUCTS LICENSING ACT OF 2003
GENERAL INFORMATION
The State Board of Equalization (Board) is responsible for administering the California Cigarette and Tobacco Products
Licensing Act of 2003 under Division 8.6 (commencing with section 22970) of the California Business and Professions
Code (the Act). The Act requires every distributor of cigarettes or tobacco products in this state to be licensed by the
Board. Under the Act, every distributor must annually obtain and maintain a license to engage in the sale of cigarettes or
tobacco products.
FILING REQUIREMENTS
You must complete and return this application to the Board in order to obtain a cigarette and tobacco products license.
The application consists of page (S1) Section I: Cigarette and Tobacco Products License Fee Computation, page (S2F)
which includes Section II: Ownership Information; Section III: Business Information; and Section IV: Certification, and
Schedule A, (if enclosed). Your application will not be processed if it is incomplete or not signed under Section I and
Section IV. The completed application must be accompanied by a remittance payable to the State Board of Equalization
for the amount of license fee due.
Credit Card Payments. You can use a Discover/Novus, MasterCard, VISA, or American Express credit card to pay
the amount due. Other credit cards cannot be accepted. EFT accounts are not eligible for credit card payments. Credit
card payments can be made by calling 800-272-9829 or through our website at After authorizing your
payment, check the box below indicating you have paid with a credit card. Be sure to sign and mail your return.
SECTION I: CIGARETTE AND TOBACCO PRODUCTS LICENSE FEE COMPUTATION
1. Enter the total number of business locations that you operate at which cigarettes or
1.
tobacco products are sold (from Schedule A if more than one location)
$1,000.00
2. Annual license fee per business location
2.
3. TOTAL AMOUNT DUE AND PAYABLE (multiply line 1 x line 2)
3.
IF PAID BY CREDIT CARD, CHECK HERE (Mandatory EFT accounts MUST pay by EFT). [
]
I hereby certify that this application, including any accompanying schedules and statements, has been
examined by me and to the best of my knowledge and belief is a true, correct, and complete application.
YOUR SIGNATURE AND TITLE
E-MAIL ADDRESS
DATE
TELEPHONE NUMBER
Make check or money order payable to State Board of Equalization.
Always write your account number on your check or money order. Make a copy of this document for your records.
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