Form Boe-400-Mco - Application For Seller'S Permit And Registration As A Retailer - (Corporations/limited Liability Company/organizations) Page 2

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BOE-400-MCO (S2B) REV. 8 (12-97)
STATE OF CALIFORNIA
BOARD OF EQUALIZATION
9. NAME OF ACCOUNTANT/BOOKKEEPER
ADDRESS
TELEPHONE
(
)
10. NAME OF BUSINESS LANDLORD
ADDRESS
TELEPHONE
(
)
11. NAME AND LOCATION OF BANK OR OTHER FINANCIAL INSTITUTION (CHECKING AND SAVINGS ACCOUNT)
ACCOUNT NUMBER
12. NAME OF MAJOR SUPPLIERS
ADDRESS
PRODUCTS PURCHASED
13. OTHER ACCOUNT NUMBERS ISSUED TO YOU BY THE BOARD
SECTION III: INCOME AND EXPENSES
2. PROJECTED MONTHLY
1. PROJECTED MONTHLY
3. INFORMATION CONCERNING EMPLOYMENT DEVELOPMENT DEPARTMENT (EDD)
BUSINESS REVENUE
BUSINESS EXPENSES
Yes
No
a. Are you registered with EDD?
Rent
$
Total Gross Revenue $
Yes
No
b. If no, will your payroll exceed $100 per quarter?
If yes, you must make application with EDD.
Payroll
$
Non-taxable
$
Number of employees
See pamphlet DE 44, “California Employer's Guide.”
Misc.
$
Taxable
$
c. I have already received pamphlet DE 44,
Total
$
Tax
$
Yes
No
“California Employer's Guide.”
SECTION IV: CERTIFICATION
The statements contained herein are hereby certified to be correct to the best knowledge and
belief of the undersigned who is duly authorized to sign this application.
SIGNATURE
TITLE
(Typed or printed)
NAME
DATE
FOR BOARD USE ONLY
Furnished to Taxpayer
REPORTING BASIS
REGULATIONS
BOE-162
X
BOE-324A
SECURITY REVIEW
BT-400Y
BT-467
BT-1009
BT-598
$ __________________________
BOE-519
BY
PAM. 73
APPROVED BY
BT-1241D
PAMPHLETS
REG. 1668
REMOTE INPUT DATE
REG. 1698
REG. 1700
BY
RETURNS
DE-44
PERMIT ISSUED
DATE
Yes
No

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