Form Boe-400-Mcu - Application For Consumer Use Tax Account - 1997

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BOE-400-MCU (S2F) REV. 5 (5-97)
STATE OF CALIFORNIA
APPLICATION FOR CONSUMER USE TAX ACCOUNT
BOARD OF EQUALIZATION
FOR BOARD USE ONLY
SECTION I: OWNERSHIP INFORMATION
TAX
OFFICE
NUMBER
S
1. PLEASE CHECK TYPE OF OWNERSHIP
Photocopy of
Driver's License and
Sole Owner
Husband/Wife Co-ownership
BUSINESS CODE
AREA CODE
Social Security Card
Corporation
Partnership
is required
PREPARER
VERIFICATION:
See instruction number 6
Other _______________________
SSN
DL
Other
2.
IF CORPORATION, ENTER FULL CORPORATE NAME. IF LIMITED LIABILITY COMPANY (LLC), ENTER FULL LLC NAME.
3.
FEDERAL EMPLOYER IDENTIFICATION NUMBER (FEIN)
4. CORPORATE OF LLC NUMBER/STATE OF INCORPORATION OR ORG.
Please check appropriate title and use additional sheet to include information about additional co-owners or members.
OWNER
PARTNER
CO-OWNER
PARTNER
PARTNER
SECRETARY
PARTNER
TREASURER
PRESIDENT
MANAGER
VICE-PRESIDENT
MANAGER
MEMBER
MANAGER
MEMBER
MEMBER
MANAGER
MEMBER
5. FULL NAME
(incl. mid. name)
6. ADDRESS
(residence)
7. TELEPHONE
(
)
(
)
(
)
(
)
(residence)
8. DAYTIME
(
)
(
)
(
)
(
)
TELEPHONE
9. SOCIAL
SECURITY NO.
10. DRIVER’S
LICENSE NO.
11. SIGNATURE
Section II: Business Information
1.
BUSINESS NAME
BUSINESS TELEPHONE
(
)
2.
BUSINESS ADDRESS (Do not use P.O. Box or address of mailing service)
CITY
STATE
ZIP CODE
3.
MAILING ADDRESS (If different from no. 2 above)
CITY
STATE
ZIP CODE
4.
DESCRIPTION OF BUSINESS
b. Type of business
a. Items sold or service performed
Manufacturing
Professional or
Construction
or wholesaling
personal service
contractor
5.
WHAT WILL YOU PURCHASE FROM OUT-OF-STATE?
6.
DATE PURCHASES BEGAN IN CALIFORNIA:
Month
Day
Year
7.
NAME OF BANK OR OTHER FINANCIAL INSTITUTION (checking and savings account) BRANCH LOCATION
ACCOUNT NUMBER
8.
MAJOR SUPPLIERS
ADDRESS
ITEMS PURCHASED
Continued on Reverse

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