Form Boe-400-Lwr (S1f) - Renewal Application For Wholesaler'S Cigarette And Tobacco Products License
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3BOE-400-LWR (S1F) REV. 4 (4-13)
STATE OF CALIFORNIA
BOARD OF EQUALIZATION
RENEWAL APPLICATION FOR WHOLESALER'S CIGARETTE AND
BOE USE ONLY
TOBACCO PRODUCTS LICENSE
RA-B/A
AUD
REG
FILE
RR-QS
REF
YOUR ACCOUNT NO.
[
]
FOID
EFF
BOARD OF EQUALIZATION
SPECIAL TAXES AND FEES
PO BOX 942879
SACRAMENTO CA 94279-0088
READ INSTRUCTIONS
BEFORE PREPARING
CALIFORNIA CIGARETTE AND TOBACCO PRODUCTS LICENSING ACT OF 2003
GENERAL INFORMATION
The State Board of Equalization (BOE) 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 wholesaler of cigarettes or tobacco products in this state to be licensed by the BOE.
Under the Act, every wholesaler 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 BOE in order to maintain your cigarette and tobacco products
license. This application must be postmarked on or before the due date. The renewal application consists of page (S1F)
Section I: Cigarette and Tobacco Products License Renewal Fee Computation; page (S1B) which includes Section II:
Cancellation Notice; Section III: Business Change; Section IV: Additional Information; Section V: Signature; and Schedule
A, (if enclosed). Your renewal application will not be processed if it is incomplete or not signed under Section I and
Section V. The completed renewal application must be accompanied by a remittance payable to the State Board of
Equalization for the amount of the license renewal fee due.
STORAGE LOCATIONS
If you are storing cigarettes and/or tobacco products at a California location other than your sales location, please refer to
Section IV on the second page.
Payments. You can make your payment by paper check, Online ACH Debit (ePay) or by credit card. To use ePay, go to
our website at , click on eServices tab and log in to make a payment. To pay by credit card, go to our
website or call 1-855-292-8931. Be sure to sign and mail your application.
SECTION I: CIGARETTE AND TOBACCO PRODUCTS LICENSE RENEWAL FEE COMPUTATION
1.
Enter the total number of business locations for renewal that you operate at which
1.
cigarettes or tobacco products are sold (from Schedule A if more than one location)
2.
Annual license renewal fee per business location
2. $1,000.00
3.
TOTAL AMOUNT DUE AND PAYABLE (multiply line 1 x line 2)
3.
Check box only if you have completed Section II and/or Section III of this form.
EMAIL ADDRESS
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.
TELEPHONE
SIGNATURE
PRINT NAME AND TITLE
DATE
(
)
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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