Form Boe-400-Xml - Application For Direct Transmission Of Tax Returns
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2BOE-400-XML (S1F) (7-09)
STATE OF CALIFORNIA
APPLICATION FOR DIRECT TRANSMISSION OF TAX RETURNS
BOARD OF EQUALIZATION
New
Revised
Reinstatement
PLEASE PRINT OR TYPE – INSTRUCTIONS ARE AVAILABLE ON THE BACK OF THIS FORM
1. LEGAL NAME OF DIRECT TRANSMITTER
FOR BOARD USE ONLY – CLIENT ID NUMBER
2. BUSINESS NAME (if different from above)
3. BUSINESS ADDRESS (street, city, state, zip code)
4. MAILING ADDRESS (if different than above; street or P.O. Box, city, state, zip code)
5. BUSINESS CONTACT INFORMATION (phone, fax, and email address)
6. CONTACT REPRESENTATIVE
Name:
Title:
Email address:
Telephone: (
)
7. TYPE OF CERTIFICATION
I WANT TO BE CERTIFIED TO TRANSMIT RETURNS AS A: (check all that apply)
Tax Professional
Business Name:
Software Developer
Name of Software Product:
Tax or Fee Payer
BOE Account Number:
Web Address
Electronic Return Originator
Test Web Address (if available)
8. APPLICATION AGREEMENT
Under penalty of perjury, I declare that I have examined this application and to the best of my knowledge the information I have pro-
vided is true, correct, and complete. I further declare that I am authorized to complete and sign this statement on behalf of the business.
This business and its employees will comply with all the provisions of the California State Board of Equalization’s Direct Transmitters
Guide and related publications. I understand that if this business is sold or its organizational structure is changed, acceptance for par-
ticipation is not transferable and a new/revised application must be filed. I further understand that noncompliance with all applicable
provisions will result in termination of this agreement.
9. NAME AND TITLE OF THE REPRESENTATIVE COMPLETING THIS FORM (type or print)
10. SIGNATURE OF THE REPRESENTATIVE COMPLETING THIS FORM
DATE
Please submit the completed application via fax to (916) 322-4530, email to eDirect@boe.ca.gov, or mail to:
State Board of Equalization
eServices Coordinator, MIC:92
PO Box 942879
Sacramento, CA 94279-0092
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