Form Boe-400-Lrr (S1f) - Renewal Application For Retailer'S Cigarette And Tobacco Products License

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BOE-400-LRR (S1F) REV. 6 (4-13)
STATE OF CALIFORNIA
BOARD OF EQUALIZATION
BOE USE ONLY
RENEWAL APPLICATION FOR RETAILER'S CIGARETTE AND TOBACCO PRODUCTS LICENSE
RA-B/A
AUD
REG
RR-QS
FILE
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 retailer of cigarettes and/or tobacco products in this state to be licensed by the BOE. Under
the Act, every retailer must obtain a separate license for each location at which cigarettes and/or tobacco products are sold.
A retailer must conspicuously (that is, easily seen by customers) display the license at each retail location.
Note: The submission of this renewal application does not allow you the privilege of selling or purchasing cigarettes and/or
tobacco products in California. You cannot legally sell cigarettes and/or tobacco products until your application is processed
and you receive your renewal Cigarette and Tobacco Products Retailer's License. Any sales or purchases of cigarettes and/or
tobacco products before receipt of a license constitutes a violation of the Act (Business and Professions Code section
22980.2) and can result in a seizure of product, penalty, and/or fine.
FILING REQUIREMENTS
In order to maintain your cigarette and tobacco products license, you must complete and return this renewal application to
the BOE. The renewal application consists of Section I: Cigarette and Tobacco Products License Account Information;
Section II: Cancellation Notice; Section III: Business Change; Section IV: Signature; and Schedule A, (if enclosed). There is no
cost to renew your license provided this form is postmarked on or before the due date. Your renewal application will not
be processed if it is incomplete or not signed under both Section I and Section IV.
Retailers who have allowed their Cigarette and Tobacco Products Retailer's License to expire and failed to renew
timely are required to pay a fee of $100.00 to have a license reinstated. The reinstatement fee applies to each license
which has expired and was not renewed timely. Please remember, you may not sell cigarettes and/or tobacco
products without a valid Cigarette and Tobacco Products Retailer's License.
SECTION I: CIGARETTE AND TOBACCO PRODUCTS LICENSE ACCOUNT INFORMATION
1.
1. Enter the total number of retail locations that you operate at which cigarettes and/or
tobacco products are sold and for which you are applying for renewal (from Schedule A if
more than one location).
Check box only if you have completed Section II and/or Section III of this form.
Check box to affirm that none of the retail locations included in line 1 are "special purpose
commercial coaches," (for example, catering trucks, lunch wagons, or other mobile facilities).
Special purpose commercial coaches can not be registered as retail locations.
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.
SIGNATURE
EMAIL ADDRESS
PRINT NAME AND TITLE
TELEPHONE
DATE
(
)
Make a copy of this document for your records.
(continued on reverse)

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