Form Boe-400-Lme - Certification For Manufacturer/importer Cigarette License
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2BOE-400-LME (S1F) REV. 1 (5-12)
STATE OF CALIFORNIA
BOARD OF EQUALIZATION
CERTIFICATION FOR MANUFACTURER/IMPORTER CIGARETTE LICENSE
Complete this form and mail it to the Board of Equalization, Special Taxes and Fees, P.O. Box 942879, Sacramento,
CA 94279-0088
On behalf of the above manufacturer or importer, the undersigned certifies the following:
1. All of the information contained in the completed Application and Schedule of Cigarette Brand Family Names is current, true, and correct.
Initial:
Date:
2. If the applicant is a "tobacco product manufacturer" as defined in subdivision (i) of section 104556 of the Health and Safety Code, the
applicant certifies it is one of the following (check appropriate box):
A "participating manufacturer" as defined in subsection II(jj) of the "Master Settlement Agreement" (MSA), or,
Is in full compliance with paragraph (2) of subdivision (a) of section 104557 of the Health and Safety Code.
Initial:
Date:
3. Applicant consents to jurisdiction of the California courts for the purpose of enforcement of the California Cigarette and Tobacco Products
Licensing Act of 2003 and has appointed a registered agent for service of process and identified the registered agent to the BOE and the
California Office of the Attorney General.
Initial:
Date:
4. Applicant certifies that all packages of cigarettes it manufactures or imports and distributes in this state fully comply with subdivision (b) of
section 30163 of the Revenue and Taxation Code, and that the cigarettes contained in those packages are the subject of filed reports that
fully comply with all requirements of the federal Cigarette Labeling and Advertising Act (15 U.S.C. sec. 13355a et seq.) for the reporting of
ingredients added to cigarettes.
Initial:
Date:
5. Applicant certifies that it will maintain purchase records, sales records, and any other records required by the BOE for one year at the
premises identified in the license and make the records available for inspection by the BOE or a law enforcement agency for four years, as
required in California Business and Professions Code sections 22979.4 and 22979.5. Failure of a manufacturer/importer to comply with
these sections shall be a misdemeanor subject to penalties and fines pursuant to California Business and Professions Code section 22981.
Initial:
Date:
6. Applicant certifies that it shall include the following information on each invoice for the sale for distribution, wholesale, or retail sale of
cigarettes pursuant to California Business and Professions Code section 22979.6.
(1) The name, address, and telephone number of the manufacturer/importer.
(2) The license number of the manufacturer/importer as provided by the BOE.
(3) The name, address, and license number of the person to whom cigarettes or tobacco products are sold.
(4) An itemized listing of the cigarettes or tobacco products sold.
(a) Each invoice for the sale of cigarettes or tobacco products shall be legible.
(b) Failure to comply with this section shall be a misdemeanor subject to penalties and fines pursuant to California Business and
Professions Code section 22981.
Initial:
Date:
7. Applicant understands and acknowledges that under California Business and Professions Code section 22980.1, no manufacturer shall
sell cigarettes to a distributor, wholesaler, importer, or any other person who is not licensed or whose license has been suspended or
revoked. Failure to comply with this section shall be a misdemeanor subject to penalties and fines pursuant to California Business and
Professions Code section 22981.
Initial:
Date:
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