Form Boe-400-Lw - Application For Wholesaler'S Cigarette And Tobacco Products License Page 3

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BOE-400-LW (S2B) REV. 4 (11-11)
CALIFORNIA CIGARETTE AND TOBACCO PRODUCTS LICENSING ACT OF 2003
APPLICATION FOR WHOLESALER'S LICENSE
PRIVACY NOTICE
Information Provided to the State Board of Equalization
We ask you for information so that we can administer 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
information will be used to determine if you meet the requirements to obtain and maintain a wholesaler's license to sell
cigarettes or tobacco products. You must provide all the information we request.
What happens if I don't provide the information?
If your application is incomplete, we will not issue your license. Penalties may also apply if you do not provide other
information we request or that is required by law, or if you give us fraudulent information. In some cases, you may be
subject to criminal prosecution.
Can anyone else see my information?
Your information is covered by state laws that protect your privacy. However, we may share information regarding your
account with certain government agencies.
We may release to the public the information printed on your license, your license status, and names of business
owners or partners.
With your written permission, we can release information regarding your account to anyone you designate.
We may disclose information to the proper officials of the following agencies, among others:
Upon request, the BOE must provide to the State Department of Health Services, the office of the Attorney General, a
law enforcement agency, and any agency authorized to enforce local tobacco control ordinances, access to the BOE's
database of licenses issued to distributors for locations within the jurisdiction of that agency or law enforcement
agency.
Can I review my records?
Yes. Please contact the Compliance Branch in Special Taxes and Fees by calling the telephone number or writing to the
address listed below. If you need additional information, you may contact our Disclosure Officer in Sacramento by
calling 916-445-2918. You may also want to obtain publication 58-A, How to Inspect and Correct Your Records. You
may download the publication from our website at or you may request a copy from our Taxpayer
Information Section at 800-400-7115 (TTY:711).
Who is responsible for maintaining my records?
You may contact the Deputy Director of the Property and Special Taxes Department at the address or telephone
number listed below.
Deputy Director
Property and Special Taxes Department
PO Box 942879
Sacramento, CA 94279-0063
916-445-1516

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