Application For Wholesaler'S Cigarette And Tobacco Products License Page 6
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6BOE-400-LW (S4) REV. 4 (11-11)
STATE OF CALIFORNIA
BOARD OF EQUALIZATION
CALIFORNIA CIGARETTE AND TOBACCO PRODUCTS LICENSING ACT OF 2003
SCHEDULE A - WHOLESALER'S BUSINESS LOCATIONS
(Instructions are in the application under No. 3 on page S3F.)
ACCOUNT NUMBER:
OWNER NAME:
PERIOD:
A
B
C
D
E
BUSINESS NAME
BUSINESS ADDRESS
TELEPHONE
EMAIL ADDRESS
ENTER 1
(must provide if not listed below)
NUMBER
IF CIGARETTE OR
(including
TOBACCO PRODUCTS
area code)
WILL BE SOLD
AT THIS LOCATION
TOTAL NUMBER OF LICENSES REQUIRED:
CLEAR
PRINT
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