BOE-400-SPA REV. 1 (FRONT) (7-05) |
|
|
|
|
|
|
|
|
|
|
|
|
STATE OF CALIFORNIA |
APPLICATION FOR SELLER’S PERMIT |
|
|
|
|
|
|
|
|
|
BOARD OF EQUALIZATION |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
1. PERMIT TYPE: (check one) |
Regular |
Temporary |
|
|
|
FOR BOARD USE ONLY |
|
|
|
2. TYPE OF OWNERSHIP (check one) |
|
* Must provide partnership agreement |
TAX |
|
IND |
OFFICE |
|
|
|
PERMIT NUMBER |
Sole Owner |
|
|
Husband/Wife Co-ownership |
S |
|
|
|
|
|
|
|
|
|
|
|
|
|
Corporation |
|
|
Limited Liability Company (LLC) |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Unincorporated Business Trust |
NAICS CODE |
BUS CODE |
A.C.C. |
REPORTING BASIS |
|
TAX AREA CODE |
General Partnership |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Limited Liability Partnership (LLP) * |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Limited Partnership (LP) * |
|
|
|
|
|
RETURN TYPE |
|
|
|
|
|
(Registered to practice law, accounting or architecture) |
PROCESSED BY |
PERMIT ISSUE |
|
|
(1) 401-A |
|
(2) 401-EZ |
|
|
|
Registered Domestic Partnership |
|
|
|
|
|
|
|
|
|
|
|
|
DATE |
|
VERIFICATION |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Other (describe) |
|
|
|
|
|
|
|
|
___ / ___ / ___ |
|
|
DL |
|
PA |
|
|
Other |
|
|
|
|
|
|
|
|
|
|
|
|
|
3. NAME OF SOLE OWNER, CORPORATION, LLC, PARTNERSHIP, OR TRUST |
|
|
|
4. STATE OF INCORPORATION OR ORGANIZATION |
|
|
|
|
|
|
|
|
|
|
|
|
5. BUSINESS TRADE NAME / “DOING BUSINESS AS” [DBA] (if any) |
|
|
|
|
|
6. DATE YOU WILL BEGIN BUSINESS ACTIVITIES (month, day, and year) |
|
|
|
|
|
|
|
|
|
|
7. CORPORATE, LLC, LLP OR LP NUMBER FROM CALIFORNIA SECRETARY OF STATE |
|
|
|
8. FEDERAL EMPLOYER IDENTIFICATION NUMBER (FEIN) |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
CHECK ONE |
Owner/Co-Owners |
Partners |
Registered Domestic |
Corp. Officers |
LLC Officers/Managers/ |
|
|
Trustees/ |
|
|
|
|
|
Partners |
|
|
|
|
Members |
|
|
|
|
Beneficiaries |
Use additional sheets to include information for more than three individuals.
9. FULL NAME (first, middle, last) |
|
|
|
|
|
|
|
|
|
10. TITLE |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
11. SOCIAL SECURITY NUMBER (corporate officers excluded) |
|
|
|
|
|
12. DRIVER LICENSE NUMBER (attach copy) |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
13. HOME ADDRESS (street, city, state, zip code) |
|
|
|
|
|
|
|
|
14. HOME TELEPHONE NUMBER |
|
|
|
|
|
|
|
|
|
|
|
( |
|
) |
|
|
|
|
|
|
|
|
|
|
|
|
15. NAME OF A PERSONAL REFERENCE NOT LIVING WITH YOU |
16. ADDRESS (street, city, state, zip code) |
|
|
17. REFERENCE TELEPHONE NUMBER |
|
|
|
|
|
|
|
|
|
|
|
( |
|
) |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
18. FULL NAME OF ADDITIONAL PARTNER, OFFICER, OR MEMBER (first, middle, last) |
|
|
|
|
|
19. TITLE |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
20. SOCIAL SECURITY NUMBER (corporate officers excluded) |
|
|
|
|
|
21. DRIVER LICENSE NUMBER (attach copy) |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
22. HOME ADDRESS (street, city, state, zip code) |
|
|
|
|
|
|
|
|
23. HOME TELEPHONE NUMBER |
|
|
|
|
|
|
|
|
|
|
|
( |
|
) |
|
|
|
|
|
|
|
|
|
|
|
|
24. NAME OF A PERSONAL REFERENCE NOT LIVING WITH YOU |
25. ADDRESS (street, city, state, zip code) |
|
|
26. REFERENCE TELEPHONE NUMBER |
|
|
|
|
|
|
|
|
|
|
|
( |
|
) |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
27. FULL NAME OF ADDITIONAL PARTNER, OFFICER, OR MEMBER (first, middle, last) |
|
|
|
|
|
28. TITLE |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
29. SOCIAL SECURITY NUMBER (corporate officers excluded) |
|
|
|
|
|
30. DRIVER LICENSE NUMBER (attach copy) |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
31. HOME ADDRESS (street, city, state, zip code) |
|
|
|
|
|
|
|
|
32. HOME TELEPHONE NUMBER |
|
|
|
|
|
|
|
|
|
|
|
( |
|
) |
|
|
|
|
|
|
|
|
|
|
|
|
33. NAME OF A PERSONAL REFERENCE NOT LIVING WITH YOU |
34. ADDRESS (street, city, state, zip code) |
|
|
35. REFERENCE TELEPHONE NUMBER |
|
|
|
|
|
|
|
|
|
|
|
( |
|
) |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
36. TYPE OF BUSINESS (check one that best describes your business) |
|
|
|
|
|
|
37. NUMBER OF SELLING LOCATIONS |
Retail |
Wholesale |
Mfg. |
Repair |
Service |
Construction |
Contractor |
|
Leasing |
|
|
(if 2 or more, see Item No. 66) |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
38. WHAT ITEMS WILL YOU SELL? |
|
|
|
|
|
|
|
|
|
39. CHECK ONE |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Full Time |
Part Time |
|
|
|
|
|
|
|
|
|
|
|
40. BUSINESS ADDRESS (street, city, state, zip code) [do not list P.O. Box or mailing service] |
|
|
|
|
|
41. BUSINESS TELEPHONE NUMBER |
|
|
|
|
|
|
|
|
|
|
|
( |
|
) |
|
|
|
|
|
|
|
|
|
|
|
|
|
42. MAILING ADDRESS (street, city, state, zip code) [if different from business address] |
|
|
|
|
|
43. BUSINESS FAX NUMBER |
|
|
|
|
|
|
|
|
|
|
|
( |
|
) |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
44. BUSINESS WEBSITE ADDRESS |
|
|
45. BUSINESS EMAIL ADDRESS |
|
|
|
|
46. DO YOU MAKE INTERNET SALES? |
www. |
|
|
|
|
|
|
|
|
|
|
|
|
Yes |
|
No |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
47. NAME OF BUSINESS LANDLORD |
|
|
48. LANDLORD ADDRESS (street, city, state, zip code) |
|
|
49. LANDLORD TELEPHONE NUMBER |
|
|
|
|
|
|
|
|
|
|
|
( |
|
) |
|
|
|
|
|
|
|
|
|
|
|
50. PROJECTED MONTHLY GROSS SALES |
|
51. PROJECTED MONTHLY TAXABLE SALES |
|
52. ALCOHOLIC BEVERAGE CONTROL LICENSE NUMBER (if applicable) |
$ |
|
|
|
$ |
|
|
|
|
___ ___ - ___ ___ ___ ___ ___ ___ |
|
|
|
|
|
|
|
|
|
|
|
53. SELLING NEW TIRES? |
|
|
54. SELLING COVERED ELECTRONIC DEVICES? |
|
|
55. SELLING TOBACCO AT RETAIL? |
Yes |
No |
|
|
Yes |
No |
|
|
|
|
|
|
|
Yes |
|
No |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|