medical marijuana - boe400spa

8/14/2019 Medical Marijuana - boe400spa

1/8

BOE-400-SPARev.1(7-05)

CaliforniaSellersPermitApplication forIndividuals/Partnerships/Corporations/Organizations

(RegularorTemporary)

StateBoardoEqualization

SellerSPermitAPPlicAtion SellerSPermitAPPlicAtion SellerSPermitAPPlicAtion SellerSPermitAPPlicAtion


SellerS Permit APPlicAtion SellerS Permit APPlicAtion SellerS Permit APPlicAtion SellerS Permit

APPlicAtion SellerS PermitAPPlicAtion SellerS PermitAPPlicAtion SellerS PermitAPPlicAtion SellerS

Permit APPlicAtion SellerS Permit APPlicAtion SellerS Permit APPlicAtion SellerS Permit APPlicAtion











APPlicAtion SellerSPermitAPPlicAtion SellerSPermitAPPlicAtion SellerSPermitAPPlicAtion SellerSPermit


PermitAPPlicAtion SellerSPermitAPPlicAtion SellerSPermit SellerSPermitAPPlicAtion SellerSPermit


Board Members

By T. Y

F D

Sn Fn

Bll Ln

Sn D

On/Sn

Mhll Sl

Th D

Rllng Hll E

Jy Ch

Fh D

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Jhn Chng

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Executive Director

Rn J. Hg


2/8

S Pm App

Ivu/Php/Cp/Ogz (Rgu Tmpy) (7-05)

Whomusthaveapermit?

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mpy u (90 y ), ppy Tm-

py pm. Yu gy xb m

C u yu hv b u pm.

DoIneedmorethanonepermit?Eh wh xb m mqu, mu py, pm. I yuhv m h g , h hu h h , w w

u h pm . I yu pp mpy pm, pm w b ugh, bu yu py py h pm h mpy.

Isthereachargeforapermit?N. Hwv, w my qu uy p.Dp u v y up x h myb w h m bu .

Isinformationaboutmyaccountsubjecttopublicdisclosure?

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Whydoyouneedacopyofmydriverlicense?Wh qu, u u h uy h m pv p g u-u u yu .

WhyamIbeingaskedifIselltires,coveredelectronicdevices,ortobaccoproductsatretail?Ev Juy 1, 001, C w bg g (uy $1.75) h w um. BggJuy 1, 005, mu yg h w ubhv py v h hv z mh u h mu gy. V pyv ubj h v v (CED). Thy u v, mpu

FrequentlyAskedQuestions

m, y h pu h hy ub, ug b h y ub, mpum, pp mpu h u quy py. F m m h ERyg F Pgm CED, v: www.boe.ca.gov/

sptaxprog/ewaste.htm. Ev Ju 30, 004, yu g / b pu, yu mu b (p m pm) h - yu h pu. Dpg yu p h qu h yp bu-, h B w yu m bu h pgm.

Whataremyrightsandresponsibilitiesasaseller?

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Youmaybuypropertyorresalewithoutpayingtaxtoyoursupplier. By pvg h v mp , yu qu py x ppy yu buyg .Yu u buy ppy yu w u (v yu p u).

Youmustkeeprecords ub yu ,puh, u u kp hm u y.

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u h g b h w mm yu pp. Yu mu u v yu hv x p.

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3/8

3

S Pm App


Step1:CompleteYourApplication

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800-400-7115.

Note: I yu bu u C, yu m-

p m BOE-403-B, Registration Information for Out-of-State Account. V

u wb www.boe.ca.gov, h Ou--S O 916-7-6600,

h Im C 800-400-7115, qu py by m by

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Step3:AterYourApplicationIsApproved

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hp yu wh yu bu. O, yu my h vw w

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P yu pm yu p bu y by yu

um.

HowDoIApplyor

MySellersPermit?

informationcenter

800-400-7115

for tdd assistance

From TDD phones: 800-735-99

From voice phones: 800-735-9

fieldoffices

call for addresses

City Area Number

Code

Bk 661 395-880

Cuv Cy 310 34-1000

E C 760 35-3431

Euk* 707 445-6500F 559 48-419

Ky M 858 636-3191

Lgu H 949 461-5711

Lg Bh 56 901-483

Nwk 56 466-1694

Ok 510 6-4100

Rh Mg 760 346-8096

Rg 530 4-479

Rv 951 680-6400

Sm 916 7-6700

S 831 443-3003

S Dg 619 55-456

S F 415 356-6600

S J 408 77-131

S M 760 510-5850

S A 714 558-4059

S R 707 576-100

Suu Cy 707 48-041

V Nuy 818 904-300

Vu 805 677-700

W Cv 66 480-700

BusinessLocated

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916-7-6600

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4/8

4

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Items28:BusinessIdentifcationInormation

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Items3649,66:TypeoBusiness,SellingLocations,andLandlordInormation

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Items7582:TemporaryPermitEventInormation

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Certifcation

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5/8

BOE-400-SPA REV. 1 (FRONT) (7-05) STATE OF CALIFORNIA

APPLICATION FOR SELLERS PERMIT BOARD OF EQUALIZATION

NAICS CODE BUS CODE A.C.C. REPORTING BASIS TAX AREA CODE

TAX OFFICE

S

PERMIT NUMBER

1. PERMIT TYPE: (check one) Reular Temporary FOR BOARD USE ONLY

DL PA Oter

2. TyPE OF OwNERShIP (check one) IND

Sole Oner

Corporation

General Partnersip

Limited Partnersip (LP)*

Registered Domestic Partnersip

Oter (describe)

(Registered to practice law, accounting or architecture)

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)

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

36. TyPE OF BUSINESS (check one that best describes your business) 37. NUMBER OF SELLING LOCATIONS

Retail wolesale Mfg. Repair Service Construction Contractor Leasing

38. whAT ITEMS wILL yOU SELL? 39. ChECK ONE

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?

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)

www.

___ ___ - ___ ___ ___ ___ ___ ___$

(continued on reverse)

$

___ / ___ / ___

53. SELLING NEw TIRES? 54. SELLING COVERED ELECTRONIC DEVICES? 55. SELLING TOBACCO AT RETAIL?

yes No yes No yes No

CHECK ONE Oner/Co-Oners Partners Registered Domestic Corp. Ofcers LLC Ofcers/Managers/ Trustees/

Partners Members BeneciariesUse additional sheets to include information for more than three individuals.

* Must provide partnership agreement

VERIFICATION

RETURN TyPE

DATEPROCESSED By PERMITISSUE (1) 401-A (2) 401-EZ


( )

Full Time Part Time

( )

( )

( )

( )

( )

( )

( )

( )

yes No

18. FULL NAME OF ADDITIONAL PARTNER, OFFICER, OR MEMBER (first, middle, last) 19. TITLE



27. FULL NAME OF ADDITIONAL PARTNER, OFFICER, OR MEMBER (first, middle, last) 28. TITLE




(if 2 or more, see Item No. 66)

husband/wife Co-onersip

Limited Liability Company (LLC)

Unincorporated Business Trust

Limited Liability Partnersip (LLP)*


6/8

70. FORMER OwNERS NAME 71. SELLERS PERMIT NUMBER

72. PURChASE PRICE 73. VALUE OF FIXTURES & EQUIPMENT

74. IF AN ESCROw COMPANy IS REQUESTING A TAX CLEARANCE ON yOUR BEhALF, PLEASE LIST ThEIR NAME, ADDRESS, TELEPhONE NUMBER, AND ThE ESCROw NUMBER

BOE-400-SPA REV. 1 (BACK) (7-05)

All Corporate Ofcers, LLC Manain Members, Partners, or Oners must sin belo.

I am dul autorized to sign te application and certif tat te statements made are correct to te best of m knoledge and belief.

I also represent and acknoledge tat te applicant ill be engaged in or conduct business as a seller of tangible personal propert.

TEMPORARY PERMIT EvENT INFORMATION

CERTIFICATION

NAME (typed or printed) SIGNATURE DATE

FOR BOARD USE ONLY

FORMS

BOE-8 BOE-400-y

BOE-162 BOE-519

BOE-467 BOE-1241-D

REGULATIONS

REG. 1668 REG. 1698

REG. 1700

PUBLICATIONS

PUB 73 PUB DE 44

RETURNS

SECURITy REVIEw

BOE-598 ($ ) or BOE-1009

REQUIRED By APPROVED By



OwNERSHIP AND ORgANIzATIONAL CHANgES (Do Not Complete for Temporary Permits)

75. PERIOD OF SALES 76. ESTIMATED EVENT SALES 77. SPACE RENTAL COST (if any) 78. ADMISSION ChARGED?

79. ORGANIZER OR PROMOTER OF EVENT (if any) 80. ADDRESS (street, city, state, zip code) 81. TELEPhONE NUMBER

82. ADDRESS OF EVENT (If more than one, use line 66, above. Attach separate list, if required.)

( )

FROM: ThROUGh: yes No$

$$

56. NAME OF PERSON MAINTAINING yOUR RECORDS 57. ADDRESS (street, city, state, zip code) 58. TELEPhONE NUMBER

59. NAME OF BANK OR OThER FINANCIAL INSTITUTION (note whether business or personal) 60. BANK BRANCh LOCATION

61. NAME OF MERChANT CREDIT CARD PROCESSOR (if you accept credit cards) 62. MERChANT CARD ACCOUNT NUMBER

63. NAMES OF MAJOR CALIFORNIA-BASED SUPPLIERS 64. ADDRESSES (street, city, state, zip code) 65. PRODUCTS PURChASED

___ / ___ / ______ / ___ / ___ $

66. PhySICAL LOCATION OR STREET ADDRESS (attach separate list, if required)

ADDITIONAL SELLINg LOCATIONS (List All Other Sellin Locations)

67. ARE yOU BUyING AN EXISTING BUSINESS?

yes No If es, complete items 70 troug 74.

68. ARE yOU ChANGING FROM ONE TyPE OF BUSINESS ORGANIZATION TO ANOThER (FOR EXAMPLE, FROM A SOLE OwNER TO A CORPORATION OR FROM A PARTNERShIP TO A

LIMITED LIABILITy COMPANy, ETC.)?

yes No If es, complete items 70 and 71.

69. OThER OwNERShIP ChANGES (please describe):

( )

CLEAR PRINT


7/8

7

S Pm App


informationcenter

800-400-7115

for tdd assistance

From TDD phones: 800-735-99

From voice phones: 800-735-9

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taxpayers rights

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916-33-3319.

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z; Txpy Rgh Av, MIC:70; PO Bx

94879; Sm, CA 9479-0070.

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9479-0044.


8/8

BOE-324-SUT REV. 2 (2-05)

Sales and Use Tax Privacy Notice

Information Proided to the Board of Equaliation

we ask ou for information so tat e can administerte states sales and use tax las (Revenue and Taxa-tion Code sections 6001-7176, 7200-7226, 7251-7279.6,7285-7288.6). we ill use te information to determineeter ou are paing te correct amount of tax andto collect an amounts ou oe. you must provide all ofte information e request, including our social securitnumber (used for identication purposes [see Title 42U.S. Code sec.405(c)(2)(C)(i)]).

what happens if I dont proide the information?

If our application is incomplete, e ma not issue oursellers permit or use tax certicate. If ou do not lecomplete returns, ou ma ave to pa penalties and

interest. Penalties ma also appl if ou dont provideoter information e request or tat is required b la, orif ou give us fraudulent information. In some cases, ouma be subject to criminal prosecution.

In addition, if ou dont provide information e request tosupport our exemptions, credits, exclusions, or adjust-ments, e ma not allo tem. you ma end up oingmore tax or receiving a smaller refund.

Can anyone else see my information?

your records are covered b state las tat protect ourprivac. hoever, e ma sare information regarding

our account it certain government agencies. we maalso sare certain information it companies autorizedto represent local governments.

Under some circumstances e ma release to te publicte information printed on our permit, account start andcloseout dates, and names of business oners or part-ners. wen ou sell a business, e can give te buer oroter involved parties information regarding our out-standing tax liabilit.

wit our ritten permission, e can release informationregarding our account to anone ou designate.

we may disclose information to the proper ofcialsof the folloin aencies, amon others:

United States government agencies: U.S. AttornesOfce; Bureau of Alcool, Tobacco and Firearms;Depts. of Agriculture, Defense, and Justice; FederalBureau of Investigation; General Accounting Ofce;Internal Revenue Service; Interstate CommerceCommission

State of California government agencies andofcials: Air Resources Board; Dept. of AlcoolicBeverage Control; Auctioneer Commission; Dept. ofMotor Veicles; Emploment Development Depart-ment; Energ Commission; Exposition and Fairs;Dept. of Food and Agriculture; Board of Forestr;Forest Products Commission; Francise Tax Board;Dept. of healt Services; higa Patrol; Dept. ofhousing and Communit Development; CaliforniaParent Locator Service

State agencies outside of California for tax enforce-ment purposes

Cit attornes and cit prosecutors; count districtattornes, police and seriff departments.

Can I reie my records?

yes. Please contact our closest Board ofce (see teite pages of our pone book). If ou need moreinformation, ou ma contact our Disclosure Ofcer inSacramento b calling 916-445-2918. you ma alsoant to obtain publication 58-A, How To Inspect andCorrect Your Records. you ma donload it from teInternet: www.boe.ca.gov(look under Forms, Pub-lications, Reports & Nes) or order a cop from ourInformation Center at 800-400-7115.

who is responsible for maintainin my records?

Te deput director of te Sales and Use Tax Depart-ment, om ou ma contact b calling 916-445-6464 orriting to te address son.

Deput DirectorSales and Use Tax Department MIC:43450 N StreetSacramento, CA 95814

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