Free Registration Information for Out-of-State Account - California

BOE-403-B FRONT REV. 3 (11-92)

STATE OF CALIFORNIA

REGISTRATION INFORMATION FOR OUT-OF-STATE ACCOUNT

BOARD OF EQUALIZATION ACCOUNT NO. ___________________________ DATE ___________________________________

1. 2. 3. 4.

OWNER ________________________________________________________________________________________________ STATE OF INCORPORATION, IF APPLICABLE _________________________________ FEIN NO: ______________________ PARENT CORPORATION, IF ANY _______________________________________ STATE OF INCORPORATION __________ Names and addresses of related companies doing business in California:

5.

Out-of-State Location of Records ____________________________________________________________________________ CHECK 1 BOX ONLY: Out-of-State Records maintained at our facility. Out-of-State Records maintained at independent accountant's office, not at our own facility. Accountant's Name __________________________________________ Telephone No. ( ) __________________________

Accountant's Address _____________________________________________________________________________________ 6. ANNUAL SALES IN CALIFORNIA Gross Sales ___________________________________________ Taxable Sales _____________________________________ CALIFORNIA LOCATIONS (Address)
FUNCTION (Warehouse, Service, etc.) TELEPHONE NUMBER INVENTORY SALES NEGOTIATED FROM LOCATION

7.

Yes No Yes No (A) ____________________________________________________________________________________________________ Yes No Yes No (B) ____________________________________________________________________________________________________ Yes No Yes No (C) ____________________________________________________________________________________________________

8.

INDEPENDENT SALES REPRESENTATIVES IN CALIFORNIA: Name and Address (Complete List) (A) __________________________________________________________________________ (B) __________________________________________________________________________ (C) __________________________________________________________________________

TELEPHONE NUMBER ( ) _______________________ ( ) _______________________ ( ) _______________________

9.

LIST OF PRINCIPAL CALIFORNIA CUSTOMERS (Names & Complete Addresses; Attach Additional Sheets if Necessary): (A) ____________________________________________________________________________________________________ (B) ____________________________________________________________________________________________________ (C) ____________________________________________________________________________________________________ (D) ____________________________________________________________________________________________________

10. PRINCIPAL SUPPLIERS (Names & Addresses)

(See Reverse)

BOE-403-B BACK REV. 3 (11-92)

11. Corporations: Please attach your latest financial statements. 12. Real Estate Owned: (Anywhere in the United States)
ADDRESS CURRENT VALUE BALANCE DUE PAYMENTS MADE TO

13. Are you a lessor or lessee of equipment situated or used in California? Yes, as a lessor Yes, as a lessee No

14. Do you lease or license computer software located in California? Yes No Yes No

15. Do you perform construction contracts in California? Type of contracts: Lump Sum Time and Material Yes

Cost plus a fee No Yes Yes No No

Are all materials purchased California tax paid?

16. Do you sell and install machinery, fixtures or equipment? 17. Do you make sales to ultimate consumers in California?

18. Do salespersons, solicitors, independent contractors, or manufacturers' agents based in, or traveling into California, solicit orders or provide assistance to customers on behalf of your company? Yes No. If your answer is yes, please list these persons on line 20 indicating their name, address and date started. 19. Please check the different advertising media you use to reach California customers. Local/regional newspapers Cable television National newspapers and magazines Telemarketing Direct mail

Radio/non-cable TV

Television shopping systems Yellow pages

Trade shows/fairs

Catalogs placed in outlets

If none of the above, please indicate how you solicit California sales:

20. Additional remarks:

Prepared by: _______________________________________________________ Title : __________________________________ ( ) Telephone number _____________________________________________

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