Free California Cigarette Tax Stamp Purchase Order - California

BOE-663-ACTS (FRONT) REV. 3 (3-08)

STATE OF CALIFORNIA

CALIFORNIA CIGARETTE TAX STAMP PURCHASE ORDER

BOARD OF EQUALIZATION

Please print or type - Instructions are available on the reverse of this form
DATE

DISTRIBUTOR'S ACCOUNT NUMBER

BOE USE ONLY Alternative Cigarette Tax Stamp Program MIC:41
DATE ENTERED

CR ET 02DISTRIBUTOR'S NAME

ENTERED BY

BUSINESS ADDRESS (city, state, zip code)

ORDER NUMBER

ORDER FORM INSTRUCTIONS
A STAMP DESCRIPTION B C ROLL QUANTITY D VALUE PER ROLL E TAX VALUE
(C X D)

1. Large Roll of 20 denomination (For high volume stamp machine) 2. Small Roll of 20 denomination (For low volume stamp machine) 3. Small Roll of 10 denomination (For low volume stamp machine) 4. Small Roll of 25 denomination (For low volume stamp machine)

30,000 stamps per roll valued at $0.87 for each stamp 1,200 stamps per roll valued at $0.87 for each stamp 1,200 stamps per roll valued at $0.435 for each stamp 1,200 stamps per roll valued at $1.0875 for each stamp

$ 26,100 $ 1,044 $ 522

$ 1,305

5. 6. 7.

Total Tax Value This Order Less Discount (0.0085 of line 5) Amount of order (Line 5, less line 6)

$

SHIPPING OPTIONS (see instructions on reverse) Standard
PRINT NAME

Expedite
USER ID NUMBER

AUTHORIZED SIGNATURE

TELEPHONE NUMBER

(

)

CRS1
CLEAR
PRINT

BOE-663-ACTS (BACK) REV. 3 (3-08)

INSTRUCTIONS CALIFORNIA CIGARETTE TAX STAMP PURCHASE ORDER
Application BOE-400-ACTS to authorize a person to order stamps must be submitted before ordering stamps.

GENERAL INSTRUCTIONS · Enterthedatethecigarettetaxstamporderisbeingsubmitted. · EntertheCaliforniadistributor'saccountnumberforwhichcigarettetaxstampsarebeingordered. · EntertheCaliforniadistributor'snameandaddressforwhichcigarettetaxstampsarebeingordered. Please note: The cigarette tax stamps will be delivered to the registered business address of the California distributor account. ORDER FORM INSTRUCTIONS Lines 1-4, Column C. Enterthequantityofcigarettetaxstamprollstobeordered. Lines 1-4, Column E. Line 5, Column E. Line 6, Column E. Line 7, Column E. Enterthetaxvalueofthecigarettetaxstampsorderedbymultiplyingthequantity (columnC)withthevalueperroll(columnD). Add lines 1 through 4 to calculate the total tax value of the cigarette tax stamp order. Calculatethediscountbymultiplying.0085withline5. Subtractline6fromline5tocalculatetheamountofthecigarettetaxstamporder.

Please review your order.Ifyouordertheincorrectrollsizeordenomination,youwillhavetosubmitaclaimforrefund whichmaytakeaminimumof6to8weekstoprocess. Signature Block.TheauthorizedpersonMUSTcompletethesignatureblockareabysigningandprintinghisorhername, enterhisorheruserID,andprovideaphonenumber. Payment Instructions.SubmityourpaymenttoBankofAmerica. NOTICE TO DISTRIBUTORS Ifpurchasingcigarettetaxstampsonadeferredpaymentplan,purchasesmustbepaidinfullbytheduedatespecifiedin yourdeferredpaymentplan.Underaweeklypaymentplan,paymentisduebyWednesdayoftheweekafterstampswere purchased.Underatwice-monthlypaymentplan,thefirstpaymentisduebythe5thofthefollowingmonthintheamount ofeitherone-halfofthetotalpriormonth'spurchase,orthetotalamountofthepriormonth'spurchasesmadebetween the1stand15thofthepriormonth,whicheverisgreater.Thesecondmonthlypayment(anybalanceremainingafterfirst payment) is dueby the 25th ofthe following month.Underamonthlypaymentplan,paymentisdueby the25thofthe followingmonth. Apenaltyoftenpercentoftheamountdueplusinterestwillbechargedforlatepayments(RevenueandTaxationCode section30171).TheBoardofEqualizationmaysuspend,withoutpriornotice,adistributor'sprivilegetopurchasestampson thedeferredpaymentbasisormayreducetheamountofpermissibledeferredpaymentpurchasesfixedforthedistributorif thedistributorfailstopromptlypayforstampswhenpaymentisdue(RevenueandTaxationCodesection30170).Deferred paymentscannotbeextendedforlongerperiods,orforamountsinexcessofthelimitssetbytheBoardofEqualization. ORDERING INSTRUCTIONS Youmayfaxyourstamporderto916-327-6235.Toensureyourstamporderwasreceived,pleasecalltheStampDeskat 916-341-6923. SHIPPING OPTIONS Thecigarettetaxstampswillbeshippeddirectlyfromthestampmanufacturer.Youmustselectoneofthetwoshipping optionsavailable.Onlyoneshippingoptionperpurchaseorderisallowed.Ifyourequireshippingviabothmethods,you mustsubmitaseparatepurchaseorderforeach.Ifnooptionisselected,thestampswillbeshippedusingthestandard shipping option. Standard Option.Allrollsonthepurchaseorderformwillarrivewithinthreebusinessdaysofshipping.Thereisnoadditional charge for this option. Expedited Option.Allrollsonthepurchaseorderformwillarrivewithinonebusinessdayofshipping.There is an additional charge for this option.Theadditionalchargewillbebilledtoyouseparatelyandispayabletothestampmanufacturer, Meyercord. Please contact the manufacturer at 630-682-6200 for the expedited shipping charge for your area. Retain this document for your records.