Free California Excise Taxes Permit Application Corporation, Limited Liability Company (LLC), or Organization - California


File Size: 701.2 kB
Pages: 8
Date: January 30, 2009
File Format: PDF
State: California
Category: Tax Forms
Author: Excise Taxes Division
Word Count: 2,717 Words, 21,092 Characters
Page Size: Letter (8 1/2" x 11")
URL

http://www.boe.ca.gov/pdf/boe400etc.pdf

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Preview California Excise Taxes Permit Application Corporation, Limited Liability Company (LLC), or Organization
California Excise Taxes Permit Application
CorPorATion, LimiTEd LiAbiLiTy ComPAny (LLC), or orgAnizATion

boE400ETC rEv. 6 (109)

of

State Board equalization
Board MeMBerS
BETTY T. YEE San Francisco First District

BILL LEONARD Ontario/Sacramento Second District MICHELLE STEEL Rolling Hills Estates Third District JUDY CHU, Ph.D. Los Angeles Fourth District JOHN CHIANG State Controller EXECUTIvE DIRECTOR Ramon J. Hirsig

2

Frequently Asked Questions

What types of excise tax permits can I apply for using this form?
You can use this form to apply for a permit from the State Board of Equalization (BOE) for one of the following excise tax programs: Cigarette and Tobacco Products Tax Alcoholic Beverage Tax Emergency Telephone Users Surcharge Energy Resources Surcharge Natural Gas Surcharge

What are my responsibilities as the holder of an excise tax permit?
You must file applications for registration, applications for permits or licenses, and tax or fee returns or reports. The Califor niaRevenueandTaxationCode,Division 2, parts 13 (Cigarette and Tobacco Products Tax),14(AlcoholicBeverageTax),19(Energy ResourcesSurcharge),20(EmergencyTelephone UsersSurcharge),and30(NaturalGasSur chargeunderCaliforniaPublicUtilitiesCode, Division1,part1),requirepersonsmeeting certainrequirementstofileapplicationsfor registration, applications for permits, and tax returns or reports in a form prescribed by the BOE. You must furnish all the required information requested on applications for registration, tax returns, and other related reports. Ifyoudo notprovidetheinformationrequiredonthe application form, we may not be able to register youorissueyourpermit.Inaddition,thelaw providespenaltiesforfailuretofileareturn; failuretofurnishspecific,requiredinformation; andforfurnishingfraudulentinformation. You must notify us if you move, sell, or change ownership of your business.Yourpermitis validonlyforthetypeofownershipspecified onit.Youshouldnotifyusofanychangein ownership.Ifyoudonot,youcouldbeheld liableforthecontinuingbusiness'staxes.You should also notify us immediately, in writing, if youdiscontinueyourbusiness.Promptnotifica tion will help us close your account and return anysecurityyoumayhavedeposited. You must provide identification numbers. Youarerequiredtoprovidecertainidenti ficationnumberstoensuretheaccuracyof informationprovidedandtoprotectyou againstfraudulentuseofyouridentification numbers. See the disclosure information on the back page of this packet.

Is there a charge for a permit?
No. However, if you are applying for a Cigarette and Tobacco Products permit, you will be required to post a security deposit of at least $1,000.Securitymayalsoberequiredforother typesofpermits.

Will I need to apply for any other permits?
You may need to obtain a seller's permit before wecanissueyourexcisetaxpermit.Ifyousell cigarettes and/or tobacco products, you must obtain a license under the Cigarette and Tobacco ProductsLicensingActof2003.Formoreinfor mation,callourTaxpayerInformationSectionat 8004007115(seepage7).Businessesthatplan tosellalcoholicbeveragesmustalsoobtaina licensefromtheDepartmentofAlcoholicBeverage Control.

Is the information on my application available to the public?
Yourrecordsaregenerallycoveredbystatelaws thatprotectyourprivacy.However,somerecords are subject to public disclosure, such as the infor mation printed on your permit, names of owners or partners, your business address, and your per mitstatus.Seealsothedisclosureinformationon thebackpage.

Why do you need to verify my driver license number?
Weneedthisverificationtoensuretheaccuracy oftheinformationyouprovideandtoprotect youagainstfraudulentuseofyouridentification numbers.

Excise Tax Permit Application Corporations, Limited Liability Companies, and Organizations January 2009

3

How do I apply for an excise tax permit?
Step 1: Make sure you have the documents you need to send with your application

Message from the
Executive Director

We appreciate the fact that as the operator of a busi ness, youare busy andhave many responsibilities. Youare responsible for income tax payments and for a variety of other obligations, such as payroll taxes, insurance, and employee benefits.
For thatreason, we want to
make it as easy as possible for you to work withus.As you can see on page 7, we provide manyservices to helpyou with your questions. If you are unable to find the answers you need, please call our Taxpayer Information Section. Our trained represen tatives will be glad to help.

You will need to send us photocopies of certain documents with your application. Please read the short checklist in the shaded box on the next page. If you don't have the documents you need, please call our Taxpayer Information Section at 8004007115 (listen for"othertaxes" and "excise taxes").

Step 2: Complete your application
Fill out the application on page 5 (perforated for easy removal). Be sure to refer to the "Tips" on page 4 and complete both sides. If you need help with the form or have questions,please call our Taxpayer Information Section.

Step 3: Send in application and support documents for processing
Makeacopyofyourcompletedapplicationforyourfiles,thenmail theoriginalapplicationto:ExciseTaxesDivision;StateBoardof Equalization;P.O.Box942879;Sacramento,California942790056. Please be sure to sign and date your application and to include copiesofallrequireddocuments.Wecannotprocessyourapplication untilitiscomplete.

Step 4: After we review your application
Wewillreviewyourapplicationandletyouknowifyoumustmake asecuritydeposit.Afterthepermitapplicationandanyrequired securityareapproved,wewillregisteryouandsendyoucopiesof pertinent forms. Thereisnochargeforthepermit.

Step 5: Filing tax or fee returns
Wewillletyouknowwhetheryoumustfilereturnsonamonthly, quarterly,orannualbasis.Youmustfileareturnevenifyoudonot oweanytaxorfeeamountsforthereportingperiod.Ifyouwould liketomakeallofyourtaxorfeepaymentsbyElectronicFunds Transfer(EFT),pleasecall9163274208.

Excise Tax Permit Application Corporations, Limited Liability Companies, and Organizations January 2009

4

Tips for Completing Your Application
taxpayer information section

Please write or print neatly. Be sure to complete both sides of the form and to sign and date it.

800-400-7115
TDD/TTY 800-735-2929

Type of application
Checktheboxforthetypeofpermityouwishtoobtain.

required documents

Section I: Ownership information
Items 1 through 9: Ownership information Checkyourtypeofownershipandprovidenamesandpersonal informationfortheofficers,LLCmembers,managers,etc.Ifthere aremorethanfourofficersorprincipals,pleaseprovideadditional informationonaseparatesheetofpaper.CorporationsandLLCs mustentertheircorporationnumberandstateofincorporation.See requireddocumentlistatleft. Item 9: Driver license Youmustprovidethisinformationandcopiesofspecifieddocu ments,aslistedatleft,forallofficers,LLCmembers,managers,etc.

You must include photocopies of the following documents with your completed and signed application form:
Copy of corporate articles of incorporation or LLC charter. Document indicating that the person signing your applica tion is authorized to do so (see"SectionIV:Certifica tion"atright). For officers, members, etc., listed on the application: DriverlicenseorstateID card. For out-of-state or foreign corpora tions or LLCs: Certificate of Qualification issued by the California SecretaryofState.

Section II: Business information
Item 2: Business address Entertheaddressofyourphysicallocationhere.DonotenteraPost OfficeBox,mailingservice,oranagentorbookkeeperaddress. Items 6 and 7: Ownership changes Ifyouarechangingfromonetypeofbusinessorganizationtoanother (for example, from a sole owner to a corporation or from a partner shiptoalimitedliabilitycompany),providethepreviousowner's
nameandexcisetaxpermitnumber.
Ifyoupurchasedanexistingbusiness,weneedtoknowtheprevious
owner'snameandexcisetaxpermitnumber.


You may also wish to include the following:
Power of Attorney form, (BOE-392), if you wish to designate someone to act on yourbehalf.Youmayobtain acopyfromourInternetsite orTaxpayerInformationSec tion(seepage7).

Section III: Requirements by category
Be sure to fully complete the section that applies to the type of per mityouwishtoobtain.

Section IV: Certification
A corporate or organization officer or LLC member or manager who is authorized to act for your business, or an authorized agent, must sign. Corporations must attach a corporate resolution authorizing the officer to sign. LLCs must attach the articles of organization which indicate whether a manager can sign or whether members have authority to actfor the LLC.Ifan agent signs, you must attach a properly completed power of attorney form or document (see shaded box at left).

Excise Tax Permit Application Corporations, Limited Liability Companies, and Organizations January 2009

BOE-400-ETC (FRONT) REv. 6 (1-09)

STATE OF CALIFORNIA

appLication for reGiStration -- eXciSe taXeS (corporation/LimiteD LiaBiLitY companY (LLc)/orGaniZation)
CIGARETTE AND TOBACCO PRODUCTS TAX LAW ALCOHOLIC BEvERAGE TAX LAW EMERGENCY TELEPHONE USERS SURCHARGE LAW ENERGY RESOURCES SURCHARGE LAW

BOARD OF EQUALIZATION
NATURAL GAS SURCHARGE LAW

Section i: ownerShip information
1. PLEASE CHECK TYPE OF OWNERSHIP

for Boe uSe onLY
Photocopy of driver license is required
taX office numBer

Corporation Other

Limited Liability Company (LLC)

et

2. ENTER FULL CORPORATE, LIMITED LIABILITY COMPANY (LLC), OR ORGANIZATION NAME

3. FEDERAL EMPLOYER IDENTIFICATION NUMBER (FEIN)

4. CALIFORNIA CORPORATE OR LLC NUMBER/STATE OF INCORPORATION OR ORGANIZATION

Each owner, corporate officer, or principal must complete lines 5 through 9.
If needed, please attach additional sheet(s) to provide the information requested in this application.

(CHECK APPROPRIATE TITLE) 5. FULL NAME (first, middle, last) 6. RESIDENCE ADDRESS (enter full address including zip code) 7. TELEPHONE NO. (residence) 8. DAYTIME TELEPHONE NO. 9. DRIvER LICENSE NO., STATE OF ISSUE, AND DATE OF BIRTH

President Manager Member Trustee Beneficiary

vice President Manager Secretary Manager Member Trustee Member Trustee Beneficiary Beneficiary

Treasurer Manager Member Trustee Beneficiary

-- tear at perforation --

( (

) )

( (

) )

( (

) )

( (

) )

Section ii: BuSineSS information
1. BUSINESS OR TRADE NAME (DBA, if any) BUSINESS TELEPHONE NUMBER

(
2. BUSINESS ADDRESS (do not list P.O. Box or mailing service) 3. MAILING ADDRESS (if different from No. 2 above) 4. DATE STARTED IN CALIFORNIA (month, day, year) 6. ARE YOU 5. DAYS AND HOURS OF OPERATION CITY CITY SUN. MON. TUE. WED. STATE STATE

)
ZIP CODE ZIP CODE FRI. SAT.

THURS.

Starting a new business?
7.

Making Internet Sales?

Website Address (http) Other

Incorporating an existing sole proprietorship or partnership?

Buying a business? (if applicable, please indicate name of former owner and account number)
8. NAME OF BOOKKEEPER/ACCOUNTANT 9. REAL ESTATE OWNED BY CORPORATION -- DESCRIPTION/ADDRESS ADDRESS TELEPHONE NUMBER

(

)

10. NAMES OF CORPORATE BANKS, SAvINGS AND LOANS, CREDIT UNIONS

ADDRESS

ACCOUNT NUMBER

TYPE OF ACCOUNT

11. PARENT CORPORATION (if any)

ADDRESS

12. OTHER ACCOUNT NUMBERS ISSUED TO YOU BY THE BOE 13. BUSINESS RECORDS WILL BE MAINTAINED AT

(Continued on reverse)

BOE-400-ETC (BACK) REv. 6 (1-09)

Section iii: reQuirementS BY cateGorY (complete only the category that pertains to the respective license/permit for which you are applying) ciGarette anD toBacco proDuctS taX Law information reQuireD
1. NATURE OF BUSINESS

a.

Cigarette manufacturer Within California Outside California

d. e. f. g.

Cooperative association vending machine operator: Number of cigarette machines Common carrier Persons authorized to sell cigarettes on common carriers

h. i. j. k.

Cigarette wholesaler



Tobacco products distributor Tobacco products wholesaler Tobacco manufacturer Within California Outside California

b. c.

Cigarette distributor Chain store

l.
2. SOURCE OF CIGARETTE/TOBACCO PRODUCTS SUPPLY (check applicable source)

Tobacco importer

Manufacturers' warehouse stock in California Manufactured in California
3. NAME OF MAJOR SUPPLIERS ADDRESS

Licensed wholesalers Licensed distributors

Imported direct from other states Imported direct from outside the country
PRODUCTS PURCHASED

4. WILL YOU BE STORING ALL OF YOUR CIGARETTE AND TOBACCO PRODUCTS AT YOUR BUSINESS LOCATION?



Yes

No

If no, list all of your additional storage locations (attach additional page if necessary)

emerGencY teLephone uSerS SurcharGe information reQuireD
1. CERTIFICATE OF PUBLIC CONvENIENCE NUMBER (ISSUED BY CA PUBLIC UTILITIES COMMISSION)

U __________ C
2. BILLING AGENT (if applicable)

3. TYPE(S) OF SERvICE OFFERED (check all that apply)

Local exchange Other (please explain)

Long distance

Long distance reseller

Cellular

vOIP

Billing Aggregator

enerGY reSourceS SurcharGe information reQuireD
1. Will you be generating and reselling electrical energy? 3. Other (please explain) Yes No Yes No

2. Will you be purchasing electrical energy without the State Energy Surcharge from the federal government?

naturaL GaS SurcharGe information reQuireD
1. Currently registered with Public Utility Commission (PUC) Number Public Utility Gas Corporation Federal Energy Regulatory Commission (FERC) Number Interstate Pipeline Consumer

2. Type of natural gas purchaser

Section iV: certification
I hereby certify that the statements contained in this application are correct to the best of my knowledge and belief, and that I am duly authorized to sign this application as an officer of this corporation, LLC, or organization.
SIGNATURE TITLE

NAME (type or print)

DATE

for Boe uSe onLY
REPORTING BASIS

furnIshEd to applIcant
returnS/formS Pamphlet 4 Pamphlet 5 Pamphlet 10 Pamphlet 11 Pamphlet 15



SECURITY

RECEIvED BY

APPROvED BY REMOTE INPUT DATE BY DATE

Pamphlet 16 Pamphlet 20 Pamphlet 39



PERMIT/LICENSE ISSUED

CLEAR

PRINT

7

Where can I get help?
Youmayhavequestionsabouthowtheexcisetaxlawsapplytoyourbusinessoperations.
Forassistance,pleasetakeadvantageoftheresourceslistedbelow.


website

taxpayer information section

www.boe.ca.gov
Our website includes lots of useful information. You can download publications such as laws, regulations, pamphlets, and policy manuals that will help you understand how the law applies toyour operations.You canalso read about upcoming Taxpayers' Bill of Rights hear ings and other Boardmeetings.
written tax advice

800-400-7115
TDD/TTY 800-735-2929

Customerservicerepresentativesareavail ablefrom8a.m.through5p.m.,Pacifictime MondayFriday,exceptstateholidays. Faxback Service.Call8004007115toorderfax copiesofselectedformsandnotices.Choosethe automatedservicesfaxoption.Thisserviceis available24hoursaday. Translator Services.Wecanprovidebilingual servicesforpersonswhoneedassistanceina languageotherthanEnglish.
taxpayers' rights advocate office

It is best to get tax advice from us in writing. You may be relieved of tax,penalty, or interest charges if we determine you did not correctly report tax because you reasonably relied on our written advice regarding a specificsituation.For this relief to apply, your request for advicemust be in writing, identify the taxpayer to whom the advice applies, and fully describe the facts and circumstances of the situation. This protection is not available for advice we give in person or over the phone. Send your request for written adviceto: Excise Taxes Division State Board of Equalization PO Box 942879 SacramentoCA 942790056

Ifyouwouldliketoknowmoreaboutyour rights as a taxpayer or if you are unable to resolveanissuewithus,pleasecontactthe Taxpayers'RightsAdvocateOfficeforhelpat 9163242798(ortollfree,8883242798).Their faxnumberis9163233319. Ifyouprefer,youcanwriteto: Taxpayers'RightsAdvocateOffice State Board of Equalization PO Box 942879 Sacramento CA 94279-0070 To obtain a copy of publication 70, Understand ing Your Rights as a California Taxpayer, please visitourwebsiteorcallourTaxpayerInforma tionSection.

Excise Tax Permit Application Corporations, Limited Liability Companies, and Organizations January 2009

8
California ExCisE TaxEs PErmiT aPPliCaTion PrivaCy noTiCE
information provided to the Board of equalization
We ask you for information so that we can administer the state's tax and fee laws. We will use the information to determine whether you are paying the correct amount of tax or fees and to collect any amounts you owe. You must provide all of the information we request, including your social security number (used for identification purposes [see Title 42 U.S. Code sec. 405(c)(2)(C)(i)]). what happens if i don't provide the information? If your application is incomplete, we may not issue your per mit, certificate, or license. If you do not file complete returns, you may have to pay penalties and interest. Penalties may also apply if you don't provide other information we request or that is required by law, or if you give us fraudulent informa tion. In some cases, you may be subject to criminal prosecu tion. In addition, if you don't provide information we request to sup port your exemptions, credits, exclusions, or adjustments, we may not allow them. You may end up owing more tax or fees or receiving a smaller refund. can anyone else see my information? Your records are covered by state laws that protect your privacy. However, we may share information regarding your account with cer tain government agencies. We may also share certain information with companies authorized to represent local governments. Under some circumstances we may release to the public the information printed on your permit or license, account start and closeout dates, and names of business owners or partners. When you sell a business, we may give the buyer or other involved parties information regarding your outstanding tax liability. With your written permission, we can release information regarding your account to anyone you designate. can i review my records? Yes. Please contact your closest BOE office (see the white pages of your phone book). If you need more information, you may contact our Disclosure Officer in Sacramento by calling 916-445-2918. You may also want to obtain publication 58-A, How to Inspect and Correct Your Records. You may download it from the Internet at www.boe.ca.gov (look under "Forms & Publications") or order a copy from our Taxpayer Information Section by calling 800-400-7115. who is responsible for maintaining my records? The officials listed below are responsible for maintaining your records. You may contact them by calling 916-445-6464 or writing to them at the address shown below: excise taxes Division State Board of Equalization Deputy Director, Property and Special Taxes Department 450 N Street, MIC:63 Sacramento, CA 95814-0063 we must collect information in order to administer the state laws listed below. Code sections are from the California Revenue and Taxation Code unless otherwise noted. AlcoholicBeverageTax(sections32001-32557) CigaretteandTobaccoProductsTax(sections3000130482, Health and Safety Code sections 104555-104558) CigaretteandTobaccoProductsLicensingActof2003 (Business and Professions Code sections 22970-22995, Government Code section 15618.5, Penal Code section 830.11) EmergencyTelephoneUsersSurcharge(sections4100141176) EnergyResourcesSurcharge(sections40001-40216) NaturalGasSurcharge(sections55001-55381,Public Utilities Code sections 890-900) TaxonInsurers(sections12001-13170) we may disclose information to the proper officials of the following agencies, among others: UnitedStatesgovernmentagencies:U.S.Attorney's Office; Bureau of Alcohol, Tobacco and Firearms; Departments of Agriculture, Defense, and Justice; Federal Bureau of Investigation; General Accounting Office; Internal Revenue Service; Interstate Commerce Commission StateofCaliforniagovernmentagenciesandofficials: Air Resources Board; Department of Alcoholic Beverage Control; Department of Child Support Services; Depart ment of Consumer Affairs; State Controller's Office; Employment Development Department; Energy Commis sion; Department of Fish and Game; Department of Food and Agriculture; Forest Products Commission; Board of Forestry and Fire Protection; Franchise Tax Board; Department of Health Services; California Highway Patrol; Department of Housing and Community Development; Integrated Waste Management Board; State Lands Com mission; Department of Motor vehicles; California Public Utilities Commission; Department of Toxic Substances Control; State Water Resources Control Board StateagenciesoutsideofCaliforniafortaxenforcement purposes Cityattorneysandcityprosecutors;countydistrictattor neys, police and sheriff departments Anyagencyauthorizedtoenforcelocaltobaccocontrol ordinances

Excise Tax Permit Application Corporations, Limited Liability Companies, and Organizations January 2009