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Form BOE-356 Fillable Cigarette Distributor's Application for Deferred Payment Option
(all forms fillable on Windows, Mac, Android tablets, and iPad using Adobe Reader XI)(AMOUNT OF DEFERRED CREDIT REQUESTED $) (BUSINESS NAME) (CIGARETTE DISTRIBUTOR EMAIL ADDRESS (email address of designated person responsible for payment processing)) (CLEAR) CLEAR (CONTACT TELEPHONE NUMBER ) (CONTACT TELEPHONE NUMBER AREA CODE ( )) (DATE) (NAME AND TITLE OF DISTRIBUTOR'S PRINCIPAL OWNER OR AUTHORIZED REPRESENTATIVE) (PRINT) PRINT A binding irrevocable letter of credit obtained through your bank or financial institution to guarantee payment Form accordance with section 30168 of the Cigarette and Tobacco Products Tax Law AMOUNT OF DEFERRED CREDIT REQUESTED APPLICATION FOR DEFERRED PAYMENT OPTION Attn: Stamp Desk MIC:41 Automatically renewable accounts held in federally insured savings institutions located in California The account based on the designated option chosen above for a period of at least one year from the date the election is made in BOARD OF EQUALIZATION BOE 356 REV 3 (6 13) BOE 487 DCB Irrevocable Letter of Credit must be submitted to the BOE BUSINESS NAME CIGARETTE DISTRIBUTOR EMAIL ADDRESS (email address of designated person responsible for payment processing) CIGARETTE DISTRIBUTOR S Cigarette distributor voluntarily and freely elects to make deferred payments for purchases of cigarette tax stamps CONTACT TELEPHONE NUMBER CR STF 02( Depending on the payment option selected a security deposit may be required Acceptable types of security deposits DEPOSIT ACCOUNTS DISTRIBUTOR PERMIT NUMBER DISTRIBUTOR PERMIT NUMBER CR STF 02 ) Fact for the Surety must be submitted Funds held by the Board of Equalization (BOE) include: Insurers issue bonds as evidence of a surety policy Approved bond forms with an original signature of the Attorneyin is held in the name of the BOE unless an assignment form accompanies the evidence of deposit Original evidence LETTER OF CREDIT Mail to: Monthly payment Twice Monthly payment NAME AND TITLE OF DISTRIBUTOR S PRINCIPAL OWNER OR AUTHORIZED REPRESENTATIVE Note to signatory: If you are not a corporate officer partner or owner this signature certifies under penalty of perjury of deposit such as certificate passbook or deposit receipt (when a certificate or passbook is not issued) must be On behalf of the above distributor the undersigned certifies the following: PAYMENT OPTION (please check only one) payments If your selection is not approved you will be notified in writing For more information visit the BOE website at PO Box 942879 Sacramento CA 94279 0041 SIGNATURE OF DISTRIBUTOR S PRINCIPAL OWNER OR AUTHORIZED REPRESENTATIVE Special Taxes Policy and Compliance Division stamps STATE AND FEDERAL CREDIT UNION SHARES STATE BOARD OF EQUALIZATION STATE OF CALIFORNIA submitted to the BOE as support of the deposit SURETY BONDS that you hold power of attorney to authorize permission to elect a deferred payment option for purchasing cigarette tax The California Credit Union League will print and provide the necessary assignment forms Upon approval of this application you will be notified in writing of the credit limit and effective start date for your deferred Weekly payment without a security deposit Weekly payment with a security deposit www boe ca gov You may also call the Taxpayer Information Section at 1 800 400 7115 (TTY:711)