Form BOE-400-XML Fillable Application for Direct Transmission of Tax Returns

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Download Form BOE-400-XML

View all CA - California Sales, Use and Other Taxes

Electronic Return Originator (: Yes1) Unchecked (: Yes2) Unchecked (: Yes3) Unchecked (1 LEGAL NAME OF DIRECT TRANSMITTER) (2 BUSINESS NAME (if different from above)) (3 BUSINESS ADDRESS (street city state zip code)) (4 MAILING ADDRESS (if different than above; street or P O Box city state zip code)) (5 BUSINESS CONTACT INFORMATION (phone fax and email address)) (6 Contact Representative Name:) (9 NAME AND TITLE OF THE REPRESENTATIVE COMPLETING THIS FORM (type or print)) (916) 323 6353 8:00 a m through 5:00 p m (Pacific Time) Monday through Friday or by email at eDirect@boe ca gov (BOE Account Number:) (Business Name:) (CLEAR) CLEAR (DATE) (Email address:) (Name of Software Product:) (PRINT) PRINT (Telephone area code: ( )) (Telephone) (Test Web Address (if available)) (Title:) (Web Address) 1 LEGAL NAME OF DIRECT TRANSMITTER 10 SIGNATURE OF THE REPRESENTATIVE COMPLETING THIS FORM 2 BUSINESS NAME (if different from above) 3 BUSINESS ADDRESS (street city state zip code) 4 MAILING ADDRESS (if different than above; street or P O Box city state zip code) 5 BUSINESS CONTACT INFORMATION (phone fax and email address) 6 CONTACT REPRESENTATIVE 7 TYPE OF CERTIFICATION 8 APPLICATION AGREEMENT 9 NAME AND TITLE OF THE REPRESENTATIVE COMPLETING THIS FORM (type or print) APPLICATION FOR DIRECT TRANSMISSION OF TAX RETURNS APPLICATION FOR DIRECT TRANSMISSION OF TAX RETURNS BOARD OF EQUALIZATION BOARD OF EQUALIZATION BOE 400 XML (S1B) (7 09) BOE 400 XML (S1F) (7 09) STATE OF CALIFORNIA clear button complete and submit an application for the Direct Transmit Program must complete these lines eFiling Program Coordinator MIC:92 Email address: FOR BOARD USE ONLY CLIENT I D NUMBER Guide and related publications I understand that if this business is sold or its organizational structure is changed acceptance for par I WANT TO BE CERTIFIED TO TRANSMIT RETURNS AS A: (check all that apply) If you have any questions regarding this form or the Direct Transmit Program please contact the eServices Coordinator at INSTRUCTIONS FOR COMPLETING THE APPLICATION Line 1 Legal Name of Direct Transmitter: Enter the legal name of the business Line 2 Business Name: Enter fictitious business name (dba) if applicable Line 3 Business Address: Enter the address of the physical location of your business Line 4 Mailing Address: Enter the mailing address if different than the business address Line 5 Business Contact Information: Enter the business phone number fax and email address Line 6 Contact Information: Enter the name title phone number and email address of the contact representative Line 7 Type of Certification: If you are a tax professional (i e Accountant CPA Bookkeeper etc) and are not employed by the Line 8 Application Agreement: Please read this section carefully prior to signing this application Lines 9 and 10 Name Title Signature of the Representative Completing This Form and Date: The individual authorized to mit your application and successfully complete testing prior to Direct Transmitting your first return or prepayment Name: P O Box 942879 pany developing software that clients will use to submit returns directly to the BOE select the Software Developer box and provide PLEASE PRINT OR TYPE INSTRUCTIONS ARE AVAILABLE ON THE BACK OF THIS FORM Please submit the completed application via fax to (916) 322 4530 email to eDirect@boe ca gov or mail to: PO Box 942879Sacramento CA 94279 0092 print button provisions will result in termination of this agreement reinstatement revised Sacramento CA 94279 0092 Software Developer Name of Software Product: SPECIAL INSTRUCTIONS State Board of Equalization State Board of EqualizationeServices Coordinator MIC:92 STATE OF CALIFORNIA Tax or Fee Payer BOE Account Number: tax or fee payer select the Tax Professional box and provide your name or the name of your business If you are a software com Tax Professional Business Name: Telephone: ( ) Test Web Address (if available) the name of the software product If you are the tax or fee payer filing your own returns select the Tax or Fee Payer box and provide This business and its employees will comply with all the provisions of the California State Board of Equalization s Direct Transmitters ticipation is not transferable and a new/revised application must be filed I further understand that noncompliance with all applicable Title: To become a Direct Transmitter as defined in the California State Board of Equalization s (BOE) eFiling publications you must sub Under penalty of perjury I declare that I have examined this application and to the best of my knowledge the information I have pro vided is true correct and complete I further declare that I am authorized to complete and sign this statement on behalf of the business vided) select the Electronic Return Originator box and provide your web address and a test web address (for testing purposes) Web Address You may submit your completed application via fax to (916) 322 4530 email to eDirect@boe ca govor mail to: your account number If you are a company offering a web interface for clients to submit tax and fee information (no software pro

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