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Form BOE-403-B Fillable Registration Information for Out-of-State Account
(all forms fillable on Windows, Mac, Android tablets, and iPad using Adobe Reader XI)(: 5a) Unchecked (: 5b) Unchecked (: con1) Unchecked (: con2) Unchecked (: cost) Unchecked (: equip1) Unchecked (: equip2) Unchecked (: equip3) Unchecked (: inv1) Unchecked (: inv10) Unchecked (: inv11) Unchecked (: inv12) Unchecked (: inv2) Unchecked (: inv3) Unchecked (: inv4) Unchecked (: inv5) Unchecked (: inv6) Unchecked (: inv7) Unchecked (: inv8) Unchecked (: inv9) Unchecked (: lic1) Unchecked (: lic2) Unchecked (: lump) Unchecked (: sol1) Unchecked (: sol2) Unchecked (: tax1) Unchecked (: tax2) Unchecked (: time) Unchecked (: ult1) Unchecked (: ult2) Unchecked (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked (Clear) Clear (Print) Print (See Reverse) (Sticky Note comment 12/13/2005 5:48:35 PM (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) 10 PRINCIPAL SUPPLIERS (Names & Addresses) 13 Are you a lessor or lessee of equipment situated or used in California? 14 Do you lease or license computer software located in California? 15 Do you perform construction contracts in California? 16 Do you sell and install machinery fixtures or equipment? 17 Do you make sales to ultimate consumers in California? 19 Please check the different advertising media you use to reach California customers 20 Additional remarks: ACCOUNT NO Accountant s Address Accountant s Name Telephone No ( ADDRESS CURRENT VALUE BALANCE DUE PAYMENTS MADE TO ANNUAL SALES IN CALIFORNIA Are all materials purchased California tax paid? BOARD OF EQUALIZATION BOE 403 B BACK REV 3 (11 92) BOE 403 B FRONT REV 3 (11 92) Cable television CALIFORNIA LOCATIONS (Address) (Warehouse Service etc ) NUMBER FROM LOCATION Catalogs placed in outlets CHECK 1 BOX ONLY: Corporations: Please attach your latest financial statements Cost plus a fee Direct mail Do salespersons solicitors independent contractors or manufacturers agents based in or traveling into California solicit orders or FUNCTION TELEPHONE INVENTORY SALES NEGOTIATED Gross Sales Taxable Sales If none of the above please indicate how you solicit California sales: INDEPENDENT SALES REPRESENTATIVES IN CALIFORNIA: Name and Address (Complete List) line 20 indicating their name address and date started LIST OF PRINCIPAL CALIFORNIA CUSTOMERS (Names & Complete Addresses; Attach Additional Sheets if Necessary): Local/regional newspapers Lump Sum Names and addresses of related companies doing business in California: National newspapers and magazines No If your answer is yes please list these persons on Out of State Location of Records Out of State Records maintained at independent accountant s office not at our own facility Out of State Records maintained at our facility OWNER PARENT CORPORATION IF ANY STATE OF INCORPORATION Prepared by: Title : provide assistance to customers on behalf of your company? Radio/non cable TV Real Estate Owned: (Anywhere in the United States) REGISTRATION INFORMATION FOR OUT OF STATE ACCOUNT STATE OF CALIFORNIA STATE OF INCORPORATION IF APPLICABLE FEIN NO: Telemarketing Telephone number Television shopping systems This form is a supplement to your application for a permit or certificate You must return to the Welcome Page click on "Register for a Permit or Certificate" and complete the actual application BOE 400 SPA BOE 400 CSU BOE 400 CSC or BOE 400 CSL Attach this form to your completed application when you submit it to the Board ) Time and Material Trade shows/fairs Type of contracts: Yellow pages Yes as a lessee Yes as a lessor