$100 00 in order to receive a renewal license If more than one location exists the reinstatement fee applies to
(BOE USE ONLY )
(button) CLEAR
(button) PRINT
(DATE)
(EMAIL ADDRESS)
(Line 1 Enter the total number of business locations you will be reinstating)
(Line 3 TOTAL AMOUNT DUE AND PAYABLE (multiply line 1 by line 2))
(PRINT NAME AND TITLE)
(text)
(text)
(YOUR ACCOUNT NO )
1 Enter the total number of business locations you will be reinstating1
2 Reinstatement fee per location2 $100 00
3 TOTAL AMOUNT DUE AND PAYABLE (multiply line 1 by line 2)3
allowed their Cigarette and Tobacco Products Retailer's License to expire to pay a reinstatement fee of
Always write your account number on your check or money order Make a copy of this document for your records
and Professions Code (the Act) The Act requires every retailer of cigarettes or tobacco products in this state
BOARD OF EQUALIZATIONSPECIAL TAXES AND FEESPO BOX 942879SACRAMENTO CA 94279 7074
BOE 400 RLF REV 2 (11 11)
CALIFORNIA CIGARETTE AND TOBACCO PRODUCTS LICENSING ACT OF 2003
CIGARETTE AND TOBACCO PRODUCTS LICENSE REINSTATEMENT REQUEST
each license which has expired
each retail location
Effective January 1 2008 Senate Bill 625 (Statutes of 2007 Chapter 654) requires any retailer who has
EMAIL ADDRESS
FOR THE PERIOD OF
GENERAL INFORMATION
location at which cigarettes or tobacco products are sold A retailer must conspicuously display the license at
Make check or money order payable to State Board of Equalization
PRINT NAME AND TITLE
Products Licensing Act of 2003 under Division 8 6 (commencing with section 22970) of the California Business
SIGNATURE
STATE OF CALIFORNIABOARD OF EQUALIZATION
TELEPHONE
The State Board of Equalization (BOE) is responsible for administering the California Cigarette and Tobacco
This fee will not be accepted to reinstate a previously revoked license
to be licensed by the BOE Under the Act every retailer must obtain and maintain a separate license for each
YOUR ACCOUNT NO
