Sellers Permit Application

Business Information

Select Type of your Business

Individual/Sole Proprietorship

Limited Liability Company (LLC)

Corporation

S-corporation

Partnership

In what state is the entity incorporated?

Legal business name

Doing business as or DBA name (optional)

Business EIN (numbers only)

Business Details

What does the business sell?

Business Address (No PO box)

City

State

Zip

Does this business currently have any suppliers?

Yes

No

Please list the name, phone number, and address of 1 supplier.

Supplier name

Supplier Address

City

State

Zip

Supplier phone

Owner or Officer Information

First Name

Last Name

Phone

Date Of Birth

Does this owner or officer have a California driver license or ID?*

Yes

No

Driver license or state ID number

Social security number (numbers only)

Owner or Officer home address

Same as Business Address

Owner or Officer home address

City

State

Zip

Seller Permit

Business Information

Select Type of your Business

Business Details

Does this business currently have any suppliers?

Owner or Officer Information

Does this owner or officer have a California driver license or ID?*

Owner or Officer home address

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