Form CalRecycle751 "Beverage Manufacturer / Distributor Registration Form" - California

What Is Form CalRecycle751?

This is a legal form that was released by the California Department of Resources Recycling and Recovery - a government authority operating within California. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on December 1, 2015;
  • The latest edition provided by the California Department of Resources Recycling and Recovery;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form CalRecycle751 by clicking the link below or browse more documents and templates provided by the California Department of Resources Recycling and Recovery.

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Download Form CalRecycle751 "Beverage Manufacturer / Distributor Registration Form" - California

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                                                                                            Department   of   Resources   Recycling   and   Recovery   (CalRecycle)  
 
 
 
 
 
 
           
           
 
           
  ____________________  
           
 
           
 
           
           
 
           
           
           
 
 
           
           
 
 
           
 
 
           
           
 
  (if   applicable)  
           
            
          )             
 
 
 
 
 
 
 
  Sole   Proprietorship  
  Married   Co‐Ownership  
  Corporation  
  Non   Profit   Corporation
  Cooperative  
  Limited   Liability   Company  
  General   Partnership  
  Limited   Partnership  
  Limited   Liability   Partnership  
  Other  
 
   YES  
State of California
CalRecycle 751 (Rev. 12/15)
Print
Clear
BEVERAGE   MANUFACTURER   /   DISTRIBUTOR   REGISTRATION   FORM
Please   complete   and   return   both   pages   to  
Reg.CRVLabeling@CalRecycle.ca.gov
or   via   fax   at   (916)   319‐7400   or   mail   to   CalRecycle ‐   Registration   Unit,   801   K   Street,   MS   17‐03,   Sacramento,   CA    95814  
Doing Business As (DBA) Name(s):
Legal Name:
Federal Tax ID # (Employer Identification Number):
ABC Certificate of Compliance #
(if applicable):
(Out‐of‐state   Beer   &   Malt   Manufacturers   only)  
Physical Business Address
Mailing Address
(if different from physical address)
Street:              
Street:              
City,   State   Zip  
City,   State   Zip  
California   Sales/Corp.   Office(s)/Other
California   Warehouse   Location(s)  
(if   applicable)  
Check   one:
Sales   
Corporate  
Other   (explain)  
Check   one:
Rented    
Leased  
Owned  
Street:  
Street:  
City,   State   Zip  
City,   State   Zip  
(Attach   additional   sheet[s]   if   necessary)  
(Attach   additional   sheet[s]   if   necessary)  
Primary   Point   of   Contact  
Secondary   Point   of   Contact  
Mr.   
Mrs.  
Ms.  
Mr.  
Mrs.   
Ms.  
Name:             
Name:  
Title:             
Title:
Phone: (
)             
Phone:   (
Email:
Email:
Fax:  
Fax:  
Preferred   method   of   contact:  
Phone  
Email  
Preferred   method   of   contact:
Phone   
Email  
Type   of   Ownership   Structure  
(Check   one)  
_________________
1. Effective   date   of   beverage   product   sales   or   transfer   in   California:   
(month/year)  
2. Are   free   beverage   product   samples   offered   or   proposed   to   be   offered   in   California?  
No  
Page   1   of   1  
 
 
 
   
 
 
 
 
 
     
 
 
 
 
   
 
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
  
 
   
 
 
 
  
   
 
 
 
  
   
 
 
 
           
            
           
 
   
   
  
            
           
 
 
  
 
 
 
 
 
 
 
 
 
 
 
 
  
 
   
                                                                                            Department   of   Resources   Recycling   and   Recovery   (CalRecycle)  
 
 
 
 
 
 
           
           
 
           
  ____________________  
           
 
           
 
           
           
 
           
           
           
 
 
           
           
 
 
           
 
 
           
           
 
  (if   applicable)  
           
            
          )             
 
 
 
 
 
 
 
  Sole   Proprietorship  
  Married   Co‐Ownership  
  Corporation  
  Non   Profit   Corporation
  Cooperative  
  Limited   Liability   Company  
  General   Partnership  
  Limited   Partnership  
  Limited   Liability   Partnership  
  Other  
 
   YES  
State of California
CalRecycle 751 (Rev. 12/15)
Print
Clear
BEVERAGE   MANUFACTURER   /   DISTRIBUTOR   REGISTRATION   FORM
Please   complete   and   return   both   pages   to  
Reg.CRVLabeling@CalRecycle.ca.gov
or   via   fax   at   (916)   319‐7400   or   mail   to   CalRecycle ‐   Registration   Unit,   801   K   Street,   MS   17‐03,   Sacramento,   CA    95814  
Doing Business As (DBA) Name(s):
Legal Name:
Federal Tax ID # (Employer Identification Number):
ABC Certificate of Compliance #
(if applicable):
(Out‐of‐state   Beer   &   Malt   Manufacturers   only)  
Physical Business Address
Mailing Address
(if different from physical address)
Street:              
Street:              
City,   State   Zip  
City,   State   Zip  
California   Sales/Corp.   Office(s)/Other
California   Warehouse   Location(s)  
(if   applicable)  
Check   one:
Sales   
Corporate  
Other   (explain)  
Check   one:
Rented    
Leased  
Owned  
Street:  
Street:  
City,   State   Zip  
City,   State   Zip  
(Attach   additional   sheet[s]   if   necessary)  
(Attach   additional   sheet[s]   if   necessary)  
Primary   Point   of   Contact  
Secondary   Point   of   Contact  
Mr.   
Mrs.  
Ms.  
Mr.  
Mrs.   
Ms.  
Name:             
Name:  
Title:             
Title:
Phone: (
)             
Phone:   (
Email:
Email:
Fax:  
Fax:  
Preferred   method   of   contact:  
Phone  
Email  
Preferred   method   of   contact:
Phone   
Email  
Type   of   Ownership   Structure  
(Check   one)  
_________________
1. Effective   date   of   beverage   product   sales   or   transfer   in   California:   
(month/year)  
2. Are   free   beverage   product   samples   offered   or   proposed   to   be   offered   in   California?  
No  
Page   1   of   1  
 
 
 
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
      
 
 
 
 
 
      
 
   
 
 
 
 
      
 
 
 
 
 
      
 
 
 
      
 
 
 
 
 
 
 
      
 
 
 
 
  ______  
  ______  
 
 
 
 
 
           
           
           
            
           
           
            
           
           
           
            
           
 
 
 
 
 
   
 
 
 
  ______  
 
 
           
           
           
           
           
           
           
         
           
 
 
   
                                                                                            Department   of   Resources   Recycling   and   Recovery   (CalRecycle)  
 
 
 
 
 
 
 
     
 
         
           
           
         
  Beer   or   Malt   Beverages
  Wine   Coolers/Distilled   Spirit   Coolers
  Carbonated   Water  
  Non‐Carbonated   Water  
  Carbonated   Soft   Drinks  
  Non‐Carbonated   Soft   Drinks  
 
  Sport   Drinks
  Carbonated   Fruit   Drinks  
  Non‐Carbonated   Fruit   Drinks  
  Coffee/Tea   Drinks
  100%   Vegetable   Juice   (Size   in   ounces):
  100%   Fruit   Juice   (Size   in   ounces):
  Other   (Describe):
  Aluminum
  Glass
  Bi‐Metal  
       Plastic
  #1   PET
  #2   HDPE    
  #3   PVC  
  #4   LDPE  
  #5   PP
  #6   PS  
  #7   Other  
  Other   (Describe):
  Under   24   ounces  
  24   ounces   or   more  
 
  All  
  None  
  Some  
   
 
 
  
  
  Retailers
  Restaurants  
  Common   Carriers   (Planes,   trains,   etc.)  
  Distributors   (If   checked,   provide   information   below)
  Other   (Describe):
 
 
 
 
 
 
 
State of California
CalRecycle 751 (Rev. 12/15)
BEVERAGE   MANUFACTURER   /   DISTRIBUTOR   REGISTRATION   FORM
Please   complete   and   return   both   pages   to  
Reg.CRVLabeling@CalRecycle.ca.gov
or   via   fax   at   (916)   319‐7400   or   mail   to   CalRecycle ‐   Registration   Unit,   801   K   Street,   MS   17‐03,   Sacramento,   CA    95814  
3. Provide   the   types   of   beverage   products,   their   container   types,   and   container   sizes   offered   for   sale   or   transfer,   or   proposed  
to   be   offered   for   sale   or   transfer   in   California:   (Check   all   that   apply)  
Product   Line:
Container   Type:
Sizes:
Refillable:
______  
______    
4. Do   you   bottle   your   own   beverages?  
All
None
Some
If   None   or   Some,   provide   the   name   and   contact   information   for   your   beverage   suppliers,   co‐packers   and/or   bottlers   (Attach  
additional   sheets   if   needed):  
Company  
Contact   Person  
Phone  
Address  
(           )
(
)
(           )
5. Who   do   you   sell   or   transfer   beverages   directly   to   in   California?   (Check   all   that   apply)  
Consumers
Distributor  
Contact   Person  
Phone  
Address  
(           )  
(           )  
(           )             
6. Do   you   prefer   to   receive   the   registration   letter   and   related   documents   by:  
Email or
Regular mail?
Provide any additional information in the space below: ____
_________________________________________________
(Attach additional sheets if needed)
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