Form CDTFA-443 "Compliance Certification" - California

What Is Form CDTFA-443?

This is a legal form that was released by the California Department of Tax and Fee Administration - 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 October 1, 2017;
  • The latest edition provided by the California Department of Tax and Fee Administration;
  • 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 CDTFA-443 by clicking the link below or browse more documents and templates provided by the California Department of Tax and Fee Administration.

ADVERTISEMENT
ADVERTISEMENT

Download Form CDTFA-443 "Compliance Certification" - California

1459 times
Rate (4.6 / 5) 102 votes
CDTFA-443 REV. 2 (10-17)
STATE OF CALIFORNIA
CALIFORNIA DEPARTMENT OF TAX AND FEE ADMINISTRATION
COMPLIANCE CERTIFICATION
Revenue and Taxation Code Section 30165.1
Applicants for a Distributor’s License under section 30140 of the Revenue and Taxation Code must
certify they will fully comply with section
30165.1
of the Revenue and Taxation Code. Your
application will not be processed or approved if it is incomplete or submitted without the proper
certifcation.
Certifcation
The distributor identifed below certifes that it will comply fully with Revenue and Taxation Code
section 30165.1 and acknowledges and understands that any person who makes this certifcation
and asserts the truth of any material matter that he or she knows to be false is guilty of a
misdemeanor punishable by imprisonment of up to one year in county jail, or a fne of not more than
$1,000, or both the fne and imprisonment.
Note: This form must be signed by an owner, partner, corporate offcer, LLC member or manager,
or by an authorized agent. For a partnership, attach authorization signed by all general partners;
for a corporation, attach corporate resolution; and for an LLC, attach articles of organization which
authorize the individual who signs below to make this certifcation. If signed by an authorized agent,
a properly completed power of attorney must be attached to this certifcation.
DISTRIBUTOR NAME
ADDRESS (street, city, state, zip code)
NAME OF PERSON AUTHORIZED TO SIGN (typed or printed)
TITLE
SIGNATURE OF PERSON AUTHORIZED TO SIGN
DATE
CLEAR
PRINT
CDTFA-443 REV. 2 (10-17)
STATE OF CALIFORNIA
CALIFORNIA DEPARTMENT OF TAX AND FEE ADMINISTRATION
COMPLIANCE CERTIFICATION
Revenue and Taxation Code Section 30165.1
Applicants for a Distributor’s License under section 30140 of the Revenue and Taxation Code must
certify they will fully comply with section
30165.1
of the Revenue and Taxation Code. Your
application will not be processed or approved if it is incomplete or submitted without the proper
certifcation.
Certifcation
The distributor identifed below certifes that it will comply fully with Revenue and Taxation Code
section 30165.1 and acknowledges and understands that any person who makes this certifcation
and asserts the truth of any material matter that he or she knows to be false is guilty of a
misdemeanor punishable by imprisonment of up to one year in county jail, or a fne of not more than
$1,000, or both the fne and imprisonment.
Note: This form must be signed by an owner, partner, corporate offcer, LLC member or manager,
or by an authorized agent. For a partnership, attach authorization signed by all general partners;
for a corporation, attach corporate resolution; and for an LLC, attach articles of organization which
authorize the individual who signs below to make this certifcation. If signed by an authorized agent,
a properly completed power of attorney must be attached to this certifcation.
DISTRIBUTOR NAME
ADDRESS (street, city, state, zip code)
NAME OF PERSON AUTHORIZED TO SIGN (typed or printed)
TITLE
SIGNATURE OF PERSON AUTHORIZED TO SIGN
DATE
CLEAR
PRINT