CDTFA-345-QP-WEB REV. 2 (3-18)                                                                                                                        STATE OF CALIFORNIA 
QUALIFIED PURCHASER - REGISTRATION UPDATE                                                               CALIFORNIA DEPARTMENT OF TAX AND FEE ADMINISTRATION 
                                                                                                                                                                      CDTFA 
                                                                                                                                                                      USE 
OWNERSHIP NAME                                                                                                ACCOUNT NUMBER (example: SU KH xxx-xxxxxx)              TIN # 

BUSINESS TRADE NAME [DBA] (if any)                                                                            BUSINESS TYPE 

CORPORATE, LLC, LLP, OR LP NUMBER (if applicable)                                                       FEDERAL EMPLOYER IDENTIFICATION NUMBER (FEIN) (if applicable) 

SECTION I: TYPE OF OWNERSHIP (check one) 
Limited Partnership (LP)                     Unincorporated Business Trust (registered to practice law, accounting, or architecture) 
Registered Domestic Partnership              Married Co-Ownership                General Partnership            Sole Owner 
Limited Liability Company (LLC)              Limited Liability Partnership (LLP) Corporation                    Other (describe) 
SECTION II: UPDATE NAME, ADD A PARTNER/CO-OWNER, DROP A PARTNER/CO-OWNER                                                                                              TIN # 
Use additional sheets to include information for more than three individuals. 
Check one    UPDATE             ADD DROP 
FULL NAME (first, middle, last)                                                                               TITLE 

SOCIAL SECURITY NUMBER (corporate officers excluded)       DRIVER LICENSE NUMBER                        STATE EMAIL 

HOME ADDRESS (street, city, state, ZIP code)                                                                  HOME TELEPHONE NUMBER 
                                                                                                              (     ) 
Check one    UPDATE             ADD DROP                                                                                                                              TIN # 
FULL NAME (first, middle, last)                                                                               TITLE 

SOCIAL SECURITY NUMBER (corporate officers excluded)       DRIVER LICENSE NUMBER                        STATE EMAIL 

HOME ADDRESS (street, city, state, ZIP code)                                                                  HOME TELEPHONE NUMBER 
                                                                                                              (     ) 
Check one    UPDATE             ADD DROP                                                                                                                              TIN # 
FULL NAME (first, middle, last)                                                                               TITLE 

SOCIAL SECURITY NUMBER (corporate officers excluded)       DRIVER LICENSE NUMBER                        STATE EMAIL 

HOME ADDRESS (street, city, state, ZIP code)                                                                  HOME TELEPHONE NUMBER 
                                                                                                              (     ) 
SECTION III: ADDRESS CHANGES AND CONTACT INFORMATION 
NEW CALIFORNIA BUSINESS ADDRESS (street, city, state, zip code) (do not list PO Box or mailing service)       BUSINESS TELEPHONE NUMBER 
                                                                                                              (     ) 
NEW MAILING ADDRESS (street, city, state, ZIP code)                                                           BUSINESS FAX NUMBER 
                                                                                                              (     ) 
NAME OF PRIMARY CONTACT (include title)                                                                       CONTACT TELEPHONE NUMBER 
                                                                                                              (     ) 
BUSINESS EMAIL (to receive email reminders to file online)                                                    BUSINESS WEB ADDRESS 

SECTION IV: SELL/CLOSE OUT 
DATE CLOSED                     WAS THE BUSINESS SOLD?                           IF YES, BUYER'S NAME AND TELEPHONE NUMBER 
                                    YES      NO 
SECTION V: COMPLETED BY 
PRINTED NAME                                               TITLE                                                                     TELEPHONE NUMBER 
                                                                                                                                     (    ) 
SIGNATURE                                                  EMAIL                                                                     DATE 

Mail to:  Your nearest CDTFA office. 
          A listing of CDTFA offices is located on our website at www.cdtfa.ca.gov. 

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