Form 61A-2, Rev. 12/2020 1
BUSINESS, CONSUMER SERVICES AND HOUSING AGENCY • GAVIN NEWSOM, GOVERNOR
DEPARTMENT OF CONSUMER AFFAIRS • BUREAU OF HOUSEHOLD GOODS AND SERVICES
4244 South Market Court, Suite D, Sacramento, CA 95834
P (916) 999-2041 | F (916) 921-7279 | https://bhgs.dca.ca.gov
APPLICATION FOR REGISTRATION
Read carefully before submitting an application. If you have any questions, please call
the Bureau of Household Goods Services (Bureau) at (916) 999-2041.
SERVICE CONTRACT SELLERS AND ADMINISTRATORS
Registration is required for persons who engage in selling, issuing, renewing or administering service contracts relating to
the maintenance, replacement, or repair of consumer goods, which includes any new or used product or part thereof that is
used, bought, or leased for use primarily for personal, family, or household purposes, including assistive devices.
Attention Internet Retailers
Offering service contracts for sale to California consumers requires one registration for each location/method of sale. A
website that utilizes a separate location from brick and mortar locations will require its own registration.
Service Contract Administrators must submit the following:
1. A copy of a service contract reimbursement insurance policy covering the contracts,
2. A copy of the service contract(s) being sold, issued and/or administered,
3. A copy of the certificate of qualifications as filed with the Secretary of State if the service contractor is
located outside California AND holds a physical location within the State of California, and
4. A listing of all clients selling your firm’s service contracts.
Service Contract Sellers must submit the following:
1. A copy of the service contract(s) being sold, issued and/or administered,
2. A copy of the certificate of qualification as filed with the Secretary of State if the service contractor is located
outside California AND holds a physical location within the State of California, and
3. Evidence of financial backing – please see last page of application for financial backing alternatives.
Service contract forms must be identified by a unique form number and date of last revision and must be filed with the
Bureau with all documents incorporated by reference into the service contract no later than 30 days before its use.
GENERAL INFORMATION
The information requested on this application is mandatory pursuant to California Business and Professions Code (BPC)
sections 9830.5, 9855.2 and 9855.3. The information provided will be used to determine qualifications for registration as
provided by Chapter 20 of Division 3 of the BPC. Failure to provide the requested information will result in the application
being rejected as incomplete. The collection of this information is authorized by the BPC section 30 and the Information
Practices Act (Civil Code section 1798, et seq.). Personal information may be disclosed in the following circumstances:
pursuant to a Public Records Act request as allowed by the Information Practices Act, to another government agency as
required by law, or in support to a court or administrative order.
You have a right to access records containing your personal information maintained by the Department of Consumer Affairs,
unless the records are specifically exempted from disclosure by law. Individuals may obtain information regarding the
location of his or her records by contacting the Public Records Request Coordinator at 4244 South Market Court, Suite D,
Sacramento, CA 95834 or (916) 999-2041.
Disclosure of your Social Security Number (SSN) or Individual Taxpayer Identification Number (ITIN) is mandatory
for all sole proprietors and partners. Federal Employer Identification Number (FEIN) is mandatory for partnerships.
Collecting your SSN, ITIN, and FEIN is required by BPC sections 30 and 31, and Public Law 94-455 (42 USCA
405(c)(2)(C)). SSNs, ITINs, or FEINs are used exclusively for the purposes of tax enforcement, compliance with any
judgment or order for family support in accordance with Family Code section 17520, measurement of employment
outcomes of students who participate in career technical education programs offered by the California Community Colleges
as required by BPC section 30, and investigation of tax evasion and violations of cash-pay reporting laws as set forth in the
Unemployment Insurance Code section 329. If you fail to disclose your SSN, ITIN, or FEIN, your application for initial or
renewal license will not be processed, AND you will be reported to the Franchise Tax Board (FTB), which may assess a
penalty against you per the Revenue and Tax Code section 19528.
NOTICE: Effective July 1, 2012, the California Department of Tax and Fee Administration and the FTB may share taxpayer
information with the Bureau. You are obligated to pay your state tax obligation and your registration may be suspended if
the state tax obligation is not paid.
This registration is not transferable. This registration shall cease to be valid if not renewed by the annual renewal date
established by the Bureau. (BPC section 9832.5). If any changes in ownership, business name, and/or address occur, you
must notify the Bureau in writing within 30 days of the change. (BPC section 9833).