Form Boe-416 - Petition For Redetermination
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1BOE-416 REV. 6 (7-11)
STATE OF CALIFORNIA
PETITION FOR REDETERMINATION
BOARD OF EQUALIZATION
BU SINESS NAME
ACCOUNT NUMBER
TAXPAYER NAME
TYPE OF TAX OR FEE
PETITION FOR REDETERMINATION
Generally, the person against whom a determination is made may petition for redetermination within 30 days from the date of a
Notice of Determination and 10 days from the date of a Jeopardy Determination. You should refer to the notice issued to you for
the specific conditions and requirements for filing a petition. Anyone submitting a petition should be prepared, upon request, to
submit documentary evidence to support the specific grounds upon which the petition is founded.
I am filing a petition for redetermination of the notice of determination dated _
______________________________
for the
period __
___________
_________________________
__ in the amount of $ __
_______________________________
__.
Please indicate below the specific grounds upon which the petition is founded:
You have the right to an appeals conference and an oral hearing before the Members of the Board. Please indicate below
whether you request an appeals conference, a Board hearing, or both. (Note: If you select only a Board hearing, an appeals
conference will, nevertheless, normally be held first. During its review of your petition, Board staff may ask that you confirm your
request for an appeals conference or Board hearing and, if you do still want a conference or hearing, you must timely respond to
that request.)
I request an appeals conference with a staff counsel or supervising tax auditor at the Board’s nearest district
office or in the Board’s Headquarters office in Sacramento.
I request an oral hearing before the Members of the Board.
SIGNATURE
DATE SIGNED
PRINTED NAME
TITLE/CAPACITY
If there is a conflict between this form or the notice you received and the law, the law is controlling. The filing of a Petition for Redetermination
does not protect your right to a refund of tax, interest, or penalty amounts paid in excess of amounts legally due. You must timely file a claim for
refund if you believe you have overpaid tax, interest or penalty amounts.
CLEAR
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