Form Boe-501-Tk - Underground Storage Tank Maintenance Fee Return - State Of California

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BOE-501-TK REV. 8 (3-03)
STATE OF CALIFORNIA
BOARD OF EQUALIZATION
UNDERGROUND STORAGE TANK MAINTENANCE FEE RETURN
BOARD USE ONLY
AUD
RA-B/A
REG
DUE ON OR BEFORE
FILE
RR-QS
REF
[
]
YOUR ACCOUNT NO.
FOID
EFF
BOARD OF EQUALIZATION
FUEL TAXES DIVISION
PO BOX 942879
SACRAMENTO CA 94279-6151
READ INSTRUCTIONS
BEFORE PREPARING
FILING REQUIREMENTS
Every owner of an underground storage tank shall file an underground storage tank maintenance fee return
showing the total number of gallons of petroleum products placed into the owner's tanks during the period
covered by the return. Do not report tank capacity. The return is due on or before the 25th day of the month
following the end of the reporting period. A return must be filed even though you have no liability for the fee, e.g.,
tanks that are empty or not in use.
If you have sold or removed any of your tanks or have moved, please notify this office. If you are not the tank
owner, please indicate the current owner's full name and address on an attachment and forward along with this
return.
Total gallons of petroleum products placed in all tanks owned.
1.
1.
Do not report tank capacity.
Rate of fee
2.
.013
2.
Total fee due (multiply line 1 by line 2)
3.
3.
$
Penalty [multiply line 3 by 10% (.10) if payment is made or return is filed
4.
4.
$
PENALTY
after the due date shown above]
INTEREST:
One month's interest is due on tax for each month or fraction of a
5.
5.
$
month that payment is delayed after the due date. The adjusted monthly
INTEREST
interest rate is
TOTAL AMOUNT DUE AND PAYABLE (add lines 3, 4 and 5)
6.
6.
$
I hereby certify that this return, including any accompanying schedules and statements, has been examined by
me and to the best of my knowledge and belief is a true, correct, and complete return.
YOUR SIGNATURE AND TITLE
TELEPHONE NUMBER
DATE
MAKE CHECK OR MONEY ORDER PAYABLE TO THE STATE BOARD OF EQUALIZATION.
Always write your account number on your check or money order. Make a copy of this document for your records.
CLEAR
PRINT

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