BOE-501-NC (FRONT) REV. 9 (7-07)
STATE OF CALIFORNIA
BOARD OF EQUALIZATION
NATURAL GAS SURCHARGE RETURN
FOR CONSUMERS - INTERSTATE PIPELINE
BOARD USE ONLY
DUE ON OR BEFORE
YOUR ACCOUNT NO.
BOARD OF EQUALIZATION
EXCISE TAXES DIVISION
P O BOX 942879
SACRAMENTO CA 94279-60 7 9
GENERAL INSTRUCTIONS - Complete form BOE-507-A, Schedule A - Computation Schedule for Natural Gas
Surcharge, prior to completing the return.
The California State Board of Equalization (Board) administers the Natural Gas Surcharge Law. The surcharge is imposed upon
the consumption of natural gas in California on and after January 1, 2001. Each public utility gas corporation and each consumer
of natural gas from an interstate pipeline must remit to the Board the amount of surcharge applicable.
This return must be filed even though you have no surcharge to report in the specific reporting period. The surcharge rate is
applicable to all billings for periods starting on or after January 1, 2001. A duplicate of the return should be retained for your
records and for verification by Board auditors. If you do not file a return on time, you will be subject to penalty and interest
COMPUTATION OF SURCHARGE
Total therms consumed
Total exempt therms consumed
Therms subject to the surcharge (subtract line 2 from line 1) (equals Schedule A column A3)
Total surcharge due (from Schedule A, column D3)
Penalty [multiply line 4 by 10% (0.10) if payment is made after due date shown above]
One month's interest is due on the surcharge for each month or fraction of a month that
payment is delayed after the due date. The adjusted monthly interest rate is
TOTAL AMOUNT DUE AND PAYABLE (add lines 4, 5, and 6)
IF PAID BY CREDIT CARD, CHECK HERE (Mandatory EFT accounts MUST pay by EFT). [
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
Make check or money order payable to State Board of Equalization.
Always write your account number on your check or money order. Make a copy of this document for your records.