Form Boe-126 - Installment Payment Agreement Proposal Submittion - 2003

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S
B
TATE
OARD
O
E
F
QUALIZATION
Your Consumer Use Tax Account May Qualify
for an Installment Payment Agreement
450 N Street
Sacramento
California 95814
You may be able to pay your Consumer Use Tax debt in smaller and more
manageable amounts by applying for an Installment Payment Agreement with the
Board. If you qualify, you may pay in weekly or monthly installments until the
balance is paid in full. The amount of your weekly or monthly installment will
depend on how much you owe and your ability to pay. You may need to complete
an Individual Financial Statement (Form BOE-403-E) and other documents. These
BOARD MEMBERS
will be reviewed to determine if you qualify for installment payments.
BETTY T. YEE
Acting Member
First District
Interest and penalties accrue on any unpaid liabilities. An Installment Payment
San Francisco
Agreement may cost you more than if you paid the entire balance by borrowing
BILL LEONARD
the money from a third party to pay the balance in full. (A lien may be filed on
Second District
Sacramento/Ontario
your property even if you enter into an agreement.)
CLAUDE PARRISH
Third District
If you are interested in submitting an Installment Payment Agreement proposal,
Long Beach
please complete the section below. Send this form, your completed tax return, and
JOHN CHIANG
Fourth District
a payment in the amount of your proposed weekly or monthly installment in the
Los Angeles
enclosed return envelope. Continue to send your proposed payments unless we
STEVE WESTLY
State Controller
notify you otherwise. Please write your account number on your check or money
Sacramento
order.
EXECUTIVE DIRECTOR
RAMON J. HIRSIG
Sacramento
Print name as shown on tax return:
Consumer Use Tax account:
Proposed payment amount: $
every (check one)
Week
Month
Signature:
Date:
Daytime phone number: (
)
For more information, contact the Centralized Collection Section at 916-445-3670 or visit our website
at
BOE-126 REV. 3 (10-03)
CLEAR
PRINT

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