Form Boe-770-Dvw - Diesel Fuel Tax Claim For Refund - Sales To Ultimate Purchasers - 2011
Download a blank fillable Form Boe-770-Dvw - Diesel Fuel Tax Claim For Refund - Sales To Ultimate Purchasers - 2011 in PDF format just by clicking the "DOWNLOAD PDF" button.
Open the file in any PDF-viewing software. Adobe Reader or any alternative for Windows or MacOS are required to access and complete fillable content.
Complete Form Boe-770-Dvw - Diesel Fuel Tax Claim For Refund - Sales To Ultimate Purchasers - 2011 with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.
Some fillable PDF-files have the option of saving the completed form that contains your own data for later use or sending it out straight away.
ADVERTISEMENT
1
2STATE OF CALIFORNIA
BOE-770-DVW REV. 6 (7-11)
BOARD OF EQUALIZATION
DIESEL FUEL TAX CLAIM FOR REFUND - SALES TO ULTIMATE PURCHASERS
BOE USE ONLY
AUD
RA-B/A
REG
REG
CLAIM PERIOD
/
/
T
HROUGH
/
/
FILE
RR-QS
REF
REF
YOUR ACCOUNT NO.
[
]
FOID
EFF
BOARD OF EQUALIZATION
SPECIAL TAXES AND FEES
PO BOX 942879
SACRAMENTO CA 94279-2O5O0 0 0 0 0 0 0 0 0 0 0 0 0
READ INSTRUCTIONS
READ INSTRUCTIONS
BEFORE PREPARING
BEFORE PREPARING
As an ultimate vendor of diesel fuel in California, you may use this form to file a claim for refund of tax you paid on undyed
diesel fuel sold without the tax reimbursement to ultimate purchasers for use on a farm for farming purposes or for use in an
exempt bus operation. Your claim must cover a period of not less than one week and total at least $200. The period covered by
your claim may include more than one week's sales if necessary to reach the $200 minimum. You must submit completed
Schedules 13D and 13E with your claim. All transactions supporting the amount claimed must be reported on BOE-810-FTF,
Disbursement Schedule.
Enter the beginning and ending dates of the period covered by this claim as mm/dd/yy in the box above.
REPORT WHOLE
GALLONS ONLY
(A)
Diesel Fuel at
Current Rate
1. Gallons of tax-paid diesel fuel claimed for refund of tax (enter from Refund
Computation Worksheet section A, line 3)
$
2. Rate of tax per gallon
$
3. Amount of refund claimed (multiply line 1 by line 2)
If refund amount is less than $200, do not submit claim.
You are required to file a monthly report, BOE-770-DV, Diesel Fuel Ultimate Vendor Report/Claim for Refund, with the Board of
Equalization (BOE), listing your receipts and disbursements of undyed and dyed diesel fuel. Even if you qualify to file weekly
claim forms, any exempt sales to ultimate purchases for the last week of the period must be claimed on the monthly report. If
you prefer, you may claim a refund on that report instead of filing this weekly claim form. You must file the monthly report
whether or not you file separate weekly claims.
CERTIFICATION
I hereby consent to disclose and authorize the Board of Equalization (BOE) to release, as necessary, certain otherwise
confidential transaction information regarding volumes, invoice numbers, bills-of-lading, locations, dates, or method of delivery
of reportable products to any person identified by me in this return as being involved in a reported transaction for the sole
purpose of verifying the accuracy of the reportable product transaction information concerning my transactions with such
person as reported in this return.
I, the undersigned, certify that, to the best of my knowledge, all information on this claim and any accompanying documents is
true, correct, and complete. I further certify that the diesel fuel covered by this claim did not show any visible evidence of dye,
and, further, that the diesel fuel tax was not included in the sales price of the diesel fuel covered by this claim and was not
collected from the purchasers. In addition, I certify that, I have in my possession, valid exemption certificates from train
operators for transactions covered by this claim, and that, to the best of my knowledge, all information on the certificates is true
and correct.
DATE
SIGNATURE
TELEPHONE
(
)
PRINT NAME AND TITLE
EMAIL ADDRESS
ADVERTISEMENT
0 votes
Related Articles
Related forms
Form Boe-770-du Diesel Fuel Claim For Refund On Nontaxable Uses - California Board Of Equalization
Legal
Form Pa-8453-c - Pennsylvania Corporation Tax Declaration For A State E-file Report - 2011
Financial
Related Categories
Parent category: Financial