Form Boe-770-Dv (S1f) - Diesel Fuel Ultimate Vendor Report/claim For Refund Page 3
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6STATE OF CALIFORNIA
BOARD OF EQUALIZATION
BOE-770-DV (S2F) REV. 9 (4-13)
REFUND COMPUTATION WORKSHEET
Use this worksheet to help you complete your claim and calculate the refund due.
Do not send this worksheet with your claim.
(A)
(B)
FROM
DIESEL FUEL
DIESEL FUEL
SECTION A. TAX-PAID CREDITS
SCHEDULE
AT
AT
(Total Gallons)
CURRENT
PRIOR RATE
RATE
1. Tax-paid fuel exported (enter totals from column 11 on Schedule 13A)
13A
2. Tax-paid fuel sold to the United States Government (enter totals from
13C
column 11 on Schedule 13C)
3. Tax-paid fuel sold for use on farms for farming purposes (enter totals
13D
from column 11 on Schedule 13D)
4. Tax-paid fuel sold to exempt bus operators (enter totals from column 11
13E
on Schedule 13E)
5. Tax-paid fuel sold to train operators (enter totals from column 11 on
13G
Schedule 13G)
6. Tax-paid fuel used in an exempt manner not reportable on another credit
13J
schedule (enter totals from column 11 on Schedule 13J)
7. TOTAL TAX-PAID GALLONS CLAIMED FOR REFUND (add lines 1
through 6 for each column) Enter this amount in columns A and B on
line 1 on the front of the claim.
Note: Any schedules required in support of this claim (Schedules 1A, 2A, 12A through 12C, and 13A through 13J) must be
submitted with the claim. You must complete Schedules 1A and 2A, as applicable to your purchases, in support of your claim. If
you are claiming a refund at the prior tax rate, you must have reported your below the rack activities on Schedules 12A, 12B,
and 12C for all previous reporting periods from the period prior to the tax rate change forward through the period on which you
are making the claim. For example, to claim a credit transaction claimed at the prior tax rate in the September 2011 period, you
would need to report on these schedules for the June 2011 period and all subsequent periods. You must also report these
schedule activities for this reporting period.
BOE-810-FTE, Instructions for Preparing Motor Fuels Schedules, is available on our website at
, and provides detailed instructions on the reporting requirements for these schedules.
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