Form Boe-715 (S2f) - Request For Special Reporting Periods Page 3

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BOE-715 (S2F) REV. 2 (12-06)
STATE OF CALIFORNIA
REQUEST FOR SPECIAL REPORTING PERIODS
BOARD OF EQUALIZATION
(Please read instructions on reverse before completing this request. Please print legibly or type.)
SECTION I: ACCOUNT AND REQUEST INFORMATION
OWNER NAME
ADDRESS (street, city, state, zip code)
ACCOUNT NUMBER(S)
TYPE OF ACTION (check only one)
Is This Request For Permanent Special Reporting Periods?
New
Revise
Yes
No
Extend
Remove
SECTION II: PROPOSED REPORTING PERIODS
(Please complete Part A, B, or C below according to your current filing basis.)
PART A: YEARLY OR FISCAL YEARLY BASIS (List one period for each year.)
1ST YEAR
2ND YEAR
FROM
TO
FROM
TO
(Month/Day/Year)
(Month/Day/Year)
(Month/Day/Year)
(Month/Day/Year)
PART B: QUARTERLY BASIS (List four periods for each year.)
1ST YEAR
2ND YEAR
FROM
TO
FROM
TO
(Month/Day/Year)
(Month/Day/Year)
(Month/Day/Year)
(Month/Day/Year)
PART C: QUARTERLY PREPAY OR MONTHLY BASIS (List twelve or thirteen periods for each year.)
1ST YEAR
2ND YEAR
FROM
TO
FROM
TO
(Month/Day/Year)
(Month/Day/Year)
(Month/Day/Year)
(Month/Day/Year)
SIgNATURE OF OWNER OR AUTHORIZED REPRESENTATIVE
DAYTIME TELEPHONE
DATE
(
)
NOTE: This request cannot be processed without the required signature.
CLEAR
PRINT

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