Form Boe-501-Ci - Cigarette And Tobacco Products Excise Tax Return
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1
2STATE OF CALIFORNIA
BOE-501-CI (FRONT) REV. 11 (4-13)
BOARD OF EQUALIZATION
CIGARETTE AND TOBACCO PRODUCTS EXCISE TAX RETURN
BOE USE ONLY
RA-B/A
AUD
REG
DUE ON OR BEFORE
RR-QS
FILE
REF
YOUR ACCOUNT NO.
[
]
FOID
EFF
BOARD OF EQUALIZATION
SPECIAL TAXES AND FEES
PO BOX 942879
SACRAMENTO CA 94279-2074
READ INSTRUCTIONS
BEFORE PREPARING
PURCHASE INFORMATION
(Attach a separate page if necessary)
NO. OF CARTONS OR
INTERNET ADDRESS (http) OR
DATE
BRAND NAME
NAME OF SELLER
COST OF TOBACCO
PHONE NO. OF SELLER
RECEIVED
PRODUCTS
COLUMN B
COLUMN A
CIGARETTE TAX CALCULATIONS
(Round cents to the nearest whole dollar)
20 STICK PACKS
25 STICK PACKS
1. Total number of cartons of cigarettes purchased (use the figures entered in
1.
the Purchase Information section)
2. Tax rate per carton of cigarettes
2.
$
$
3. Total excise tax due on purchase of cigarettes (multiply line 1 by line 2)
3.
$
.00
$
.00
4. Total cigarette tax due (add columns A and B on line 3)
4.
$
.00
TOBACCO PRODUCTS TAX CALCULATIONS
(If only cigarettes purchased, skip to line 8)
5. Total cost of Tobacco Products purchased (other than cigarettes or small cigars)
5.
$
.00
6. Tobacco Products Tax Rate
6.
7. Total excise tax due on cost of tobacco products (multiply line 5 by line 6)
7.
$
.00
TOTALS
8. Total excise tax due for all cigarettes and tobacco products (add lines 4 and 7)
8.
$
.00
9. Penalty [multiply line 8 by 10% (0.10) if payment made after due date shown above]
9.
$
.00
10.
Interest:
One month's interest is due on tax for each month or fraction of a month that payment
$
10.
.00
is delayed after the due date. The adjusted monthly interest rate is
11. TOTAL AMOUNT DUE AND PAYABLE (add lines 8, 9, and 10)
11.
$
.00
EMAIL ADDRESS
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.
SIGNATURE
PRINT NAME AND TITLE
TELEPHONE
DATE
(
)
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.
CLEAR
PRINT
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