Form Boe-501-Av - Vendor Use Fuel Tax Return
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4BOE-501-AV (S1F) REV. 5 (4-13)
STATE OF CALIFORNIA
BOARD OF EQUALIZATION
VENDOR USE FUEL 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
MOTOR CARRIER OFFICE
PO BOX 942879
SACRAMENTO CA 94279-6169
READ INSTRUCTIONS
BEFORE PREPARING
REPORT WHOLE UNITS/GALLONS ONLY
A
B
C
D
KEROSENE,
COMPRESSED
LPG & LIQUID
ALCOHOL
DISTILLATE &
NATURAL GAS
NATURAL GAS
FUELS
STOVE OIL
1. Total gallons and/or units of fuel sold and delivered
1.
into fuel tanks of motor vehicles
2. Fuel sold to the United States Government
2.
3. Fuel sold to users of LPG, LNG, and CNG whose
3.
vehicles have flat rate identification decal affixed
4. Other nontaxable fuel included in line 1 (enter from
4.
Schedule A)
5.
Total deductions
(add lines 2, 3, and 4)
5.
6. Taxable fuel (subtract line 5 from line 1)
6.
7.
7. Tax rate per unit/gallon on use fuel
$
$
$
$
8. Tax (multiply line 6 by line 7)
8.
$
$
$
$
9. Combined total tax (add columns A, B, C, and D of line 8)
9.
$
10.
$
10. Tax credit on bad debt losses (enter from Schedule B)
11. Balance of tax (subtract line 10 from line 9)
11.
$
12.
$
12. Tax recoveries on bad debt losses (enter from Schedule C)
13. Total tax due (add lines 11 and 12)
13.
$
14.
$
14. Penalty [multiply line 13 by 10% (0.10) if payment made or return filed after the due date shown above]
PENALTY
15. INTEREST: One month's interest is due on tax for each month or fraction of a month that payment is
15.
$
INTEREST
delayed after the due date. The adjusted monthly interest rate is
16. TOTAL AMOUNT DUE AND PAYABLE (add lines 13, 14, and 15)
16.
$
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.
CONTINUED
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