Form Boe-501-Av - Vendor Use Fuel Tax Return Page 2

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BOE-501-AV (S1B) REV. 5 (4-13)
SCHEDULE A - SALES TO USERS AUTHORIZED TO PURCHASE EX-TAX FUEL UNDER REGULATIONS 1319 AND 1320
COMPRESSED
LPG & LIQUID
KEROSENE,
USER'S PERMIT
NATURAL GAS
NATURAL GAS
ALCOHOL FUELS
DISTILLATE &
USER'S NAME AND ADDRESS
NUMBER
(Gallons)
(Units)
(Gallons)
STOVE OILS
TOTAL (enter on line 4 of return)
SCHEDULE B - TAX CREDIT ON BAD DEBT LOSSES
DATE OF
SALE
USER'S PERMIT
GALLONS
AMOUNT OF
MO/YR
NUMBER
USER'S NAME & ADDRESS
OR UNITS
DELINQUENT TAX
$
$
$
TOTAL (enter on line 10 of return)
$
SCHEDULE C - TAX RECOVERIES ON BAD DEBT LOSSES [Attach pink copy of Notice of Worthless Account (Bad Debts) (form BOE-120)]
USER'S PERMIT
AMOUNT OF TAX
NUMBER
USER'S NAME
USER'S ADDRESS
RECOVERED
$
$
$
TOTAL (enter on line 12 of return)
$
SCHEDULE D - DELINQUENT OR UNCOLLECTABLE ACCOUNTS [Attach the blue and yellow copies of Notice of Worthless Account (Bad Debts) (form BOE-120)]
DATE OF
SALE
USER'S
GALLONS
AMOUNT OF
PERMIT NUMBER
MO/YR
USER'S NAME & ADDRESS
OR UNITS
DELINQUENT TAX
$
$
$
$
CLEAR
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