Form Boe-400-Iy - Renewal Application For Ifta License And Decals
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2BOE-400-IY (FRONT) REV. 6 (8-11)
STATE OF CALIFORNIA
BOARD OF EQUALIZATION
RENEWAL APPLICATION FOR IFTA LICENSE AND DECALS
BOE USE ONLY
AUD
RA-B/A
REG
DUE ON OR BEFORE
FILE
RR-QS
REF
YOUR ACCOUNT NO.
[
]
FOID
EFF
BOARD OF EQUALIZATION
MOTOR CARRIER OFFICE
PO BOX 942879
SACRAMENTO CA 94279-6180
IFTA RENEWAL INFORMATION
You must complete and return this renewal application to maintain your IFTA license. Your application will not be processed
unless it is complete and accompanied by the required fees. If you do not return this form, it will result in the cancellation of
your license.
SECTION I: Decal and Fee Computation (this section must be completed)
1. Enter the number of vehicles that you operate in IFTA jurisdictions
1.
2. Fee per set of decals
2.
$
3. Total decal fee (multiply line 1 by line 2)
3.
$
4. Annual license fee
4.
$
5. TOTAL AMOUNT ENCLOSED (add lines 3 and 4)
5.
$
SECTION II: Vehicle Information (list complete information for each of your qualified motor vehicles; attach a separate sheet
to include information about additional vehicles)
U.S. Department of Transportation Number (DOT)
BASE STATE VEHICLE
TYPE OF
REGISTERED OWNER IF
ODOMETER
MAKE AND YEAR
VIN/LICENSE NUMBER
REGISTRATION
FUEL USED
READING
DIFFERENT THAN IFTA ACCOUNT
Make check or money order payable to the State Board of Equalization. Remittance must be in U.S. funds.
Always write your account number on your check or money order. Make a copy of this document for your records.
SIGNATURE
EMAIL ADDRESS
PRINT NAME AND TITLE
TELEPHONE
DATE
(
)
(continued on reverse)
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