Form Boe-501-Db - Exempt Bus Operator Diesel Fuel Tax Return
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4BOE-501-DB (S1) REV. 7 (4-13)
STATE OF CALIFORNIA
BOARD OF EQUALIZATION
EXEMPT BUS OPERATOR DIESEL 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 94279-6155
READ INSTRUCTIONS
BEFORE PREPARING
REPORT WHOLE
REPORT OF EX-TAX DIESEL FUEL TRANSACTIONS
GALLONS ONLY
1. Total gallons of undyed diesel fuel purchased ex-tax (enter from Receipt Schedule 2A)
1.
2. Total gallons of dyed diesel fuel purchased (enter from Receipt Schedule 2A)
2.
3. Total gallons of ex-tax diesel fuel used off-highway
3.
EXEMPT BUS OPERATOR RETURN
4. Total gallons of ex-tax diesel fuel used in exempt bus operations
4.
5. Tax rate on ex-tax diesel fuel used in exempt bus operations
5.
$
$
6. Tax due on ex-tax diesel fuel used in exempt bus operations (multiply line 4 by line 5)
6.
7. Total gallons of ex-tax diesel fuel used in non-exempt bus operations
7.
(may include charter and passenger stage operations)
8. Tax rate on ex-tax diesel fuel used in non-exempt bus operations
$
8.
9. Tax due on ex-tax diesel fuel used in non-exempt bus operations (multiply line 7 by line 8)
9.
$
10.
$
10. Tax due (add lines 6 and 9)
11. Penalty [multiply line 10 by 10% (0.10) if payment is made or return is filed after the
11.
$
PENALTY
due date shown above]
12.
INTEREST:
One month's interest is due on tax for each month or fraction of a month that payment
$
12.
INTEREST
is delayed after the due date. The adjusted monthly interest rate is
13. TOTAL AMOUNT DUE AND PAYABLE (add lines 10, 11, and 12)
13.
$
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.
CONTINUE
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