Form Boe-512-Ad - Request For Additional Annual Flat Rate Decals
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3BOE-512-AD (S1) REV. 4 (4-13)
STATE OF CALIFORNIA
BOARD OF EQUALIZATION
REQUEST FOR ADDITIONAL ANNUAL FLAT RATE DECALS
BOE USE ONLY
RA-B/A
AUD
REG
EXPIRES AT THE END OF
RR-QS
FILE
REF
YOUR ACCOUNT NO.
[
]
FOID
EFF
BOARD OF EQUALIZATION
MOTOR CARRIER OFFICE
PO BOX 942879
SACRAMENTO CA 94279-6192
READ INSTRUCTIONS
BEFORE PREPARING
GENERAL INFORMATION
You may use this form to order decals for use fuel vehicles that you wish to add to your Annual Flat Rate Fuel Tax fleet.
You must have a current Annual Flat Rate Fuel Tax account with the State Board of Equalization (BOE), and your account must
be in good standing.
DECALS MAY NOT BE TRANSFERRED TO ANOTHER VEHICLE
The fees and/or the decals may not be transferred from one vehicle to another. The decal identifies the vehicle for the purpose
of purchasing liquefied petroleum gas (LPG), liquid natural gas (LNG), or compressed natural gas (CNG) without payment of the
use fuel tax to vendors. Sales tax applies to all purchases of LPG, LNG, or CNG, even though the flat rate fuel tax has
been paid.
FILING REQUIREMENTS
The flat rate is an annual tax. The period for which the annual fee payment applies is any 12-month period beginning with the
first day of the month in which the payment was made and ending one year thereafter. The BOE, in order to facilitate the
administration of the annual flat rate fuel tax program, requires that when additional vehicles are added, the fees shall be
prorated so that vehicles under the same use fuel tax account will have a like starting month. The fee for vehicles added
part-way through the 12-month period is reduced by one-twelfth (1/12) for each month which has passed since the starting
month of the 12-month period. For example, the fee for a vehicle added in August to an account with a starting month of
March would be seven-twelfths (7/12) of the appropriate fee.
FILING INSTRUCTIONS
PLEASE COMPLETE THE ENCLOSED SUPPLEMENTAL VEHICLE LIST BEFORE COMPLETING THIS FORM. FULL
PAYMENT MUST ACCOMPANY THE REQUEST.
Line 1. Add the number of use fuel vehicles listed on the Supplemental Vehicle List and enter the total on line 1.
Line 2. Add the fees (column F) for the vehicles listed on the Supplemental Vehicle List and enter the total amount on line 2.
1.
1. Enter the number of additional use fuel vehicles for which you are requesting decals
2. Enter the total amount of prorated fees for additional decals requested
2.
I understand that the tax/fee applies to a specific vehicle and is not subject to refund or transfer to another vehicle and that I
may be required to file a return showing the total number of gallons used in vehicles for which the flat rate fee has been paid.
I certify under the laws of the State of California that the foregoing is true and correct.
SIGNATURE
EMAIL ADDRESS
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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