Petition Form For Redetermination

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BOE-416 REV. 7 (10-13)
STATE OF CALIFORNIA
PETITION FOR REDETERMINATION
BOARD OF EQUALIZATION
BUSINESS NAME
ACCOUNT NUMBER
TAXPAYER NAME
TYPE OF TAX OR FEE
PETITION FOR REDETERMINATION
Administrative Appeal
Generally, if you have received a notice of amount due from the Board of Equalization (BOE), you may file an administrative appeal of
that notice using this Petition for Redetermination. There are two important deadlines:
1.
If you received a Notice of Determination, a Notice of Deficiency Assessment, or a Notice of Successor Liability, you have
30 days from the date on the notice to appeal.
2.
If you received a Jeopardy Notice of Determination, you only have 10 days from the date listed on that document to appeal
and pay the amount due or deposit security considered acceptable by the BOE.
Look carefully at the notice you received for the specific conditions and requirements for filing this petition. Anyone submitting a petition
should be prepared, upon request, to provide documents that support the specific grounds upon which the petition is founded.
I am filing a petition of the notice dated _______________________________ for the period ___________________________________
in the amount of $ ___________________________________.
Please indicate below the specific grounds upon which the petition is founded (required):
You have the right to an appeals conference and an oral hearing before the Members of the Board (Board hearing). Please indicate
below whether you request an appeals conference, a Board hearing, or both. (Note: If you select only a Board hearing, an appeals
conference will, nevertheless, normally be held first.) During its review of your petition, BOE staff may ask that you confirm your request
for an appeals conference or Board hearing, and if you do still want an appeals conference or Board hearing, you must timely respond to
that request. Furthermore, if your case is accepted into the administrative appeals process, you may request that your case be
considered under the BOE’s administrative Settlement Program. Review under the Settlement Program is confidential and will not affect
your appeal rights.
Please indicate below whether you request an appeals conference, a Board hearing, or both, and if you are interested in the Settlement
Program.
I request an appeals conference with an Appeals Division attorney or auditor at the BOE’s nearest district office or in the
BOE’s Headquarters office in Sacramento.
I request a Board hearing.
I request my appeal be considered under the Settlement Program.
SIGNATURE
DATE SIGNED
DAYTIME TELEPHONE NUMBER
PRINTED NAME
TITLE/CAPACITY
EMAIL ADDRESS
If there is a conflict between this form or the notice you received and the law, the law is controlling. The filing of a Petition for Redetermination
does not protect your right to a refund of tax, interest, or penalty amounts paid in excess of amounts legally due. You must timely file a claim for
refund if you believe you have overpaid tax, interest, or penalty amounts. Filing a petition will not prevent interest from accruing on any unpaid tax
due.
CLEAR
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