Form BOE-400-IY Fillable Renewal Application for IFTA License and Decals

(all forms fillable on Windows, Mac, Android tablets, and iPad using Adobe Reader XI)

Download Form BOE-400-IY

View all CA - California Sales, Use and Other Taxes

(1) NEW FEIN (Federal Employer Identification Number)) (10) NEW AGENT/BOOKKEEPER TELEPHONE NUMBER (AREA CODE)) (12) NEW BANK OR OTHER FINANCIAL INSTITUTION) (2) NEW DEPARTMENT OF TRANSPORTATION NUMBER (DOT)) (4) NEW CORPORATION/LLC NAME AND NUMBER (list names of corporate/LLC officers members or managers below)) (5) NEW OWNER/PARTNER/PRESIDENT NAME) (6) NEW TRADE NAME/DBA) (7) NEW LOCATION OF BUSINESS (do not use a PO Box or agent's address for location of business)) (8) NEW MAILING ADDRESS (if different from business location; do not enter agent's address here)) (9) NEW AGENT/BOOKKEEPER NAME) (ACCOUNT NUMBER) (ACCOUNTANT CODE) (button) CLEAR (button) PRINT (CITY) (CITY) (continued on reverse) (Date business discontinued:) (Date of last interstate trip:) (DATE) (Effective date:) (EMAIL ADDRESS) (Lessor's IFTA account number:) (LOCATION) (NEW PARTNER/SECRETARY NAME) (NEW PARTNER/TREASURER NAME) (NEW PARTNER/VICE PRESIDENT NAME) (Other (please explain)) (PHONE NUMBER ( )) (PHONE NUMBER (AREA CODE)) (PHONE NUMBER (AREA CODE)) (PHONE NUMBER (AREA CODE)) (PHONE NUMBER) (PHONE NUMBER) (PHONE NUMBER) (PHONE NUMBER) (Please indicate the jurisdiction where you will register:) (PRINT NAME AND TITLE) (SOCIAL SECURITY NUMBER) (SOCIAL SECURITY NUMBER) (STATE) (STATE) (STREET ADDRESS (residence)) (STREET ADDRESS (residence)) (TELEPHONE NUMBER) (ZIP CODE) (ZIP CODE) [ FOID ] YOUR ACCOUNT NO 1 Enter the number of vehicles that you operate in IFTA jurisdictions 1) NEW FEIN (Federal Employer Identification Number) 10) NEW AGENT/BOOKKEEPER TELEPHONE NUMBER 11) NEW AGENT/BOOKKEEPER MAILING ADDRESS 12) NEW BANK OR OTHER FINANCIAL INSTITUTION 2 Fee per set of decals $ 2) NEW DEPARTMENT OF TRANSPORTATION NUMBER (DOT) 3 Total decal fee (multiply line 1 by line 2) 3) TYPE OF NEW OWNERSHIP 4 Annual license fee $ 4) NEW CORPORATION/LLC NAME AND NUMBER (list names of corporate/LLC officers members or managers below) 5 TOTAL AMOUNT ENCLOSED (add lines 3 and 4) 5) NEW OWNER/PARTNER/PRESIDENT NAME 6) NEW TRADE NAME/DBA 7) NEW LOCATION OF BUSINESS (do not use a PO Box or agent's address for location of business) 8) NEW MAILING ADDRESS (if different from business location; do not enter agent's address here) 800 400 7115 (TTY:711); from the main menu select the option Special Taxes and Fees 9) NEW AGENT/BOOKKEEPER NAME ACCOUNT NUMBER ACCOUNTANT CODE Always write your account number on your check or money order Make a copy of this document for your records BASE STATE VEHICLE BOARD OF EQUALIZATION BOARD OF EQUALIZATION BOE 400 IY (BACK) REV 6 (8 11)STATE OF CALIFORNIA BOE 400 IY (FRONT) REV 6 (8 11) BOE USE ONLY Corporation/LLC DIFFERENT THAN IFTA ACCOUNT DUE ON OR BEFORE Effective date: for the account mailing address) fuel usage and pay any tax due Lessor's IFTA account number: FUEL USED I am no longer in business Date business discontinued: I am no longer operating outside the state of California Date of last interstate trip: I am not renewing my IFTA license because (check only one box) I choose to purchase fuel trip permits when traveling interstate (including return trips into California) I will be applying for an IFTA license in another jurisdiction If you need additional information please contact the State Board of Equalization Motor Carrier Office P O Box 942879 IFTA RENEWAL INFORMATION LOCATION MAKE AND YEAR Make check or money order payable to the State Board of Equalization Remittance must be in U S funds Married Co Partnership MOTOR CARRIER OFFICE My truck(s) is/are leased to another carrier (lessor) who is licensed under IFTA and who is responsible to report NEW PARTNER/SECRETARY NAME NEW PARTNER/TREASURER NAME NEW PARTNER/VICE PRESIDENT NAME ODOMETER or if there has been a change in the ownership of the business) Other (please explain) Other Partnership PHONE NUMBER PHONE NUMBER PHONE NUMBER Please indicate the jurisdiction where you will register: Please use this address as my mailing address (check box and attach signed power of attorney form to use agent address PO BOX 942879 PRINT NAME AND TITLE PRINT NAME AND TITLE TELEPHONE RA B/A AUD REG READING REGISTERED OWNER IF REGISTRATION RENEWAL APPLICATION FOR IFTA LICENSE AND DECALS RR QS FILE REF Sacramento CA 94279 0065 You may also visit the BOE website at www boe ca gov or call the Taxpayer Information Section at SACRAMENTO CA 94279 6180 SECTION I: Decal and Fee Computation (this section must be completed) SECTION II: Vehicle Information (list complete information for each of your qualified motor vehicles; attach a separate sheet SECTION III: Cancellation Notice (complete this section if you will not be renewing your California IFTA License) SECTION IV: Business Change (complete this section only if the information preprinted on the front of this application is incorrect SECTION V: Signature (this section must be completed) SIGNATURE EMAIL ADDRESS SOCIAL SECURITY NUMBER SOCIAL SECURITY NUMBER Sole Proprietor STATE STATE STATE OF CALIFORNIA STREET ADDRESS (residence) STREET ADDRESS (residence) TELEPHONE to include information about additional vehicles) TYPE OF U S Department of Transportation Number (DOT) unless it is complete and accompanied by the required fees If you do not return this form it will result in the cancellation of VIN/LICENSE NUMBER You must complete and return this renewal application to maintain your IFTA license Your application will not be processed your license ZIP CODE ZIP CODE

Main Navigation