"none" in line 3
& STOVE OIL
(10 Total tax (add lines 7 and 9) REPORT WHOLE UNITS/GALLONS ONLY A COMPRESSED NATURAL GAS $)
(11 Tax paid to California vendors on fuel included in line 1 (retain invoices) REPORT WHOLE UNITS/GALLONS ONLY A COMPRESSED NATURAL GAS $)
(12 Balance of tax (subtract line 11 from line 10; if line 11 is larger than line 10 enter a minus sign [ ]) REPORT WHOLE UNITS/GALLONS ONLY A COMPRESSED NATURAL GAS $)
(12 Balance of tax (subtract line 11 from line 10; if line 11 is larger than line 10 enter a minus sign [ ]) REPORT WHOLE UNITS/GALLONS ONLY B LPG & Liquid NATURAL GAS $)
(13 Total tax due or refund claimed (add columns A B C and D of line 12) If claiming a refund enter the amount as a negative number Do not claim credit on future returns; a refund will be processed $ )
(14 PENALTY [multiply line 13 by 10% (0 10) if payment made or return filed after the due date shown above] $)
(15 INTEREST: One month's interest is due on tax for each month or fraction of a month that payment is delayed after the due date The adjusted monthly interest rate is )
(16 TOTAL AMOUNT DUE AND PAYABLE OR REFUND CLAIMED (add lines 13 14 and 15) $)
(2 Total nontaxable use of fuel (enter from Schedule A line A6) REPORT WHOLE UNITS/GALLONS ONLY A COMPRESSED NATURAL GAS )
(3 Taxable use of fuel (subtract line 2 from line 1) REPORT WHOLE UNITS/GALLONS ONLY A COMPRESSED NATURAL GAS )
(4 Fuel used in qualifying exempt: 4a Local Transit Services REPORT WHOLE UNITS/GALLONS ONLY A COMPRESSED NATURAL GAS )
(4 Fuel used in qualifying exempt: 4c Total (add lines 4a and 4b) REPORT WHOLE UNITS/GALLONS ONLY A COMPRESSED NATURAL GAS )
(5 Fuel used in non exempt operations including non qualifying charter party carrier and passenger stage operations REPORT WHOLE UNITS/GALLONS ONLY A COMPRESSED NATURAL GAS )
(6 Tax rate per unit/gallon on fuel used in exempt bus operations (including local transit services and school bus transit) REPORT WHOLE UNITS/GALLONS ONLY A COMPRESSED NATURAL GAS $)
(7 Total tax on exempt use of fuel shown in line 4c (multiply line 4c by line 6) REPORT WHOLE UNITS/GALLONS ONLY A COMPRESSED NATURAL GAS $)
(A1 Fuel used in vehicles operated outside California REPORT WHOLE UNITS/GALLONS ONLY Alcohol Fuels (gallons) NOTE: ONLY FUEL INCLUDED ON LINE 1 OF THE RETURN CAN BE CLAIMED ON LINES A1 THRU A6 )
(A1 Fuel used in vehicles operated outside California REPORT WHOLE UNITS/GALLONS ONLY B LPG & Liquid Natural Gas (gallons) NOTE: ONLY FUEL INCLUDED ON LINE 1 OF THE RETURN CAN BE CLAIMED ON LINES A1 THRU A6 )
(A2 Fuel used in vehicles operated off highway in California REPORT WHOLE UNITS/GALLONS ONLY A COMPRESSED NATURAL GAS (units) NOTE: ONLY FUEL INCLUDED ON LINE 1 OF THE RETURN CAN BE CLAIMED ON LINES A1 THRU A6 )
(A2 Fuel used in vehicles operated off highway in California REPORT WHOLE UNITS/GALLONS ONLY B LPG & Liquid Natural Gas (gallons) NOTE: ONLY FUEL INCLUDED ON LINE 1 OF THE RETURN CAN BE CLAIMED ON LINES A1 THRU A6 )
(A2 Fuel used in vehicles operated off highway in California REPORT WHOLE UNITS/GALLONS ONLY C Alcohol fuels (gallons) NOTE: ONLY FUEL INCLUDED ON LINE 1 OF THE RETURN CAN BE CLAIMED ON LINES A1 THRU A6 )
(A2 Fuel used in vehicles operated off highway in California REPORT WHOLE UNITS/GALLONS ONLY D KEROSENE DISTILLATE & STOVE OIL (gallons) NOTE: ONLY FUEL INCLUDED ON LINE 1 OF THE RETURN CAN BE CLAIMED ON LINES A1 THRU A6 )
(A3 Fuel used on highways in California under jurisdiction of U S Department of Agriculture REPORT WHOLE UNITS/GALLONS ONLY A COMPRESSED NATURAL GAS (units) NOTE: ONLY FUEL INCLUDED ON LINE 1 OF THE RETURN CAN BE CLAIMED ON LINES A1 THRU A6 )
(A3 Fuel used on highways in California under jurisdiction of U S Department of Agriculture REPORT WHOLE UNITS/GALLONS ONLY B LPG & LIQUID NATURAL GAS (gallons) NOTE: ONLY FUEL INCLUDED ON LINE 1 OF THE RETURN CAN BE CLAIMED ON LINES A1 THRU A6 )
(A3 Fuel used on highways in California under jurisdiction of U S Department of Agriculture REPORT WHOLE UNITS/GALLONS ONLY C ALCOHOL FUELS (gallons) NOTE: ONLY FUEL INCLUDED ON LINE 1 OF THE RETURN CAN BE CLAIMED ON LINES A1 THRU A6 )
(A3 Fuel used on highways in California under jurisdiction of U S Department of Agriculture REPORT WHOLE UNITS/GALLONS ONLY D KEROSENE DISTILLATE & STOVE OIL (gallons) NOTE: ONLY FUEL INCLUDED ON LINE 1 OF THE RETURN CAN BE CLAIMED ON LINES A1 THRU A6 )
(A4 Liquefied petroleum gas liquid natural gas and compressed natural gas used in vehicles for which the annual flat rate tax has been paid REPORT WHOLE UNITS/GALLONS ONLY B LPG & LIQUID NATURAL GAS (gallons) NOTE: ONLY FUEL INCLUDED ON LINE 1 OF THE RETURN CAN BE CLAIMED ON LINES A1 THRU A6 )
(A5 Other nontaxable use of fuel REPORT WHOLE UNITS/GALLONS ONLY B LPG & LIQUID NATURAL GAS (gallons) NOTE: ONLY FUEL INCLUDED ON LINE 1 OF THE RETURN CAN BE CLAIMED ON LINES A1 THRU A6 )
(A5 Other nontaxable use of fuel REPORT WHOLE UNITS/GALLONS ONLY D KEROSENE DISTILLATE & STOVE OIL (gallons) NOTE: ONLY FUEL INCLUDED ON LINE 1 OF THE RETURN CAN BE CLAIMED ON LINES A1 THRU A6 )
(A6 Total nontaxable use of fuel (add lines A1 thru A5; enter on line 2 of return) C Alcohol Fuels (gallons) REPORT WHOLE UNITS/GALLONS ONLY NOTE: ONLY FUEL INCLUDED ON LINE 1 OF THE RETURN CAN BE CLAIMED ON LINES A1 THRU A6 )
(A6 Total nontaxable use of fuel (add lines A1 thru A5; enter on line 2 of return) REPORT WHOLE UNITS/GALLONS ONLY A COMPRESSED NATURAL GAS (units) NOTE: ONLY FUEL INCLUDED ON LINE 1 OF THE RETURN CAN BE CLAIMED ON LINES A1 THRU A6 )
(A6 Total nontaxable use of fuel (add lines A1 thru A5; enter on line 2 of return) REPORT WHOLE UNITS/GALLONS ONLY B LPG & LIQUID NATURAL GAS (gallons) NOTE: ONLY FUEL INCLUDED ON LINE 1 OF THE RETURN CAN BE CLAIMED ON LINES A1 THRU A6 )
(A6 Total nontaxable use of fuel (add lines A1 thru A5; enter on line 2 of return) REPORT WHOLE UNITS/GALLONS ONLY D KEROSENE DISTILLATE & STOVE OIL (gallons) NOTE: ONLY FUEL INCLUDED ON LINE 1 OF THE RETURN CAN BE CLAIMED ON LINES A1 THRU A6 )
(B O E USE ONLY)
(CLEAR) CLEAR
(CNG) which is reported as units For tax reporting purposes 100 cubic feet of natural gas measured at standard
(DATE)
(DUE ON OR BEFORE)
(EMAIL ADDRESS)
(gallons)
(gallons)
(multiply line 4c by line 6)
(please describe)
(PRINT NAME AND TITLE)
(PRINT) PRINT
(REPORT WHOLE UNITS/GALLONS ONLY B LPG & LIQUID NATURAL GAS $)
(REPORT WHOLE UNITS/GALLONS ONLY B LPG & LIQUID NATURAL GAS $)
(REPORT WHOLE UNITS/GALLONS ONLY B LPG & LIQUID NATURAL GAS $)
(REPORT WHOLE UNITS/GALLONS ONLY B LPG & LIQUID NATURAL GAS )
(REPORT WHOLE UNITS/GALLONS ONLY B LPG & LIQUID NATURAL GAS )
(REPORT WHOLE UNITS/GALLONS ONLY B LPG & LIQUID NATURAL GAS )
(REPORT WHOLE UNITS/GALLONS ONLY C ALCOHOL FUELS $)
(REPORT WHOLE UNITS/GALLONS ONLY C ALCOHOL FUELS $)
(REPORT WHOLE UNITS/GALLONS ONLY C ALCOHOL FUELS $)
(REPORT WHOLE UNITS/GALLONS ONLY C ALCOHOL FUELS )
(REPORT WHOLE UNITS/GALLONS ONLY C ALCOHOL FUELS )
(REPORT WHOLE UNITS/GALLONS ONLY C ALCOHOL FUELS )
(REPORT WHOLE UNITS/GALLONS ONLY C ALCOHOL FUELS )
(REPORT WHOLE UNITS/GALLONS ONLY D KEROSENE DISTILLATE & STOVE OIL $)
(REPORT WHOLE UNITS/GALLONS ONLY D KEROSENE DISTILLATE & STOVE OIL $)
(REPORT WHOLE UNITS/GALLONS ONLY D KEROSENE DISTILLATE & STOVE OIL $)
(REPORT WHOLE UNITS/GALLONS ONLY D KEROSENE DISTILLATE & STOVE OIL $12 Balance of tax (subtract line 11 from line 10; if line 11 is larger than line 10 enter a minus sign [ ]) REPORT WHOLE UNITS/GALLONS ONLY D Kerosene Distillate & stove oil $)
(REPORT WHOLE UNITS/GALLONS ONLY D KEROSENE DISTILLATE & STOVE OIL )
(REPORT WHOLE UNITS/GALLONS ONLY D KEROSENE DISTILLATE & STOVE OIL )
(REPORT WHOLE UNITS/GALLONS ONLY D KEROSENE DISTILLATE & STOVE OIL )
(REPORT WHOLE UNITS/GALLONS ONLY D KEROSENE DISTILLATE & STOVE OIL )
(TELEPHONE (AREA CODE))
(TELEPHONE)
(text)
(units)
(You must complete Schedule A on the back before preparing the return 1 Total fuel used in motor vehicles REPORT WHOLE UNITS/GALLONS ONLY A COMPRESSED NATURAL GAS )
(YOUR ACCOUNT NO )
[ FOID ]
1 Total fuel used in motor vehicles
10 Total tax (add lines 7 and 9) $
11 Tax paid to California vendors on fuel included in
12 Balance of tax (subtract line 11 from line 10; if line 11
13 Total tax due or refund claimed (add columns A B C and D of line 12)
14 Penalty [multiply line 13 by 10% (0 10) if payment made or return filed after the due date shown above] PENALTY $
15 INTEREST: One month's interest is due on tax for each month or fraction of a month that payment is
16 TOTAL AMOUNT DUE AND PAYABLE OR REFUND CLAIMED (add lines 13 14 and 15) $
2 Total nontaxable use of fuel (enter from Schedule A
3 Taxable use of fuel (subtract line 2 from line 1)
4 Fuel used in qualifying exempt:
4a Local Transit Services
4b School Bus Transit
4c Total (add lines 4a and 4b)
5 Fuel used in non exempt operations including
6 Tax rate per unit/gallon on fuel used in exempt bus
7 Total tax on exempt use of fuel shown in line 4c
8 Tax rate per unit/gallon on fuel used in non exempt
9 Tax on use of fuel in non exempt operations shown
a refund will be processed
A1 Fuel used in vehicles operated outside California
A2 Fuel used in vehicles operated off highway in California
A3 Fuel used on highways in California under jurisdiction
A4 Liquefied petroleum gas liquid natural gas and
A5 Other nontaxable use of fuel
A6 Total nontaxable use of fuel (add lines A1 thru A5;
agreement with a public agency authorized to provide public transportation services
ALCOHOL
Alcohol fuels containing not more than 15 percent gasoline or diesel fuel (for example ethanol and methanol)
Always write your account number on your check or money order Make a copy of this document for your records
annual flat rate tax has been paid
Any common carrier of passengers operating exclusively within the limits of a single city between fixed terminals
Any fuel used or suitable for use in motor vehicles other than fuel subject to the diesel fuel tax or the motor
Any passenger stage corporation subject to the jurisdiction of the PUC and providing transportation of persons
Any private entity providing transportation services under a contract or agreement other than a general franchise
Any school district community college district or county superintendent of schools owning leasing or operating
Any transit district transit authority or a city owning and operating a local transit system itself or through a
BE CLAIMED ON LINES A1 THRU A6
BEFORE PREPARING
BOARD OF EQUALIZATION
BOARD OF EQUALIZATION
bus operations
bus transit
bus transit)
buses for the purpose of transporting pupils to and from school and for other school activities or any private
by line 6
CLEAR BUTTON
COMPRESSED
Compressed natural gas (CNG)
compressed natural gas used in vehicles for which the
delayed after the due date The adjusted monthly interest rate is
DISTILLATE
DUE ON OR BEFORE
EMAIL ADDRESS
enter on line 2 of return)
enter the amount as a negative number Do not claim credit on future returns; a refund will be processed
entity providing such transportation services under a contract with the school district
examined by me and to the best of my knowledge and belief is a true correct and complete return
EXEMPT BUS OPERATOR USE FUEL TAX RETURN
federal fuel tax or state and local sales and use taxes
FILING REQUIREMENTS
following the end of the reporting period Payments should be made payable to the State Board of Equalization A return
for hire when the motor vehicle is exclusively operated in urban or suburban areas or between cities in close
Fuel users must file this return to report use of the following types of fuels (when used in the fuel tanks of motor vehicles):
FUELS
GENERAL INFORMATION
I hereby certify that this return including any accompanying schedules and statements has been
If claiming a refund enter the amount as a negative number Do not claim credit on future returns;
in line 5 (multiply line 5 by line 8)
Include fuel used by a lessee of your vehicles if you are responsible for furnishing the fuel see Regulation 1304
included in line 1 can be claimed on line 2
INSTRUCTIONS FOR EXEMPT BUS OPERATOR USE FUEL TAX RETURN
INTEREST $
is larger than line 10 enter a minus sign [ ]) $
KEROSENE
Kerosene distillate and stove oil
line 1 (retain invoices) $
Line 1 Enter the total number of gallons or units of fuel which you used to operate vehicles both in and out of California
Line 10 Add lines 7 and 9
Line 11 Enter the amount of the Use Fuel Tax paid to the vendor on fuel purchased in California Do not include the
Line 12 Subtract line 11 from line 10 and enter the difference on line 12 If line 10 is larger than line 11 enter the amount
Line 13 Combine columns A B C and D of line 12 and enter the total on line 13 If the total on line 13 results in a credit
Line 14 If you are paying your tax on line 13 after the due date shown on the front of this return you will owe a penalty
Line 15 If you are paying your tax on line 13 after the due date shown on the front of this return you will owe interest
Line 16 Enter the total amount due and payable by adding lines 13 14 and 15 If claiming a refund enter the amount of
Line 2 Enter the number of gallons or units of fuel used in a nontaxable manner from line A6 of Schedule A Only fuel
Line 3 Subtract line 2 from line 1
Line 4a Enter the total number of gallons or units of fuel used in an exempt manner for qualifying local transit services by:
Line 4b Enter the total number of gallons or units of fuel used in an exempt manner for school bus transit operations by:
Line 4c Enter the sum of lines 4a and 4b
Line 5 Enter the number of gallons or units of fuel used in operations other than exempt local transit services or school
Line 6 Section 8655 of the Revenue and Taxation Code imposes a tax of 1 cent per unit/gallon on the fuel used for
Line 7 Enter the amount of tax computed on the units/gallons for which exemption is claimed in line 4c Multiply line 4c
Line 8 Tax rate on fuel used in non exempt bus operations
Line 9 Enter the amount of tax computed by multiplying line 7 by the tax rate shown on line 8 for each type of fuel
line A6)
Liquefied petroleum gas (LPG) and liquid natural gas (LNG)
local transit services or school bus transit
LPG & LIQUID
Make check or money order payable to State Board of Equalization
MOTOR CARRIER OFFICE
motor vehicle fuel tax and as a result are not subject to use fuel tax)
must be filed for each period even though no fuel may have been used during the period If no fuel was used write the word
NATURAL GAS
NATURAL GAS
non qualifying charter party carrier and passenger
Note gallons vs units: Fuel transactions are reported in terms of gallons except for compressed natural gas
NOTE: ONLY FUEL INCLUDED ON LINE 1 OF THE RETURN CAN
Note: The sum of lines 4c and 5 must equal line 3
of 10 percent of the amount of tax due Enter the penalty by multiplying the tax due on line 13 by 0 10 and enter
of tax due with this return If line 11 is larger than line 10 indicate the credit by entering a minus sign ( )
of U S Department of Agriculture
operations (including local transit services and school
or over a regular route 98 percent of whose operations are within the limits of a single city
over 7 000 pounds and is powered by fuels described above Returns are also required of owners/operators of vehicles that
payment is late Enter the interest by multiplying the tax due on line 13 by the interest rate shown then multiply
PO BOX 942879
preparing the return
pressure and temperature (14 73 pounds per square inch at 60 degrees Fahrenheit) will be shown as one unit
PRINT BUTTON
PRINT NAME AND TITLE
proximity Do not include fuel used on any route which exceeds 50 miles one way
READ INSTRUCTIONS
REPORT WHOLE UNITS/GALLONS ONLY
SACRAMENTO CA 94279 6171
SCHEDULE A NONTAXABLE USE OF FUEL
SIGNATURE
stage operations
STATE OF CALIFORNIA
storage facilities except fuel supply tanks of vehicles
TAX LIABILITY
TELEPHONE
tenths of units to the nearest whole unit "Bulk storage" includes fuel stored in drums barrels tanks or other
The interest rate noted on the front of this return applies for each month or fraction of a month that your
the refund claimed as a negative number
the result by the number of months or fraction of a month that have elapsed since the due date and enter here
use the above fuels in commercial vehicles weighing less than 7 000 pounds and are paying the annual flat rate tax
User of Fuel Exempt Under Section 8655 of the Revenue and Taxation Code
User Report whole gallons or whole units only Round off tenths of gallons to the nearest whole gallon Round off
Users of fuel subject to the use fuel tax must file returns The return and payment is due on the last day of the month
vehicle fuel tax (for example gasoline and blended fuels with more than 15 percent gasoline are subject to the
wholly owned non profit corporation
You must complete Schedule A on the back before
You must have a user use fuel permit and file returns if you operate on California highways a vehicle that weighs unladen
YOUR ACCOUNT NO