Form BOE-501-PS Fillable Supplier of Motor Vehicle Fuel Tax Return

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Sorted by Product Description for a list of taxable products (0 10) and enter here Enter this amount on line 5 on the front of the return (4 PENALTY (multiply line 3 by 10% (0 10) if payment made or return filed after the due date Enter this amount on line 5 on the front of the return ) $) (5 PENALTY (multiply line 4 by 10% (0 10) if payment made or return filed after due date shown above See return instructions if you made a prepayment ) $) (6 INTEREST $) (7 TOTAL AMOUNT DUE AND PAYABLE (add lines 4 5 and 6) $) (CLEAR) CLEAR (Column A; Row 1; SECTION B TAX PAID CREDITS (Total Gallons); 1 Tax paid fuel exported (enter total from column 11 of Schedule 13A); FROM SCHEDULE; 13A; MOTOR VEHICLE FUEL AT CURRENT RATE) (Column A; Row 1; SECTION C TAXABLE GALLONS COMPUTATION; MOTOR VEHICLE FUEL AT CURRENT RATE; 1 Total gallons from transactions subject to tax (enter from section A line 10 for each column)) (Column A; Row 10; SECTION A TAXABLE TRANSACTIONS(Total Gallons); 10 TOTAL OF TRANSACTIONS SUBJECT TO TAX (add lines 1 through 9 for each column); FROM SCHEDULE; MOTOR VEHICLE FUEL AT CURRENT RATE) (Column A; Row 2; SECTION B TAX PAID CREDITS (Total Gallons); 2 Tax paid fuel sold to a consulate officer or employee bycredit card (enter total from column 11 of Schedule 13B); FROM SCHEDULE; 13B; MOTOR VEHICLE FUEL AT CURRENT RATE) (Column A; Row 3; SECTION A TAXABLE TRANSACTIONS(Total Gallons); 3 Fuel sold above the rack to unlicensed parties (enter total from column 11 of Schedule 5A); FROM SCHEDULE; 5A; MOTOR VEHICLE FUEL AT CURRENT RATE) (Column A; Row 3; SECTION B TAX PAID CREDITS (Total Gallons); 3 Tax paid aviation fuel sold to the Armed Forces of the United States for use in ships or aircraft or for use outside this state (enter total from column 11 of Schedule 13C); FROM SCHEDULE; 13C; MOTOR VEHICLE FUEL AT CURRENT RATE) (Column A; Row 4; SECTION A TAXABLE TRANSACTIONS(Total Gallons); 4 Fuel sold and originating tax collected (enter total from column 11 of Schedule 5H); FROM SCHEDULE; 5H; MOTOR VEHICLE FUEL AT CURRENT RATE) (Column A; Row 4; SECTION B TAX PAID CREDITS (Total Gallons); 4 Tax paid fuel sold to train operators (enter total from column 11 of Schedule 13G) ; FROM SCHEDULE; 13G; MOTOR VEHICLE FUEL AT CURRENT RATE) (Column A; Row 5; SECTION A TAXABLE TRANSACTIONS(Total Gallons); 5 Taxable gallons of fuel used (enter total from column 11 of Schedule 5Q); FROM SCHEDULE; 5Q; MOTOR VEHICLE FUEL AT CURRENT RATE) (Column A; Row 5; SECTION B TAX PAID CREDITS (Total Gallons); 5 Tax paid fuel used in an exempt manner not reportable on another credit schedule (enter total from column 11 of Schedule 13J); FROM SCHEDULE; 13J; MOTOR VEHICLE FUEL AT CURRENT RATE) (Column A; Row 6; SECTION B TAX PAID CREDITS (Total Gallons); 6 Tax paid fuel removed from a terminal as a second taxable event (enter total from column 11 of Schedule 13M); FROM SCHEDULE; 13M; MOTOR VEHICLE FUEL AT CURRENT RATE) (Column A; Row 7; SECTION A TAXABLE TRANSACTIONS(Total Gallons); 7 Untaxed products blended with or added to fuel resulting in a product which is used as or is usable as a taxable fuel (enter total from column 11 of Schedule 5W); FROM SCHEDULE; 5W; MOTOR VEHICLE FUEL AT CURRENT RATE) (Column A; Row 7; SECTION B TAX PAID CREDITS (Total Gallons); 7 Tax paid fuel used to manufacture other products (enter total from column 11 of Schedule 13N); FROM SCHEDULE; 13N; MOTOR VEHICLE FUEL AT CURRENT RATE) (Column A; Row 8; SECTION A TAXABLE TRANSACTIONS(Total Gallons); 8 Gallons delivered partially taxed (enter total from column 11 of Schedule 5X); FROM SCHEDULE; 5X; MOTOR VEHICLE FUEL AT CURRENT RATE) (Column A; Row 8; SECTION B TAX PAID CREDITS (Total Gallons); 8 Other tax paid credits (enter total from column 11 of Schedule S03A); FROM SCHEDULE; S03A; MOTOR VEHICLE FUEL AT CURRENT RATE) (Column A; Row 9; SECTION A TAXABLE TRANSACTIONS(Total Gallons); 9 Miscellaneous fuel transactions subject to tax (enter total from column 11 of Schedule S02A); FROM SCHEDULE; S02A; MOTOR VEHICLE FUEL AT CURRENT RATE) (Column A; Row 9; SECTION B TAX PAID CREDITS (Total Gallons); 9 TOTAL OF TAX PAID CREDITS (add lines 1 through 8 for each column); FROM SCHEDULE; MOTOR VEHICLE FUEL AT CURRENT RATE) (Column B; Row 1; MOTOR VEHICLE FUEL AT PRIOR RATE) (Column B; Row 1; MOTOR VEHICLE FUEL AT PRIOR RATE) (Column B; Row 10; MOTOR VEHICLE FUEL AT PRIOR RATE) (Column B; Row 2; MOTOR VEHICLE FUEL AT PRIOR RATE) (Column B; Row 3; MOTOR VEHICLE FUEL AT PRIOR RATE) (Column B; Row 4; MOTOR VEHICLE FUEL AT PRIOR RATE) (Column B; Row 5; MOTOR VEHICLE FUEL AT PRIOR RATE) (Column B; Row 6; MOTOR VEHICLE FUEL AT PRIOR RATE) (Column B; Row 7; MOTOR VEHICLE FUEL AT PRIOR RATE) (Column B; Row 8; MOTOR VEHICLE FUEL AT PRIOR RATE) (Column B; Row 9; MOTOR VEHICLE FUEL AT PRIOR RATE) (Column C; Row 1; AVIATION GASOLINE) (Column C; Row 1; AVIATION GASOLINE) (Column C; Row 10; AVIATION GASOLINE) (Column C; Row 2; AVIATION GASOLINE) (Column C; Row 3; AVIATION GASOLINE) (Column C; Row 4; AVIATION GASOLINE) (Column C; Row 5; AVIATION GASOLINE) (Column C; Row 6; AVIATION GASOLINE) (Column C; Row 7; AVIATION GASOLINE) (Column C; Row 8; AVIATION GASOLINE) (Column C; Row 9; AVIATION GASOLINE) (Continued on Reverse) (EMAIL ADDRESS) (PRINT NAME AND TITLE) (PRINT) PRINT (REPORT WHOLE GALLONS ONLY 1 Column (A) Motor Vehicle Fuel at Current Rate 1 Taxable gallons (enter from Tax Computation Worksheet section C line 3 columns A B and C) ) (REPORT WHOLE GALLONS ONLY 1 Column (B) Motor Vehicle Fuel at Prior Rate 1 Taxable gallons (enter from Tax Computation Worksheet section C line 3 columns A B and C) ) (REPORT WHOLE GALLONS ONLY 1 Column (B) Motor Vehicle Fuel at Prior Rate 2 Rates of tax per gallon $) (REPORT WHOLE GALLONS ONLY 1 Column (B) Motor Vehicle Fuel at Prior Rate 2 Subtotal of tax due (multiply line 1 by line 2 for columns A B and C) $) (REPORT WHOLE GALLONS ONLY 2 Column (A) Motor Vehicle Fuel at Current Rate 2 Rates of tax per gallon $) (REPORT WHOLE GALLONS ONLY 2 Column (C) Aviation Gasoline 2 Rates of tax per gallon $) (REPORT WHOLE GALLONS ONLY 3 Column (A) Motor Vehicle Fuel at Current Rate 2 Subtotal of tax due (multiply line 1 by line 2 for columns A B and C) $) (REPORT WHOLE GALLONS ONLY 3 Column (C) Aviation Gasoline 2 Subtotal of tax due (multiply line 1 by line 2 for columns A B and C) $) (SECTION D PREPAYMENT ACCOUNTS ONLY PENALTY AND INTEREST CALCULATION AMOUNT; MOTOR VEHICLE FUEL AND AVIATION GASOLINE; 1 Total tax due (enter from line 4 on the front of the return) $) (SECTION D PREPAYMENT ACCOUNTS ONLY PENALTY AND INTEREST CALCULATION AMOUNT; MOTOR VEHICLE FUEL AND AVIATION GASOLINE; 2 Tax prepayment (enter amount of tax already paid for the period) $) (SECTION D PREPAYMENT ACCOUNTS ONLY PENALTY AND INTEREST CALCULATION AMOUNT; MOTOR VEHICLE FUEL AND AVIATION GASOLINE; 3 Remaining tax due (subtract line 2 from line 1) $) (TELEPHONE (AREA CODE)) (TELEPHONE ) (text) (text) (YOUR ACCOUNT NO ) [ FOID] 1 800 400 7115 (TTY:711) or visit our website at www boe ca gov/elecsrv/efiling/efilemotorfuels htm for more information 10YFuel Removed and Sold to Train Operators Tax Exempt10ZGasoline Blendstocks Removed Tax Exempt Not in Connection with a Sale Which Will Not Be Used to 12AAll Other Sales or Use of Tax Paid Fuel Below the Rack 12BAll Other Sales or Use of Ex Tax Fuel Below the Rack12CEnding Inventory of Below the Rack Products 2 Rates of tax per gallon2 $ 3 Subtotal of tax due (multiply line 1 by line 2 for 3 TAXABLE GALLONS (subtract line 2 from line 1) This may not result 3AImports Above the Terminal Rack3BImports of Tax Free Motor Vehicle Fuel Blendstocks to an Approved Refinery or Terminal3XImports Below the Terminal Rack Subject to Tax3YImports Below the Terminal Rack Not Subject to Tax 4 Total tax due (add columns A B and C of line 3)4 $ 5 Penalty (multiply line 4 by 10% (0 10) if payment made or return filed after due date 5Fuel Removed Subject to Tax5AFuel Sold Above the Rack to Unlicensed Parties5HFuel Sold Originating Tax Collected5QTaxable Gallons of Fuel Used5VEx tax Gallons of Blendstocks Resold to Persons Not Furnishing an Exemption Certificate5WUntaxed Products Blended with or Added to Fuel Resulting in a Product Which Is Used as or Is Usable as 6 INTEREST: One month's interest is due on tax for each month or fraction of a month that 7 TOTAL AMOUNT DUE AND PAYABLE (add lines 4 5 and 6)7 $ a Taxable Fuel5XGallons Delivered and Partially Taxed6FReportable Products Removed Not Subject to Tax7Fuel Removed and Exported Tax Exempt7DExports Above the Terminal Rack8Fuel Removed and Sold to the United States Government Tax Exempt Only sales to the Armed Forces of Account " this is the total amount due for the period including the prepayment Your payment with this return Accountability activities: removal of motor vehicle fuel from a refinery or terminal rack; importation of motor vehicle fuel outside the bulk adding the totals from column 11 for each disbursement schedule coded 5A adding the totals from column 11 for each disbursement schedule coded 5Q adding the totals from column 11 for each disbursement schedule coded 5X Always write your account number on your check or money order Make a copy of this document and the accompanying schedules for your records an exemption certificate and resold to a person not furnishing an exemption certificate by adding the totals from and C on line 1 on the front of the return As a supplier of motor vehicle fuel in California you are required to report all imports exports blending and terminal rack AVIATION AVIATION AviationGasoline1 Taxable gallons (enter from Tax Computation Worksheet BBargeCESummary InformationGSGas StationJTruckPLPipelineRRailRTRemoval from TerminalSShip (Ocean Marine Vessel) be offset on Schedule 5H Credits offset on Schedule 5H must be claimed for refund of the tax which is filed with Before completing the return prepare the applicable Receipt Disbursement and Summary Schedules and the before the last day of the calendar month following the reporting period to which it relates Paying your tax or filing your Below the Rack Activity Schedules best of my knowledge and belief is a true correct and complete return BOARD OF EQUALIZATION BOE 501 PS (S1) REV 9 (4 13) BOE 501 PS (S1B) REV 9 (4 13) BOE 501 PS (S2B) REV 9 (4 13) BOE 501 PS (S2F) REV 9 (4 13) BOE 501 PS (S3B) REV 9 (4 13) BOE 501 PS (S3F) REV 9 (4 13) BOE 501 PS (S4B) REV 9 (4 13) BOE 501 PS (S4F) REV 9 (4 13) BOE USE ONLYAUDRA B/AREGFILERR QSREFEFF BOE's website at www boe ca gov/sptaxprog/spftdmfuels htm by adding the totals from column 11 for each disbursement schedule coded 13C by adding the totals from column 11 for each disbursement schedule coded 13N C results in a negative tax due amount then one or more of the credits Certificate Stating the Blendstocks Will Not Be Used to Produce Finished Gasoline13ATax Paid Fuel Exported13BTax Paid Fuel Sold to a Consulate Officer or Employee by Credit Card13CTax Paid Aviation Fuel Sold to the Armed Forces of the United States for Use in Aircraft13GTax Paid Fuel Sold to Train Operators13JTax Paid Fuel Used in an Exempt Manner Not Reportable on Another Credit Schedule13MTax Paid Fuel Removed from a Terminal as a Second Taxable Event13NTax Paid Fuel Used to Manufacture Other Products CERTIFICATION click on the eServices tab and log in to make a payment To pay by credit card go coded 13J column 11 for each disbursement schedule coded 5V columns A B and C on the front of the return (Taxable gallons may not result in a negative tax due amount If columns A B and C) confidential transaction information regarding volumes invoice numbers bills of lading locations dates or method of credit by adding the totals from column 11 for each summary schedule coded S03A credits current tax rate and prior tax rate as well as aviation gasoline must be reported separately in columns A B and C Customer service representatives are available weekdays from 8:00 a m to 5:00 p m (Pacific time) except state holidays delivery of reportable products to any person identified by me in this return as being involved in a reported transaction for the Disbursement Schedules disbursements of motor vehicle fuel in this state DUE ON OR BEFORE each schedule EFT (payment by check for example) However 10 percent is the maximum penalty applied to late returns and EMAIL ADDRESS employee by credit card by adding the totals from column 11 for each disbursement schedule coded 13B enter here (If your account is a "Tax Prepayment Account " see section D of the Tax Computation Worksheet exporting above and below the terminal rack blending and refinery or terminal rack removals of motor vehicle fuel in this Filing Requirements for detailed instructions on the use of and for detailed instructions on the use of and reporting requirements for fraction of a month that has elapsed since the due date and enter the amount here Also enter this amount on from column 11 for each disbursement schedule coded 5W FROMSCHEDULE 13A FROMSCHEDULE 13B FROMSCHEDULE 13C FROMSCHEDULE 13G FROMSCHEDULE 13J FROMSCHEDULE 13M FROMSCHEDULE 13N FROMSCHEDULE 3X FROMSCHEDULE 5 FROMSCHEDULE 5A FROMSCHEDULE 5H FROMSCHEDULE 5Q FROMSCHEDULE 5V FROMSCHEDULE 5W FROMSCHEDULE 5X FROMSCHEDULE S02A FROMSCHEDULE S03A FROMSCHEDULE(A) FUEL AND FUELAT CURRENTRATE(B) FUELAT CURRENTRATE(B) FUELAT PRIORRATE(C) FUELAT PRIORRATE(C) gasoline Gasoline includes both finished gasoline and gasoline blendstocks It also includes gasohol GASOLINE SECTION A TAXABLE TRANSACTIONS(Total Gallons) 1 Imports of taxable products below the terminal rack (enter totalfrom column 11 of Schedule 3X) GASOLINE SECTION B TAX PAID CREDITS(Total Gallons) 1 Tax paid fuel exported 13A) (enter total from column 11 of Schedule GASOLINE SECTION C TAXABLE GALLONS COMPUTATION 1 Total gallons from transactions subject to tax (enter from section A line 10 for each column) GASOLINE SECTION D PREPAYMENT ACCOUNTS ONLYPENALTY AND INTEREST CALCULATION AMOUNT 1 Total tax due (enter from line 4 on the front of the return) gasoline to determine the total gallons to be included in each column of the worksheet Refer to BOE 810 FTE www boe ca gov/sptaxprog/pdf/boe810fte pdf General Information I hereby certify that this return including any accompanying schedules and statements has been examined by me and to the I hereby consent to disclose and authorize the Board of Equalization (BOE) to release as necessary certain otherwise If you are interested in filing your Supplier of Motor Vehicle Fuel Tax Return electronically with the BOE please contact us If you need additional information please contact the State Board of Equalization Special Taxes and Fees Division imports of products will be compared to exports reported to the BOE by other states Failure to report fully may result in in a negative tax due amount If the total of line 3 columns A B and in section B must be offset on Schedule 5H Credits offset on includes gasoline gasoline blendstocks and aviation gasoline The Motor Vehicle Fuel Tax is imposed on the following including any fraction of a month that has elapsed since the due date and enter here (If your account is a "Tax INSTRUCTIONSSUPPLIER OF MOTOR VEHICLE FUEL TAX RETURN interest Interest applies for each month or fraction of a month that your payment is late Multiply the remaining interest rate noted on the front of this return applies for each month or fraction of a month that your payment is It is important that you report all transactions that you are required to report on this return and the supporting schedules late Multiply the tax due on line 4 by the interest rate shown then multiply the result by the number of months Line 1 Enter the total gallons for transactions subject to tax from section A line 10 columns A B and C Line 1 Enter the total gallons of ex tax motor vehicle fuel and aviation gasoline imported into California below the Line 1 Enter the total gallons of tax paid motor vehicle fuel and aviation gasoline exported below the California terminal Line 1 Enter the total gallons on which tax applies from section C line 3 columns A B and C of the Tax Computation Line 1 Enter the total tax due from line 4 on the front of the return Line 10 Enter the total gallons of motor vehicle fuel and aviation gasoline transactions subject to tax by adding lines 1 line 2 columns A B and C of section C on the worksheet Line 2 Enter the amount of the tax already paid for the period Line 2 Enter the total gallons of motor vehicle fuel and aviation gasoline removed from California terminal racks that Line 2 Enter the total gallons of tax paid credits from section B line 8 columns A B and C Line 2 Enter the total gallons of tax paid motor vehicle fuel and aviation gasoline sold to a consulate officer or Line 2 These are the rates of tax for motor vehicle fuel and aviation gasoline Line 3 Enter taxable gallons by subtracting line 2 from line 1 for columns A B and C Also enter these totals on line 1 Line 3 Enter the remaining tax due by subtracting line 2 from line 1 Line 3 Enter the total gallons of motor vehicle fuel and aviation gasoline sold above the rack to unlicensed parties by Line 3 Enter the total gallons of tax paid aviation fuel sold to the Armed Forces of the United States for use in aircraft Line 3 For columns A B and C multiply line 1 by line 2 for each column and enter the result in the appropriate column Line 4 Enter the total gallons of motor vehicle fuel and aviation gasoline sold and originating tax collected by adding the Line 4 Enter the total gallons of tax paid motor vehicle fuel sold to train operators by adding the totals from column 11 Line 4 Enter the total tax due by adding columns A B and C of line 3 Line 4 If you file this return or pay your remaining tax due on line 3 after the date shown on the front of this return you Line 5 Enter the total gallons of motor vehicle fuel and aviation gasoline used by you during the reporting period by Line 5 Enter the total gallons of tax paid motor vehicle fuel and aviation gasoline used in an exempt manner not Line 5 If you are paying the remaining tax due on line 3 after the date shown on the front of this return you will owe Line 5 If you pay the tax due on line 4 or file your return after the due date shown on the front of this return you owe a Line 6 Enter the total gallons of ex tax blendstocks entered removed from a California terminal rack or purchased with Line 6 Enter the total gallons of tax paid motor vehicle fuel and aviation gasoline removed from a terminal as a Line 6 If you are paying your tax on line 4 after the date shown on the front of this return you will owe interest The line 6 on the front of the return Line 7 Enter the total amount due and payable by adding lines 4 5 and 6 (If your account is a "Tax Prepayment Line 7 Enter the total gallons of tax paid motor vehicle fuel and aviation gasoline used to manufacture other products Line 7 Enter the total gallons of untaxed products blended with or added to motor vehicle fuel or aviation gasoline Line 8 Enter the difference between gross gallons sold to customers and net gallons purchased from suppliers by Line 8 Enter the total gallons of tax paid motor vehicle fuel and aviation gasoline allowed to be taken as a tax paid Line 9 Enter the total gallons of miscellaneous motor vehicle fuel and aviation gasoline transactions that are subject to Line 9 Enter the total of tax paid credits by adding lines 1 through 8 for columns A B and C Also enter these totals on Make check or money order payable to the State Controller may have transactions at multiple rates The effective date of any future rate change will be July 1 Mode Codes Motor Vehicle Fuel Product Codes MOTOR VEHICLE FUEL SCHEDULE CODES/MODE CODES/PRODUCT CODES Motor Vehicle Fuel Tax Law Motor Vehicle Fuelat Current Rate(B) Motor Vehicle Fuelat Prior Rate(C) MOTORVEHICLE MOTORVEHICLE MOTORVEHICLE Note: Effective July 1 2010 the motor vehicle fuel tax rate may be adjusted annually Do to this annual adjustment you of Schedule 13G of the first page To prepare the return you must first complete the applicable schedules and the Tax Computation of the return to be considered timely If the due date falls on a Saturday Sunday or state holiday returns of the worksheet on line 3 operators or call the P O Box 942879 Sacramento CA 94279 0088 You may also visit the BOE website at www boe ca gov payment is delayed after the due date The adjusted monthly interest rate is6 $ payments Payments: You can make your payment by paper check Online ACH Debit (ePay) or by credit card To use ePay go penalty of ten percent (0 10) of the amount of remaining tax due Multiply the tax due on line 4 by (0 10) and person as reported in this return PO BOX 942879 postmarked or received on the next business day will be considered timely Businesses required to pay motor Preparation of Schedules Preparation of the Return Preparation of the Tax Computation Worksheet Prepayment Account " see section D of the Tax Computation Worksheet to calculate the interest due ) PRINT NAME AND TITLE Produce Finished Gasoline10ABGasoline Blendstocks Removed Tax Exempt in Connection with a Sale When the Buyer Has Issued a racks by adding the totals from column 11 for each disbursement schedule coded 13A READ INSTRUCTIONSBEFORE PREPARING Receipt Schedule and a standard Disbursement Schedule For detailed information regarding preparation of Receipt Schedules Refer to BOE 810 FTE www boe ca gov/sptaxprog/pdf/boe810fte pdf removal entry or sale; and removal or sale of blended motor vehicle fuel outside the bulk transfer/terminal system All REPORT WHOLEGALLONS ONLY(A) reportable on any other credit schedule by adding the totals from column 11 for each disbursment schedule reporting period Your tax return is not considered valid unless it is signed and dated in the space provided at the bottom reporting requirements for each mode code respectively on the worksheet Add the totals from column 11 on each of the schedules for motor vehicle fuel and aviation resulting in a product which is used as or is usable as motor vehicle fuel or aviation gasoline by adding the totals return after the due date may result in interest and penalty charges You must file a return even if no tax is due for the S02AMiscellaneous Fuel Transactions Subject to TaxS03AOther Tax Paid CreditsS05IOther Exempt Removals SACRAMENTO CA 94279 6135 Schedule 5H must be claimed as a refund of the tax which is filed with schedule coded 5 schedules see BOE 810 FTE Instructions for Preparing Motor Fuels Schedules available on our website at www boe ca gov/sptaxprog/pdf/boe810fte pdf second taxable event by adding the totals from column 11 for each disbursement schedule coded 13M Section A Taxable Transactions SECTION A TAXABLE TRANSACTIONS(Total Gallons) SECTION A TAXABLE TRANSACTIONS(Total Gallons) 10 TOTAL OF TRANSACTIONS SUBJECT TO TAX (add lines 1 through 9 for each column) SECTION A TAXABLE TRANSACTIONS(Total Gallons) 2 Fuel removed subject to tax (enter total from column 11 of Schedule 5) SECTION A TAXABLE TRANSACTIONS(Total Gallons) 3 Fuel sold above the rack to unlicensed parties (enter total from column 11 of Schedule 5A) SECTION A TAXABLE TRANSACTIONS(Total Gallons) 4 Fuel sold and originating tax collected (enter total from column 11 of Schedule 5H) SECTION A TAXABLE TRANSACTIONS(Total Gallons) 5 Taxable gallons of fuel used (enter total from column 11 of Schedule 5Q) SECTION A TAXABLE TRANSACTIONS(Total Gallons) 6 Ex tax gallons of blendstocks resold to unlicensed persons not furnishing an Exemption Certificate (enter total from column 11 of Schedule 5V) SECTION A TAXABLE TRANSACTIONS(Total Gallons) 7 Untaxed products blended with or added to fuel resulting ina product which is used as or is usable as a taxable fuel (enter total from column 11 of Schedule 5W) SECTION A TAXABLE TRANSACTIONS(Total Gallons) 8 Gallons delivered partially taxed (enter total from column 11 of Schedule 5X) SECTION A TAXABLE TRANSACTIONS(Total Gallons) 9 Miscellaneous fuel transactions subject to tax (enter total from column 11 of Schedule S02A) Section B Tax Paid Credits SECTION B TAX PAID CREDITS(Total Gallons) SECTION B TAX PAID CREDITS(Total Gallons) 2 Tax paid fuel sold to a consulate officer or employee bycredit card (enter total from column 11 of Schedule 13B) SECTION B TAX PAID CREDITS(Total Gallons) 3 Tax paid aviation fuel sold to the Armed Forces of theUnited States for use in ships or aircraft or for use outside (enter total from column 11 of Schedule 13C)this state SECTION B TAX PAID CREDITS(Total Gallons) 4 Tax paid fuel sold to train operators (enter total from column 11 of Schedule 13G) SECTION B TAX PAID CREDITS(Total Gallons) 5 Tax paid fuel used in an exempt manner not reportable on another credit schedule (enter total from column 11 of Schedule 13J) SECTION B TAX PAID CREDITS(Total Gallons) 6 Tax paid fuel removed from a terminal as a second taxable event (enter total from column 11 of Schedule 13M) SECTION B TAX PAID CREDITS(Total Gallons) 7 Tax paid fuel used to manufacture other products (enter total from column 11 of Schedule 13N) SECTION B TAX PAID CREDITS(Total Gallons) 8 Other tax paid credits (enter total from column 11 of Schedule S03A) SECTION B TAX PAID CREDITS(Total Gallons) 9 TOTAL OF TAX PAID CREDITS (add lines 1 through 8 for each column) section C line 3 columns A B and C) Section C Taxable Gallons Computation SECTION C TAXABLE GALLONS COMPUTATION 2 Total tax paid gallons claimed for credit (enter from section B line 8 for each column) SECTION C TAXABLE GALLONS COMPUTATION(A) SECTION D PREPAYMENT ACCOUNTS ONLYPENALTY AND INTEREST CALCULATION AMOUNT 2 Tax prepayment (enter amount of tax already paid for the period) SECTION D PREPAYMENT ACCOUNTS ONLYPENALTY AND INTEREST CALCULATION AMOUNT 3 Remaining tax due (subtract line 2 from line 1) SECTION D PREPAYMENT ACCOUNTS ONLYPENALTY AND INTEREST CALCULATION AMOUNT 4 Penalty (multiply line 3 by 10% (0 10) if payment made or return filed after the due date Enter this amount on line 5 on the front of the return ) SECTION D PREPAYMENT ACCOUNTS ONLYPENALTY AND INTEREST CALCULATION AMOUNT 5 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(Enter this amount on line 6 on the front of the return ) SECTION D PREPAYMENT ACCOUNTS ONLYPENALTY AND INTEREST CALCULATION AMOUNTMOTOR VEHICLE Section D Prepayment Accounts Penalty and Interest Calculation should only be for the remaining tax due plus penalty and interest if applicable ) shown above See return instructions if you made a prepayment ) SIGNATURE sole purpose of verifying the accuracy of the reportable product transaction information concerning my transactions with such SPECIAL TAXES AND FEES STATE OF CALIFORNIABOARD OF EQUALIZATION STATE OF CALIFORNIABOARD OF EQUALIZATION STATE OF CALIFORNIABOARD OF EQUALIZATION state The return and your payment made payable to the State Controller for the amount due must be submitted on or Summary Code Schedules SUPPLIER OF MOTOR VEHICLE FUEL TAX RETURN Suppliers of motor vehicle fuel use this tax return to report the Motor Vehicle Fuel Tax due on motor vehicle fuel which tax by adding the totals from column 11 for each disbursement schedule coded S02A TAX COMPUTATION WORKSHEET Tax Computation Worksheet tax due on line 3 by the interest rate shown then multiply the result by the number of months including any Taxpayer Information Section at 1 800 400 7115 (TTY:711); from the main menu select the option Special Taxes and Fees TELEPHONE( ) terminal rack by adding the totals from column 11 for each receipt schedule coded 3X for taxable products Refer that would result in a negative tax return A claim for refund must be filed with the State Controller for any unused the BOE contacting you to determine why your reports differ from reports submitted by third parties such as the terminal The BOE will be comparing your total rack removals as reported by terminals against removals reported by you Your The Motor Vehicle Fuel Tax is imposed on motor vehicle fuel The law defines motor vehicle fuel to be gasoline and aviation the State Controller ) the State Controller Otherwise enter these amounts in columns A B The Tax Computation Worksheet is provided to assist you in calculating the tax due and completing your return (This the total of line 3 columns A B and C is a negative amount then one or more of the credits in section B must the United States for use in ships or aircraft or for use outside this state are tax exempt There are two types of supporting schedules included with every Supplier of Motor Vehicle Fuel Tax Return; a standard This Page Intentionally Left Blank through 9 for columns A B and C Also enter this total on line 1 columns A B and C respectively of section C to BOE 810 FTA Product Code Table Sorted by Product Code Number or BOE 810 FTB Product Code Table to calculate the penalty due ) Returns and payments must be postmarked or received on or before the due date To obtain the latest information on any product codes or if you need help completing this form please call us or visit the to our website at www boe ca gov to our website or call 1 855 292 8931 Mandatory EFT accounts must pay by EFT or ePay Be sure to sign and mail totals from column 11 for each disbursement schedule coded 5H Note: Schedule 5H is used to offset credits transactions involving these activities are subject to tax unless the transaction meets one of the exemptions allowed in the transfer/terminal system; removal or sale of motor vehicle fuel to an unlicensed person unless there was a prior taxable Use this worksheet to help you complete your return and calculate the tax due Do not send this worksheet with your return vehicle fuel tax by electronic funds transfer (EFT) may also be subject to a 10 percent penalty for failure to pay by were subject to tax during the reporting period by adding the totals from column 11 for each disbursement will owe a penalty of ten percent (0 10) of the amount of tax due Multiply the remaining tax due on line 3 by Worksheet worksheet "motor vehicle fuel" includes only gasoline gasoline blendstocks and gasohol Motor vehicle fuel at the worksheet should be kept with your records Do not send the worksheet with your return ) For purposes of this You must file a tax return with the BOE on which you report on a monthly basis activities such as importing and YOUR ACCOUNT NO your return

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