Form Boe-501-Ps (S1) - Supplier Of Motor Vehicle Fuel Tax Return
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9BOE-501-PS (S1) REV. 5 (7-07)
STATE OF CALIFORNIA
BOARD OF EQUALIZATION
SUPPLIER OF MOTOR VEHICLE FUEL TAX RETURN
BOARD USE ONLY
AUD
RA-B/A
REG
DUE ON OR BEFORE
FILE
RR-QS
REF
YOUR ACCOUNT NO.
[
]
FOID
EFF
BOARD OF EQUALIZATION
FUEL TAXES DIVISION
PO BOX 942879
SACRAMENTO CA 94279-6135
READ INSTRUCTIONS
BEFORE PREPARING
As a supplier of motor vehicle fuel in California, you are required to report all imports, exports, blending, and terminal rack
removals of motor vehicle fuel in this state.
REPORT WHOLE
GALLONS ONLY
1.
Taxable gallons (enter from Tax Computation Worksheet section C, line 3)
1.
2.
Rate of tax per gallon
2.
$
3.
$
3.
Total tax due (multiply line 1 by line 2)
4.
Penalty (multiply line 3 by 10% (0.10) if payment made or return filed after due date shown above)
4. $
5.
INTEREST:
5.
$
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
6.
TOTAL AMOUNT DUE AND PAYABLE (add lines 3, 4, and 5)
6.
$
IF PAID BY CREDIT CARD, CHECK HERE (Mandatory EFT accounts MUST pay by EFT). [ ]
CERTIFICATION
I hereby consent to disclose and authorize the Board to release, as necessary, certain otherwise confidential transaction
information regarding volumes, invoice numbers, bills-of-lading, locations, dates, or method of delivery of reportable products
to any person identified by me in this return as being involved in a reported transaction for the sole purpose of verifying the
accuracy of the reportable product transaction information concerning my transactions with such person as reported in this
return.
I hereby certify that this return, including all accompanying schedules and statements, has been examined by me and to the
best of my knowledge and belief is a true, correct, and complete return.
YOUR SIGNATURE AND TITLE
TELEPHONE NUMBER
DATE
Make check or money order payable to the State Controller.
Always write your account number on your check or money order. Make a copy of this document and the accompanying schedules for your records.
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