Form Boe-501-Dd - Supplier Of Diesel Fuel Tax Return
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4STATE OF CALIFORNIA
BOE-501-DD (S1) REV. 9 (4-13)
BOARD OF EQUALIZATION
SUPPLIER OF DIESEL FUEL TAX RETURN
BOE USE ONLY
AUD
RA-B/A
REG
DUE ON OR BEFORE
FILE
REF
RR-QS
YOUR ACCOUNT NO.
[
]
FOID
EFF
BOARD OF EQUALIZATION
SPECIAL TAXES AND FEES
PO BOX 942879
SACRAMENTO CA 94279-6161
READ INSTRUCTIONS
BEFORE PREPARING
As a supplier of diesel fuel in California, you are required to report all imports, exports, blending, and terminal rack
disbursements of diesel fuel in this state. You are also required to report all imports, exports, and sales of jet fuel or
kerosene.
REPORT WHOLE
GALLONS ONLY
(B)
(A)
Diesel Fuel at
Diesel Fuel at
Prior Rate
Current Rate
1. Gallons on which tax applies or on which refund is due (enter from Tax
Computation Worksheet section C, line 3, columns A and B)
2. Rates of tax per gallon
$
3. Subtotal of tax on these gallons (multiply line 1 by line 2 for columns
$
$
A and B)
4. Amount of tax due or refund claimed (add columns A and B of line 3)
$
5. Penalty (multiply line 4 by 10% (0.10) if payment made or return filed
$
after due date shown above)
6. 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
$
7. TOTAL AMOUNT DUE AND PAYABLE OR REFUND CLAIMED (add lines 4, 5, and 6)
CERTIFICATION
I hereby consent to disclose and authorize the Board of Equalization (BOE) 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.
SIGNATURE
EMAIL ADDRESS
TELEPHONE
DATE
PRINT NAME AND TITLE
(
)
Make check or money order payable to the State Board of Equalization.
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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