Form BOE-403-CLW Fillable Tax Gap Instate Service Contact-Use Tax Return Worksheet

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Download Form BOE-403-CLW

View all CA - California Sales, Use and Other Taxes

NAME (print) (1 A ITEM PURCHASED) (1 B A/S) (1 C PURCHASE DATE) (1 D LOCATION USED (CITY COUNTY)) (1 E PURCHASE PRICE) (1 f tax rate) (1 g tax) (1 h vendor contact information ADDRESS:) (1 h vendor contact information NAME:) (1 h vendor contact information PHONE NUMBER:) (10 Balance of tax due (subtract line 9 from line 8 g tax) (11 penalty of 10% (0 10) is due on tax paid after [ ] See instructions for line 11 ) (11 penalty of 10% (0 10) is due on tax paid after [ ] See instructions for line 11 g tax) (12 intereest: one month's interest is due on tax for each month or fraction of a month that payment is made after [ ] See instructions for line 12 ) (12 interest: one month's interest is due on tax for each month or fraction of a month that payment is made after [ ] See instructions for line 12 g tax) (13 total due (sum of lines 10 12); mail with payment to: po box 942879 mic:05 sacramento ca 94279 0005 g tax) (2 A ITEM PURCHASED) (2 B A/S) (2 C PURCHASE DATE) (2 D LOCATION USED (CITY COUNTY)) (2 E PURCHASE PRICE) (2 f tax rate) (2 g tax) (2 h vendor contact information ADDRESS:) (2 h vendor contact information NAME:) (2 h vendor contact information PHONE NUMBER:) (3 A ITEM PURCHASED) (3 B A/S) (3 C PURCHASE DATE) (3 D LOCATION USED (CITY COUNTY)) (3 E PURCHASE PRICE) (3 f tax rate) (3 g tax) (3 h vendor contact information ADDRESS:) (3 h vendor contact information NAME:) (3 h vendor contact information PHONE NUMBER:) (4 A ITEM PURCHASED) (4 B A/S) (4 C PURCHASE DATE) (4 D LOCATION USED (CITY COUNTY)) (4 E PURCHASE PRICE) (4 f tax rate) (4 g tax) (4 h vendor contact information ADDRESS:) (4 h vendor contact information NAME:) (4 h vendor contact information PHONE NUMBER:) (5 A ITEM PURCHASED) (5 B A/S) (5 C PURCHASE DATE) (5 D LOCATION USED (CITY COUNTY)) (5 E PURCHASE PRICE) (5 f tax rate) (5 g tax) (5 h vendor contact information ADDRESS:) (5 h vendor contact information NAME:) (5 h vendor contact information PHONE NUMBER:) (6 A ITEM PURCHASED) (6 B A/S) (6 C PURCHASE DATE) (6 D LOCATION USED (CITY COUNTY)) (6 E PURCHASE PRICE) (6 f tax rate) (6 h vendor contact information ADDRESS:) (6 h vendor contact information NAME:) (6 h vendor contact information PHONE NUMBER:) (7 total from attached spreadsheet(s) Please attach additional spreadsheets if needed e purchase price ) (7 total from attached spreadsheet(s) Please attach additional spreadsheets if needed g tax ) (8 total (sum of lines 1 7) e purchase price) (8 total (sum of lines 1 7) g tax) (9 credit for sales or use tax paid to any other state(s) for purchases listed above Attach copies of invoices showing the amount of sales or use tax paid in other states g tax) (button) CLEAR (button) PRINT (DATE) (Due) (EMAIL ADDRESS) (in state service use tax return worksheet for purchases made from) (PHONE (include area code)) (Reference no:) (sign date and provide contact information on each return worksheet Submit worksheet(s) with payment(s) in full by Keep a copy for your records ) (Taxpayers name) (text) (through) (TITLE) ] Keep a copy for your records ] THROUGH [ 10 Balance of Tax Due (subtract line 9 from line 8) 11 PENALTY of 10% (0 10) is due on tax paid after [ ] See instructions for line 11 12 INTEREST: One month s interest is due on tax for each month or fraction of a month that payment 13 Total Due (sum of lines 10 12); mail with payment to: PO Box 942879 MIC:05 Sacramento CA 94279 0005 7 Total from attached spreadsheet(s) Please attach additional spreadsheets if needed 8 TOTAL (sum of lines 1 7) 9 Credit for sales or use tax paid to any other state(s) for purchases listed above Attach copies of ADDRESS: ADDRESS: ADDRESS: another state on purchases being reported To support this credit you must attach a copy of the invoice(s) showing the payment of the sales or use tax attach them to this worksheet BOE 403 CLW (BACK) REV 3 (5 13) BOE 403 CLW (FRONT) REV 3 (5 13) Column A Item Purchased Provide a general description of the tangible item(s) being reported (for example mixer printer x ray machine printing press solvents towels furnishings Column B A/S Enter A (asset) if the item purchased is being depreciated Enter S (supply) if the item purchased was expensed Column C Purchase Date Enter the date of purchase of the item(s) purchased Column D Location Used Enter the city where the item or items purchased were first used If the location is different than the mailing address please provide the full street address of the Column E Purchase Price Excluding separately stated charges for shipping by common carrier enter the purchase price (cost) of the item(s) being reported Column F Tax Rate Enter the sales and use tax rate in effect at the time of purchase for the location in Column D If you do not know the sales and use tax rate you may call our Taxpayer Column G Tax Multiply the tax rate entered in column F by the Purchase Price entered in column E and enter the result (round to the nearest dollar) Column H Vendor Contact Information Enter the name address and phone number of the vendor from whom you made your purchase computer hardware) DATED DUE [ EMAIL ADDRESS Enter the interest due For payments made after the return worksheet due date one month's interest is due on the tax (line 10 amount) for each month or fraction of a month that FOR PURCHASES MADE FROM [ I certify to the best of my knowledge that I am a corporate officer partner owner or hold a power of attorney to execute this document and that to the best of my knowledge the amounts reported are a true and complete If you prefer you may call the Taxpayer Information Section at 1 800 400 7115 for assistance IN STATE SERVICE USE TAX RETURN WORKSHEET Information Section at 1 800 400 7115 for assistance or consult publication 71 California City and County Sales and Use Tax Rates at www boe ca gov/pdf/pub71 pdf INSTRUCTIONS FOR COMPLETING THE IN STATE SERVICE USE TAX WORKSHEET invoices showing the amount of sales or use tax paid in other states is made after [ ] See instructions for line 12 ITEM PURCHASED Line 10 Enter the balance of use tax due (line 8 minus line 9) Line 11 For payments made after the return worksheet due date a 10% penalty applies Multiply line 10 by 0 10 and enter the result on this line Line 12 Line 13 Enter the total of lines 10 12 Line 7 Enter the amount of purchases (column E) and the amount of tax (column G) due from any supplemental worksheet(s) you prepared Line 8 Enter the sum of lines 1 7 for the amount of purchases (column E) and the amount of tax (column G) Line 9 Enter sales or use tax paid to another state on purchases being reported You are allowed to claim a credit up to the amount of use tax you owe for sales or use tax paid to Lines 1 thru 6 Enter items purchased location used LOCATION USED (CITY COUNTY) NAME: NAME: NAME: Note: Report transactions on a calendar year basis Complete a separate worksheet for each calendar year or portion of a calendar year If additional pages are needed you may payment is late To assist you in calculating the correct amount of interest due an interest calculator is available on the BOE website To access the calculator go to PHONE (include area code) PHONE NUMBER: PHONE NUMBER: PHONE NUMBER: PRICE PURCHASE Reference No: [ reporting of purchases of supplies fixtures and equipment for use in this state without the payment of California use tax Sign date and provide contact information on each return worksheet Submit worksheet(s) with payment(s) in full by [ SIGNATURE Taxpayer s Name: [ TITLE VENDOR CONTACT INFORMATION www boe ca gov and type Interest Calculator in the search box or type https://efile boe ca gov/boewebservices/interestCalculation jsp in the address box of your web browser

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