Form BOE-501-CM Fillable Cigarette Manufacturer's Tax Return of Taxable Distributions in California
(all forms fillable on Windows, Mac, Android tablets, and iPad using Adobe Reader XI)

[ FOID 1 800 400 7115 (TTY:711); from the main menu select the option Special Taxes and Fees Customer service representatives 1 Samples in packages of 5 or less cigarettes 10 TOTAL AMOUNT DUE AND PAYABLE (add lines 7 8 and 9) $ 2 Samples in packages of more than 5 cigarettes 3 Taxable sales to the U S Government 4 Other distributions subject to tax 5 Total distributions subject to tax (add lines 1 through 4) 6 Rate of tax per cigarette $ 7 Total amount of tax due (multiply line 5 by line 6) $ 8 Penalty [multiply line 7 by 10% (0 10) if payment is made after due date indicated 9 INTEREST: One month's interest is due on tax for each month or fraction of a month that above] ACCOUNTABILITY accuracy of the reportable product transaction information concerning my transactions with such person as reported in this tax form All schedules applicable to cigarette manufacturers must be completed and submitted with this return if the Always write your account number on your check or money order This return must be signed amount to the nearest whole dollar applicable Round all quantities and dollars reported to the nearest whole number are available weekdays from 8:00 a m to 5:00 p m (Pacific time) except state holidays As a cigarette manufacturer in California you are required to report all taxable distributions on lines one through be comparing your distributions to the receipts that distributors reported on their tax forms Information on this report will be BEFORE PREPARING BOARD OF EQUALIZATION BOARD OF EQUALIZATION BOE 501 CM (S1B) REV 9 (4 13) BOE 501 CM (S1F) REV 9 (4 13) BOE 501 CM (S2) REV 9 (4 13) BOE 810 CTE Instructions for Preparing Cigarette Tax Schedules BOE USE ONLY business day will be considered timely Businesses required to pay the tax due by electronic funds transfer (EFT) CERTIFICATION CIGARETTE MANUFACTURER SCHEDULE CODES CIGARETTE MANUFACTURER'S TAX RETURN CIGARETTE MANUFACTURER'S TAX RETURN OF CIGARETTES CLEAR PRINT considered valid unless it is signed and dated in the space provided at the bottom of the first page detailed information regarding preparation of schedules see BOE 810 CTE Instructions for Preparing Cigarette Tax Schedules Disbursement Schedules distributions on lines one through four of the return You are also required to report all distributions on the schedules identified dollar DUE ON OR BEFORE EMAIL ADDRESS Enter the amount of tax due by multiplying line 5 by line 6 Round this amount to the nearest whole dollar Enter the total amount due and payable by adding lines 7 8 and 9 Round this amount to the nearest whole Enter the total number of cigarette distributions subject to tax by adding lines 1 through 4 Enter the total number of cigarettes that were distributed as other taxable distributions Enter the total number of cigarettes that were distributed in sample packages of 5 or less cigarettes Enter the total number of cigarettes that were distributed in sample packages of 6 or more cigarettes Enter the total number of cigarettes that were distributed to the United States Government Every cigarette manufacturer shall file a return with the BOE on or before the 25th day of each month reporting all taxable example) However 10 percent (10%) is the maximum penalty applied to late returns and payments Round this Exempt Distributions or Sales to Interstate or Foreign Commerce Exempt Distributions or Sales to the United States Government Tax Exempt Fees at 1 800 400 7115 (TTY:711) FILING REQUIREMENTS For detailed information regarding preparation of schedules see BOE 810 CTE Instructions for Preparing Cigarette Tax four of the return You are also required to report all distributions on the schedules identified in this form where GENERAL I hereby certify that this return including any accompanying schedules and statements has been examined by I hereby consent to disclose and authorize the Board of Equalization (BOE) to release as necessary certain otherwise confidential If you are interested in filing this form electronically or if you need help completing this form please contact Special Taxes and If you need additional information visit the BOE website at www boe ca gov or call the Taxpayer Information Section at If you pay the tax due on line 7 after the date shown on the front of this return you will owe interest The interest If you pay the tax due on line 7 or file your return after the due date shown on the front of this return you owe a in this form where applicable You must file a report even if you have no activity for the reporting period information to any person identified by me in this tax form as being involved in a reported transaction for the sole purpose of verifying the INSTRUCTIONS It is important that you report all transactions for which you are required to account on the supporting schedules The BOE will Line 1 Line 10 Line 2 Line 3 Line 4 Line 5 Line 6 Line 7 Line 8 Line 9 Make a copy of this document and the accompanying schedules for your records Make check or money order payable to the State Board of Equalization manufacturer's activities warrant reporting on the schedule Round all amounts reported to the nearest whole may also be subject to a 10 percent (10%) penalty for a failure to pay by EFT (payment made by check for me and to the best of my knowledge and belief is a true correct and complete return Multiply the tax due on line 7 by the interest rate shown and then multiply the result by the number of months no tax is due for the reporting period The supporting schedule is considered an integral part of the return Your tax return is not NUMBER OF number or dollar on our website at www boe ca gov/pdf/boe810cte pdf or fraction of a month that have elapsed since the due date and enter here Round this amount to the nearest Paying your tax or filing your return after the due date may result in interest and penalty charges You must file a return even if payment is delayed after the due date The adjusted monthly interest rate is Payments: You can make your payment by paper check Online ACH Debit (ePay) or by credit card To use ePay go to our penalty of 10 percent (10%) of the amount of tax due Multiply the tax due on line 7 by (0 10) and enter here please call us at 1 800 400 7115 (TTY:711) or visit the BOE's website at www boe ca gov/sptaxprog/spftdcigs htm PO BOX 942879 PREPARATION OF SCHEDULES PREPARATION OF THE RETURN Prior to completing the return prepare the applicable distribution schedules identified on this form as described in RA B/A AUD REG rate noted on the front of this return applies for each month or fraction of a month that your payment is late READ INSTRUCTIONS Returns and payments must be postmarked or received on or before the due date of the return to be considered RR QS FILE REF SACRAMENTO CA 94279 6067 Sample Cigarettes and Tobacco Products for additional information on the distribution of samples Schedules Schedules available on our website at www boe ca gov/pdf/boe810cte pdf If you need help completing this form shared with and used by other government agencies Failure to report fully may result in the BOE contacting you to determine SIGNATURE PRINT NAME AND TITLE TELEPHONE SPECIAL TAXES AND FEES Stamp Unaffixed or Tax Unpaid Product STATE OF CALIFORNIA TAXABLE DISTRIBUTIONS IN CALIFORNIA The BOE 810 CTF Cigarette Tax Disbursement Schedule is included with every Cigarette Manufacturer's Tax Return For The California State Board of Equalization (BOE) is responsible for administering the California Cigarette Tax Law This includes the distribution of unstamped cigarettes as samples by manufacturers' agents or representatives Refer to Regulation 4081 This is the current rate of tax per cigarette timely If the due date falls on a Saturday Sunday or state holiday returns postmarked or received on the next To obtain the latest information on schedule filing instructions or reporting requirements visit the BOE's website at transaction information regarding quantities invoice numbers bills of lading locations dates method of delivery or any other applicable website at www boe ca gov click on the eServices tab and log in to make a payment To pay by credit card go to our website or call 1 855 292 8931 Mandatory EFT accounts must pay by EFT or ePay Be sure to sign and mail your return whole dollar why your reports differ from reports submitted by third parties www boe ca gov YOUR ACCOUNT NO