Form BOE-501-DG Fillable Government Entity Diesel Fuel Tax Return
(all forms fillable on Windows, Mac, Android tablets, and iPad using Adobe Reader XI)

(14 PENALTY [multiply line 13 by 10% (0 10) if payment made or return filed after the due date shown above] $) (15 INTEREST $) (15 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 ) (16 TOTAL AMOUNT DUE AND PAYABLE OR REFUND CLAIMED (Add lines 13 14 and 15 if tax is due If claiming a refund enter the amount from line 13 as a negative number )) (add columns A and B of line W3 then (BOE USE ONLY ) (CLEAR) CLEAR (DATE) (DUE ON OR BEFORE) (EMAIL ADDRESS) (GOVERNMENT ENTITY TAX RETURN OR CLAIM FOR REFUND 11 Total tax due on diesel fuel used on highway (multiply line 9 by rate on line 10) $) (GOVERNMENT ENTITY TAX RETURN OR CLAIM FOR REFUND 12 California diesel fuel tax paid to retail vendor on fuel included in line 5 (enter total from California Undyed Diesel Fuel Worksheet line W4 on the back of the return) $) (GOVERNMENT ENTITY TAX RETURN OR CLAIM FOR REFUND 13 Amount of tax due or refund claimed (If line 11 is greater than line 12 enter the difference as tax due If line 12 is greater than line 11 enter the difference as refund amount Enter amount of refund as a negative ) (Do not claim credit on the next return; a refund will be processed ) $) (GOVERNMENT ENTITY TAX RETURN OR CLAIM FOR REFUND 5 Total gallons of undyed diesel fuel used REPORT WHOLE GALLONS ONLY ) (GOVERNMENT ENTITY TAX RETURN OR CLAIM FOR REFUND 6 Total gallons of dyed diesel fuel used REPORT WHOLE GALLONS ONLY ) (GOVERNMENT ENTITY TAX RETURN OR CLAIM FOR REFUND 7 Total gallons of diesel fuel used (add lines 5 and 6) REPORT WHOLE GALLONS ONLY ) (GOVERNMENT ENTITY TAX RETURN OR CLAIM FOR REFUND 8 Total gallons of diesel fuel used off highway included in line 7 REPORT WHOLE GALLONS ONLY ) (GOVERNMENT ENTITY TAX RETURN OR CLAIM FOR REFUND 9 Taxable diesel fuel used on highway (subtract line 8 from line 7) REPORT WHOLE GALLONS ONLY ) (PRINT NAME AND TITLE) (PRINT) PRINT (REPORT OF DIESEL FUEL TRANSACTIONS 1 Total gallons of undyed diesel fuel purchased REPORT WHOLE GALLONS ONLY ) (REPORT OF DIESEL FUEL TRANSACTIONS 2 Total gallons of dyed diesel fuel purchased REPORT WHOLE GALLONS ONLY ) (REPORT OF DIESEL FUEL TRANSACTIONS 3 Total gallons of undyed diesel fuel sold REPORT WHOLE GALLONS ONLY ) (REPORT OF DIESEL FUEL TRANSACTIONS 4 Total gallons of dyed diesel fuel sold REPORT WHOLE GALLONS ONLY ) (TELEPHONE (AREA CODE)) (TELEPHONE) (text) (text) (User of Fuel Under Revenue and Taxation Code sections 60050 60100 (a)(5)(D) and 60108) (W1 Gallons of undyed diesel fuel purchased from a retail vendor REPORT WHOLE GALLONS ONLY (B) Diesel Fuel at Prior Rate ) (W2 Rate of tax per gallon REPORT WHOLE GALLONS ONLY (A) Diesel Fuel at Current Rate ) (W2 Rate of tax per gallon REPORT WHOLE GALLONS ONLY (B) Diesel Fuel at Prior Rate ) (W3 Subtotal of tax (multiply line 1 times line 2 for columns A and B) REPORT WHOLE GALLONS ONLY (A) Diesel Fuel at Current Rate ) (W3 Subtotal of tax (multiply line 1 times line 2 for columns A and B) REPORT WHOLE GALLONS ONLY (B) Diesel Fuel at Prior Rate ) (W4 Amount of California diesel fuel tax paid to retail vendor on fuel included in line 5 of the return (add columns A and B of line W3 then enter here and on the front page line 12) REPORT WHOLE GALLONS ONLY (B) Diesel Fuel at Prior Rate ) (YOUR ACCOUNT NO ) [ FOID ] 1 855 292 8931 To pay by paper check make your check or money order payable to State Board of Equalization Always write 1 Total gallons of undyed diesel fuel purchased1 10 Rate of tax per gallon10 11 Total tax due on diesel fuel used on highway(multiply line 9 by rate on line 10) 11 $ 12 California diesel fuel tax paid to retail vendor on fuel included in line 5(enter total from 13 Amount of tax due or refund claimed (If line 11 is greater than line 12 enter the difference 14 Penalty [multiply line 13 by 10% (0 10) if payment made or return filed after the 15 INTEREST: One month's interest is due on tax for each month or fraction of a month that payment is 16 TOTAL AMOUNT DUE AND PAYABLE OR REFUND CLAIMED(Add lines 13 14 and 15 if tax 2 Total gallons of dyed diesel fuel purchased2 3 Total gallons of undyed diesel fuel sold3 4 Total gallons of dyed diesel fuel sold4 5 Total gallons of undyed diesel fuel used5 6 Total gallons of dyed diesel fuel used6 7 Total gallons of diesel fuel used (add lines 5 and 6)7 8 Total gallons of diesel fuel used off highway included in line 78 9 Taxable diesel fuel used on highway(subtract line 8 from line 7)9 94279 0065 You may also visit the BOE website at www boe ca gov or call the Taxpayer Information Section at 1 800 400 7115 (TTY:711); from A publicly maintained or constructed roadway that is not open to public vehicular use for example a bike path a A road in a federal area that is restricted from public use A road within a national or state forest such as a logging road that is privately constructed or maintained Amount of California diesel fuel tax paid to retail vendor on fuel amount of refund as a negative ) (Do not claim credit on the next return; a refund will amount of tax paid to a retail vendor that is calculated on line W4 must be entered on line 12 of your return This worksheet area such as a national forest or military reservation also qualifies as a highway provided it is publicly maintained and open as tax due If line 12 is greater than line 11 enter the difference as refund amount Enter be processed ) BEFORE PREPARING BEFORE PREPARINGBEFORE PREPARING BOARD OF EQUALIZATION BOARD OF EQUALIZATION BOE 501 DG (S1B) REV 6 (4 13) BOE 501 DG (S1F) REV 6 (4 13) BOE 501 DG (S2) REV 6 (4 13) BOE USE ONLY California Diesel Fuel Tax Paid to Retail Vendor Worksheet on the back of the return CALIFORNIA UNDYED DIESEL FUEL WORKSHEET California Undyed Diesel Fuel Worksheet line W4 on the back of the return) Complete the worksheet below for your undyed diesel fuel purchased in a prior period but used in the current period The Current Rate DEFINITIONS DEFINITIONS (CONTINUED) delayed after the due date The adjusted monthly interest rate is Diesel Fuel at difference as a negative amount (refund) A refund will be processed for this amount Do not carry tax credits due date shown above] PENALTY DUE ON OR BEFORE Dyed diesel fuel means diesel fuel that is dyed under the United States Environmental Protection Agency or the Internal Revenue EMAIL ADDRESS enter here and on the front page line 12) enter here This does not apply to credit amounts Environmental Protection Agency or the Internal Revenue Service and considered destined for nontaxable off highway uses Every government entity owes diesel fuel tax on diesel fuel used to operate motor vehicles on the highway You are allowed to examined by me and to the best of my knowledge and belief is a true correct and complete return Exempt bus operator is a transit district transit authority school district community college district or county superintendent of FILING REQUIREMENTS forward to another return freeway under construction or a street closed for repairs GALLONS ONLY GENERAL INFORMATION GOVERNMENT ENTITY DIESEL FUEL TAX RETURN Government entity means this state and its political subdivisions except for a political subdivision that is only an exempt bus GOVERNMENT ENTITY TAX RETURN OR CLAIM FOR REFUND Highway means any road inside California that is publicly maintained and open to the public for motor vehicle travel Roads I hereby certify that this return including any accompanying schedules and statements has been If you need additional information please contact the State Board of Equalization Motor Carrier Office P O Box 942879 Sacramento CA in line 5 If you purchased tax paid fuel in a prior period but used the fuel in the current period complete the included in line 5 of the return INSTRUCTIONS INTEREST 15 $ is due If claiming a refund enter the amount from line 13 as a negative number ) Line 1 Enter the total gallons of undyed diesel fuel purchased Line 10 The current rate of tax per gallon Line 11 Total tax due on diesel fuel used on highway Multiply gallons on line 9 by the tax rate on line 10 Line 12 Enter the amount of California diesel fuel tax paid to a retail vendor in California on the diesel fuel that is included Line 13 If line 11 is greater than line 12 enter the difference as tax due If line 12 is greater than line 11 enter the Line 14 If you are filing the return or paying the tax amount shown on line 13 after the due date shown on the front of the Line 15 If you are paying the tax amount shown on line 13 after the due date shown on the front of the return you will Line 16 Enter the total amount due and payable by adding lines 13 14 and 15 If claiming a refund enter the amount of Line 2 Enter the total gallons of dyed diesel fuel purchased Line 3 Enter the total gallons of undyed diesel fuel sold Line 4 Enter the total gallons of dyed diesel fuel sold Line 5 Enter the total gallons of undyed diesel fuel used Line 6 Enter the total gallons of dyed diesel fuel used Line 7 Enter the total gallons of diesel fuel used Add lines 5 and 6 Line 8 Enter the total gallons of both dyed and undyed diesel fuel used off highway This amount must be included in Line 9 Enter the total gallons of diesel fuel used on highway Subtract line 8 from line 7 MOTOR CARRIER OFFICE must be submitted with your return operator owe interest The interest rate shown on the front of the return applies for each month or fraction of a month PAYMENTS PO BOX 942879 PREPARATION OF THE TAX RETURN Prior Rate RA B/A AUD REG READ INSTRUCTIONS READ INSTRUCTIONSREAD INSTRUCTIONS records refund claimed on line 13 as a negative REPORT OF DIESEL FUEL TRANSACTIONS REPORT WHOLE REPORT WHOLE GALLONS ONLY return must be filed even if no tax is due Be sure to sign and mail your return Make a copy of this document for your return you will owe a penalty of 10 percent of the amount of tax due Multiply the tax on line 13 by 0 10 and Roads that do not qualify as highways include: RR QS FILE REF SACRAMENTO CA 94279 6157 schools as described in Revenue and Taxation Code sections 60039 and 60040 Service diesel fuel dyeing requirements Service rules for high sulfur diesel fuel or low sulfur diesel fuel or any requirements subsequently set by the United States SIGNATURE PRINT NAME AND TITLE STATE OF CALIFORNIA Subtotal of tax (multiply line 1 times line 2 for columns A and B) W3 TELEPHONE that qualify as highways include both interstate freeways and publicly maintained surface streets A road within a federal that your payment is late Multiply the tax due on line 13 by the interest rate shown then multiply the result by the main menu select the option Special Taxes and Fees the number of months or fraction of a month that have elapsed since the due date and enter here The return must be filed on or before the last day of the calendar month following the period for which the tax is due A The State Board of Equalization (BOE) is responsible for collecting taxes under the Diesel Fuel Tax Law the total gallons shown on line 7 to the public Undyed diesel fuel means diesel fuel that is not subject to United States Environmental Protection Agency or Internal Revenue undyed diesel fuel Purchases of dyed diesel fuel used on the highway must be reported and the tax paid with this return use both dyed or undyed diesel fuel on the highway You must pay the diesel fuel tax directly to your supplier on purchases of W1 Gallons of undyed diesel fuel purchased from a retail vendor W2 Rate of tax per gallon 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 You can make your payment by paper check Online ACH Debit (ePay) or by credit card To use ePay go to our website at YOUR ACCOUNT NO your account number on your check or money order