Form BOE-501-EF Fillable Environmental Fee Return

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Download Form BOE-501-EF

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(10 Penalty (multiply line 9 by 10% (0 10) if payment is made after due date shown above] PENALTY 10 D AMOUNT OF FEES DUE (column B x C)) (11 INTEREST: One month's interest is due on the total fee for each month or fraction of a month that payment is delayed after the due date The adjusted monthly interest rate is For assistance see BOE website for Interest Calculator ) (12 TOTAL AMOUNT DUE AND PAYABLE (add lines 9 10 and 11) 12 D AMOUNT OF FEES DUE (column B x C)) (7 digits) (9 TOTAL AMOUNT DUE (add lines 3 through 8 of column D) 9 D AMOUNT OF FEES DUE (column B x C)) (A ENVIRONMENTAL FEE CATEGORIES 2 Organizations that employed from 1 to 49 employees during the calendar year covered by this return 2 B NUMBER OF ORGANIZATIONS (NOT NUMBER OF EMPLOYEES)) (A ENVIRONMENTAL FEE CATEGORIES 3 Organizations that employed from 50 to 74 employees during the calendar year covered by this return 3 B NUMBER OF ORGANIZATIONS (NOT NUMBER OF EMPLOYEES)) (A ENVIRONMENTAL FEE CATEGORIES 3 Organizations that employed from 50 to 74 employees during the calendar year covered by this return 3 D AMOUNT OF FEES DUE (column B x C)) (A ENVIRONMENTAL FEE CATEGORIES 4 Organizations that employed from 75 to 99 employees during the calendar year covered by this return 4 B NUMBER OF ORGANIZATIONS (NOT NUMBER OF EMPLOYEES)) (A ENVIRONMENTAL FEE CATEGORIES 4 Organizations that employed from 75 to 99 employees during the calendar year covered by this return 4 D AMOUNT OF FEES DUE (column B x C)) (A ENVIRONMENTAL FEE CATEGORIES 5 Organizations that employed from 100 to 249 employees during the calendar year covered by this return 5 B NUMBER OF ORGANIZATIONS (NOT NUMBER OF EMPLOYEES)) (A ENVIRONMENTAL FEE CATEGORIES 5 Organizations that employed from 100 to 249 employees during the calendar year covered by this return 5 D AMOUNT OF FEES DUE (column B x C)) (A ENVIRONMENTAL FEE CATEGORIES 6 Organizations that employed from 250 to 499 employees during the calendar year covered by this return 6 B NUMBER OF ORGANIZATIONS (NOT NUMBER OF EMPLOYEES)) (A ENVIRONMENTAL FEE CATEGORIES 6 Organizations that employed from 250 to 499 employees during the calendar year covered by this return 6 D AMOUNT OF FEES DUE (column B x C)) (A ENVIRONMENTAL FEE CATEGORIES 7 Organizations that employed from 500 to 999 employees during the calendar year covered by this return 7 B NUMBER OF ORGANIZATIONS (NOT NUMBER OF EMPLOYEES)) (A ENVIRONMENTAL FEE CATEGORIES 7 Organizations that employed from 500 to 999 employees during the calendar year covered by this return 7 D AMOUNT OF FEES DUE (column B x C)) (A ENVIRONMENTAL FEE CATEGORIES 8 Organizations that employed 1 000 or more employees during the calendar year covered by this return 8 B NUMBER OF ORGANIZATIONS (NOT NUMBER OF EMPLOYEES)) (A ENVIRONMENTAL FEE CATEGORIES 8 Organizations that employed 1 000 or more employees during the calendar year covered by this return 8 D AMOUNT OF FEES DUE (column B x C)) (B O E Use Only) (B O E USE ONLY) (B O E USE ONLY) (CLEAR BUTTON) CLEAR (column B x C) (Complete only if you are reporting more than one corporation or organization ) (DATE) (DUE ON OR BEFORE) (EFT) or credit card To use ePay go to our website at www boe ca gov click on the eServices tab and log in to make a (EMAIL ADDRESS) (INTEREST 11 D AMOUNT OF FEES DUE (column B x C)) (NAME OF CORPORATION (Per Articles of Incorporation) OR ORGANIZATION Row 1) (NAME OF CORPORATION (Per Articles of Incorporation) OR ORGANIZATION Row 10) (NAME OF CORPORATION (Per Articles of Incorporation) OR ORGANIZATION Row 11) (NAME OF CORPORATION (Per Articles of Incorporation) OR ORGANIZATION Row 12) (NAME OF CORPORATION (Per Articles of Incorporation) OR ORGANIZATION Row 2) (NAME OF CORPORATION (Per Articles of Incorporation) OR ORGANIZATION Row 3) (NAME OF CORPORATION (Per Articles of Incorporation) OR ORGANIZATION Row 4) (NAME OF CORPORATION (Per Articles of Incorporation) OR ORGANIZATION Row 5) (NAME OF CORPORATION (Per Articles of Incorporation) OR ORGANIZATION Row 6) (NAME OF CORPORATION (Per Articles of Incorporation) OR ORGANIZATION Row 7) (NAME OF CORPORATION (Per Articles of Incorporation) OR ORGANIZATION Row 8 ) (NAME OF CORPORATION (Per Articles of Incorporation) OR ORGANIZATION Row 9 ) (NOT NUMBER OF (Per Articles of Incorporation) (PRINT BUTTON) PRINT (PRINT NAME AND TITLE) (SELECT THE APPROPRIATE FEE CATEGORY Row 1 EDD Number (7 digits)) (SELECT THE APPROPRIATE FEE CATEGORY Row 1 Line 2 1 to 49 Employees) (SELECT THE APPROPRIATE FEE CATEGORY Row 1 Line 3 50 to 74 Employees) (SELECT THE APPROPRIATE FEE CATEGORY Row 1 Line 4 75 to 99 Employees) (SELECT THE APPROPRIATE FEE CATEGORY Row 1 Line 5 100 to 249 Employees) (SELECT THE APPROPRIATE FEE CATEGORY Row 1 Line 6 250 to 499 Employees) (SELECT THE APPROPRIATE FEE CATEGORY Row 1 Line 7 500 to 999 Employees) (SELECT THE APPROPRIATE FEE CATEGORY Row 1 Line 8 1000 or more Employees) (SELECT THE APPROPRIATE FEE CATEGORY Row 10 EDD Number (7 digits)) (SELECT THE APPROPRIATE FEE CATEGORY Row 10 Line 2 1 to 49 Employees) (SELECT THE APPROPRIATE FEE CATEGORY Row 10 Line 3 50 to 74 Employees) (SELECT THE APPROPRIATE FEE CATEGORY Row 10 Line 4 75 to 99 Employees) (SELECT THE APPROPRIATE FEE CATEGORY Row 10 Line 5 100 to 249 Employees) (SELECT THE APPROPRIATE FEE CATEGORY Row 10 Line 6 250 to 499 Employees) (SELECT THE APPROPRIATE FEE CATEGORY Row 10 Line 7 500 to 999 Employees) (SELECT THE APPROPRIATE FEE CATEGORY Row 10 Line 8 1000 or more Employees) (SELECT THE APPROPRIATE FEE CATEGORY Row 11 EDD Number (7 digits)) (SELECT THE APPROPRIATE FEE CATEGORY Row 11 Line 2 1 to 49 Employees) (SELECT THE APPROPRIATE FEE CATEGORY Row 11 Line 3 50 to 74 Employees) (SELECT THE APPROPRIATE FEE CATEGORY Row 11 Line 4 75 to 99 Employees) (SELECT THE APPROPRIATE FEE CATEGORY Row 11 Line 5 100 to 249 Employees) (SELECT THE APPROPRIATE FEE CATEGORY Row 11 Line 6 250 to 499 Employees) (SELECT THE APPROPRIATE FEE CATEGORY Row 11 Line 7 500 to 999 Employees) (SELECT THE APPROPRIATE FEE CATEGORY Row 11 Line 8 1000 or more Employees) (SELECT THE APPROPRIATE FEE CATEGORY Row 12 EDD Number (7 digits)) (SELECT THE APPROPRIATE FEE CATEGORY Row 12 Line 2 1 to 49 Employees) (SELECT THE APPROPRIATE FEE CATEGORY Row 12 Line 3 50 to 74 Employees) (SELECT THE APPROPRIATE FEE CATEGORY Row 12 Line 4 75 to 99 Employees) (SELECT THE APPROPRIATE FEE CATEGORY Row 12 Line 5 100 to 249 Employees) (SELECT THE APPROPRIATE FEE CATEGORY Row 12 Line 6 250 to 499 Employees) (SELECT THE APPROPRIATE FEE CATEGORY Row 12 Line 7 500 to 999 Employees) (SELECT THE APPROPRIATE FEE CATEGORY Row 12 Line 8 1000 or more Employees) (SELECT THE APPROPRIATE FEE CATEGORY Row 2 EDD Number (7 digits)) (SELECT THE APPROPRIATE FEE CATEGORY Row 2 Line 2 1 to 49 Employees) (SELECT THE APPROPRIATE FEE CATEGORY Row 2 Line 3 50 to 74 Employees) (SELECT THE APPROPRIATE FEE CATEGORY Row 2 Line 4 75 to 99 Employees) (SELECT THE APPROPRIATE FEE CATEGORY Row 2 Line 5 100 to 249 Employees) (SELECT THE APPROPRIATE FEE CATEGORY Row 2 Line 6 250 to 499 Employees) (SELECT THE APPROPRIATE FEE CATEGORY Row 2 Line 7 500 to 999 Employees) (SELECT THE APPROPRIATE FEE CATEGORY Row 2 Line 8 1000 or more Employees) (SELECT THE APPROPRIATE FEE CATEGORY Row 3 EDD Number (7 digits)) (SELECT THE APPROPRIATE FEE CATEGORY Row 3 Line 2 1 to 49 Employees) (SELECT THE APPROPRIATE FEE CATEGORY Row 3 Line 3 50 to 74 Employees) (SELECT THE APPROPRIATE FEE CATEGORY Row 3 Line 4 75 to 99 Employees) (SELECT THE APPROPRIATE FEE CATEGORY Row 3 Line 5 100 to 249 Employees) (SELECT THE APPROPRIATE FEE CATEGORY Row 3 Line 6 250 to 499 Employees) (SELECT THE APPROPRIATE FEE CATEGORY Row 3 Line 7 500 to 999 Employees) (SELECT THE APPROPRIATE FEE CATEGORY Row 3 Line 8 1000 or more Employees) (SELECT THE APPROPRIATE FEE CATEGORY Row 4 EDD Number (7 digits)) (SELECT THE APPROPRIATE FEE CATEGORY Row 4 Line 2 1 to 49 Employees) (SELECT THE APPROPRIATE FEE CATEGORY Row 4 Line 3 50 to 74 Employees) (SELECT THE APPROPRIATE FEE CATEGORY Row 4 Line 4 75 to 99 Employees) (SELECT THE APPROPRIATE FEE CATEGORY Row 4 Line 5 100 to 249 Employees) (SELECT THE APPROPRIATE FEE CATEGORY Row 4 Line 6 250 to 499 Employees) (SELECT THE APPROPRIATE FEE CATEGORY Row 4 Line 7 500 to 999) (SELECT THE APPROPRIATE FEE CATEGORY Row 4 Line 8 1000 or more Employees) (SELECT THE APPROPRIATE FEE CATEGORY Row 5 EDD Number (7 digits)) (SELECT THE APPROPRIATE FEE CATEGORY Row 5 Line 2 1 to 49 Employees) (SELECT THE APPROPRIATE FEE CATEGORY Row 5 Line 3 50 to 74 Employees) (SELECT THE APPROPRIATE FEE CATEGORY Row 5 Line 4 75 to 99 Employees) (SELECT THE APPROPRIATE FEE CATEGORY Row 5 Line 5 100 to 249 Employees) (SELECT THE APPROPRIATE FEE CATEGORY Row 5 Line 6 250 to 499 Employees) (SELECT THE APPROPRIATE FEE CATEGORY Row 5 Line 7 500 to 999 Employees) (SELECT THE APPROPRIATE FEE CATEGORY Row 5 Line 8 1000 or more Employees) (SELECT THE APPROPRIATE FEE CATEGORY Row 6 EDD Number (7 digits)) (SELECT THE APPROPRIATE FEE CATEGORY Row 6 Line 2 1 to 49 Employees) (SELECT THE APPROPRIATE FEE CATEGORY Row 6 Line 3 50 to 74 Employees) (SELECT THE APPROPRIATE FEE CATEGORY Row 6 Line 4 75 to 99 Employees) (SELECT THE APPROPRIATE FEE CATEGORY Row 6 Line 5 100 to 249 Employees) (SELECT THE APPROPRIATE FEE CATEGORY Row 6 Line 6 250 to 499 Employees) (SELECT THE APPROPRIATE FEE CATEGORY Row 6 Line 7 500 to 999 Employees) (SELECT THE APPROPRIATE FEE CATEGORY Row 6 Line 8 1000 or more Employees) (SELECT THE APPROPRIATE FEE CATEGORY Row 7 EDD Number (7 digits)) (SELECT THE APPROPRIATE FEE CATEGORY Row 7 Line 2 1 to 49 Employees) (SELECT THE APPROPRIATE FEE CATEGORY Row 7 Line 3 50 to 74 Employees) (SELECT THE APPROPRIATE FEE CATEGORY Row 7 Line 4 75 to 99 Employees) (SELECT THE APPROPRIATE FEE CATEGORY Row 7 Line 5 100 to 249 Employees) (SELECT THE APPROPRIATE FEE CATEGORY Row 7 Line 6 250 to 499 Employees) (SELECT THE APPROPRIATE FEE CATEGORY Row 7 Line 7 500 to 999 Employees) (SELECT THE APPROPRIATE FEE CATEGORY Row 7 Line 8 1000 or more Employees) (SELECT THE APPROPRIATE FEE CATEGORY Row 8 EDD Number (7 digits)) (SELECT THE APPROPRIATE FEE CATEGORY Row 8 Line 2 1 to 49 Employees) (SELECT THE APPROPRIATE FEE CATEGORY Row 8 Line 3 50 to 74 Employees ) (SELECT THE APPROPRIATE FEE CATEGORY Row 8 Line 4 75 to 99 Employees ) (SELECT THE APPROPRIATE FEE CATEGORY Row 8 Line 5 100 to 249 Employees ) (SELECT THE APPROPRIATE FEE CATEGORY Row 8 Line 6 250 to 499 Employees ) (SELECT THE APPROPRIATE FEE CATEGORY Row 8 Line 7 500 to 999 Employees ) (SELECT THE APPROPRIATE FEE CATEGORY Row 8 Line 8 1000 or more Employees ) (SELECT THE APPROPRIATE FEE CATEGORY Row 9 EDD Number (7 digits)) (SELECT THE APPROPRIATE FEE CATEGORY Row 9 Line 2 1 to 49 Employees) (SELECT THE APPROPRIATE FEE CATEGORY Row 9 Line 3 50 to 74 Employees) (SELECT THE APPROPRIATE FEE CATEGORY Row 9 Line 4 75 to 99 Employees) (SELECT THE APPROPRIATE FEE CATEGORY Row 9 Line 5 100 to 249 Employees ) (SELECT THE APPROPRIATE FEE CATEGORY Row 9 Line 6 250 to 499 Employees ) (SELECT THE APPROPRIATE FEE CATEGORY Row 9 Line 7 500 to 999 Employees) (SELECT THE APPROPRIATE FEE CATEGORY Row 9 Line 8 1000 or more Employees ) (TELEPHONE (AREA CODE)) (TELEPHONE) (text) (Total Line 2) (Total Line 3) (Total Line 4) (Total Line 5) (Total Line 6) (Total Line 7) (Total Line 8) (TOTAL ORGANIZATIONS Enter the total number of organizations for each fee category Carry the totals to the front of the return Remember to include the organization shown on the face of the return in your totals ) (YOUR ACCOUNT NO ) [ FOID] 1 000 or 1 to 49 1 Was your organization operating in the State of California during the reporting 10 Penalty [multiply line 9 by 10% (0 10) if payment is made after due date shown above] PENALTY 10 100 to 249 11 INTEREST: One month's interest is due on the total fee for each month or fraction of a month that 12 12 TOTAL AMOUNT DUE AND PAYABLE (add lines 9 10 and 11) $ 2 Organizations that employed from 1 to 49 employees 2 250 to 499 3 Organizations that employed from 50 to 74 employees 3 4 Organizations that employed from 75 to 99 employees 4 5 5 Organizations that employed from 100 to 249 employeesduring the calendar year covered by this return 50 to 74 500 to 999 6 Organizations that employed from 250 to 499 employees 6 7 Organizations that employed from 500 to 999 employees 7 75 to 99 8 Organizations that employed 1 000 or more employees 8 9 9 TOTAL AMOUNT DUE (add lines 3 through 8 of column D) 94279 0088 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); a separate return the separate return must be filed for that organization on that organization's account absent due to vacation illness holidays personal time off (PTO) or on call for the duration of their employment all corporate entity types Always write your account number on your check or money order Make a copy of this document for your records AMOUNT OF an adjusted annual rate established under RTC section 6591 5 An organization does not have to pay the fee if it falls into one of these categories: and 11 and all corporate entity types ANSWER YES OR NO TO THE FOLLOWING QUESTION Banks that pay a tax on net income in lieu of all other California taxes and licenses BEFORE PREPARING BOARD OF EQUALIZATION BOARD OF EQUALIZATION BOE 501 EF (S1B) REV 20 (4 13) BOE 501 EF (S1F) REV 20 (4 13) STATE OF CALIFORNIA BOE 501 EF (S2) REV 20 (4 13) STATE OF CALIFORNIA BOE USE ONLY by the organization in California for more than 500 hours during the calendar year covered by the return Code (H&SC;) Pursuant to that section the Department of Toxic Substances Control (Department) must annually provide the BOE with a column Last carry the totals for each fee category to the respective fee category on the front of the return Please remember to corporation then you need to report any related organizations on the schedule below Make sure you only report those covered by the return Do not include any related organization that received a separate return If the related organization received covered by the return The term "employed" in California includes the hours for which an employee is paid even when the employee is DEFINITIONS DUE ON OR BEFORE during the calendar year covered by this return during the calendar year covered by this return during the calendar year covered by this return EMAIL ADDRESS employed for more than 500 hours in California must file a return with a remittance payable to the State Board of Equalization This return Employees Employees Employees Employees Employees are the number of persons employed by the organization in California for more than 500 hours each during the calendar year employees in this state during the calendar year covered by the return EMPLOYEES) Enter the total number of organizations for which you are reporting in column B If you are reporting for more than one ENVIRONMENTAL FEE CATEGORIES ENVIRONMENTAL FEE RETURN ENVIRONMENTAL FEE SCHEDULE ePay Be sure to sign and mail your return examined by me and to the best of my knowledge and belief is a true correct and complete return Except as provided above (see Exemptions from the Fee) all qualifying organizations with 50 or more employees that were each employed EXEMPTIONS FROM THE FEE Fee returns and payments that are mailed must be postmarked on or before the due date shown on the return If the due date falls on a Fee) For more information please see publication 90 on our website at www boe ca gov FEES DUE FILING REQUIREMENTS For assistance see BOE website for Interest Calculator for more than 500 hours in California must file a return and pay the fee The qualifying organizations include general partnerships limited forth by the U S Office of Management and Budget (OMB) in the Standard Classification Manual 1987 which are used to designate the four digit numerical SIC code system with a five or more digit numerical code system from the main menu select the option Special Taxes and Fees GENERAL INFORMATION hazardous materials and the Department identified all but two industry codes as being subject to the fee Therefore every qualifying hazardous materials the Department determined that all organizations in this state use generate store or conduct activities related to hours each To avoid receiving a delinquency notice the return must be completed and filed even though you employed less than 50 I hereby certify that this return including any accompanying schedules and statements has been If you checked "No" to the question above enter 0 on line 12 and sign date and mail this return to the address shown above If you checked "Yes" to the question above you must complete the rest of this return If you need additional information please contact the State Board of Equalization Special Taxes and Fees P O Box 942879 Sacramento CA If you pay the fee and file the return after the due date shown on the front of this return additional amounts are due for If your organization received this return and is related to one or more other organizations such as a parent or subsidiary IMPORTANT NOTICE include each organization's California Employment Development Department (EDD) number Next place a check mark in include the organization shown on the face of the include the organization shown on the front of the return in the appropriate fee category total includes general partnerships limited partnerships limited liability partnerships limited liability companies sole proprietorships industries that use generate store or conduct activities in this state related to hazardous materials Based on the broad definition of INSTRUCTIONS ENVIRONMENTAL FEE RETURN Insurance companies that pay a tax on gross premiums in lieu of all other California taxes and licenses INTEREST 11 is due even if you ceased activities during the calendar year as long as you employed at least 50 employees in California for more than 500 limited liability partnerships limited liability companies sole proprietorships and Line 1 Indicate whether your organization operates in the State of California This includes all general partnerships limited Line 12 Enter total amount due and payable by adding lines 9 10 and 11 Line 2 Line 2 Line 3 Line 4 Line 5 Line 6 Line 7 Line 8 Line 3 Line 4 Line 5 Line 6 Line 7 Line 8 Line 9 Add the total amount of the fees entered in column D Lines 10 Lines 2 Make check or money order payable to State Board of Equalization must be filed even if you have no tax liability Under RTC section 43155 late payment will result in a 10 percent (0 10) penalty and interest at NAME OF CORPORATION Nonprofit residential care facilities (SIC code 8361 or NAICS codes 623312 62322 and 62399) Number NUMBER OF of organizations for each fee category Carry the on the front of this form and applies for each month or portion of a month that payment is received after the due date OR ORGANIZATION organization (see Filing Requirements below) identified in H&SC; 25205 6 must pay the fee except as set forth below (Exemptions from the organization complete the Environmental Fee Schedule Summary of Corporations or Other Organizations on the reverse of ORGANIZATIONS organizations that had 50 or more employees each employed more than 500 hours in California during the previous calendar year partnerships limited liability partnerships limited liability companies sole proprietorships and all corporate entity types partnerships limited liability partnerships limited liability companies sole proprietorships and all corporate entity types Additionally the fee payment is delayed after the due date The adjusted monthly interest rate is payment To pay by credit card go to our website or call 1 855 292 8931 Mandatory EFT accounts must pay by EFT or Payments: You can make your payment by paper check money order online ACH Debit (ePay) Electronic Funds Transfer penalty and interest charges The penalty is 10 percent (0 10) of the amount of fee owed The interest rate is noted on line 11 period? "Organization" includes general partnerships limited partnerships PO BOX 942879 primary activity of a business operation Private households (SIC code major group 88) RA B/A AUD REG READ INSTRUCTIONS return in your totals RETURN PREPARATION RR QS FILE REF SACRAMENTO CA 94279 6001 Saturday Sunday or legal holiday returns postmarked on the next business day are considered timely schedule add the number of check marks in each of the fee categories and place the total at the bottom of each fee category schedule of Standard Industrial Classification (SIC) codes or North American Industry Classification System (NAICS) codes which identify See next page if reporting multiple organizations SELECT THE APPROPRIATE FEE CATEGORY SIGNATURE PRINT NAME AND TITLE SPECIAL Standard Industrial Classification (SIC) codes are four digit numerical codes with the first two digits referencing the major industry group set Summary of Organizations TAXES TELEPHONE the box for the appropriate fee category to the right of each organization Once you have entered all organizations on the The Environmental Fee Return provides a mechanism for reporting the liability of two or more related organizations "Organization" The North American Industry Classification System (NAICS) is a system of codes adopted by the OMB and the U S Census Bureau that are The State Board of Equalization (BOE) administers the Environmental Fee imposed by section 25205 6 of the California Health and Safety this return Be sure to include the corporation or organization listed on the front of the return in the appropriate fee category thru 8 To complete the schedule below list the related organizations that did not receive a separate return Please make sure you To determine the amount of fee due select a category below based on the number of persons who were employed total Multiply column B x C and enter the result on the applicable line of column D TOTAL ORGANIZATIONS Enter the total number totals to the front of the return Remember to U S Government agencies and instrumentalities Under section 43152 9 of the Revenue and Taxation Code (RTC) all qualifying organizations with 50 or more employees that were each used to provide more detailed designation of activities than provided by the SIC code system The NAICS was created to replace the Yes No YOUR ACCOUNT NO

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