Form BOE-501-UI Fillable Cigarette & Tobacco Products Use Tax Return
(all forms fillable on Windows, Mac, Android tablets, and iPad using Adobe Reader XI)

1 Total cost of cigarettes purchased (less shipping charges if separately stated) 1 (1 Total cost of cigarettes purchased (less shipping charges if separately stated) ROUND CENTS TO THE NEAREST WHOLE DOLLAR $ ) (2 Total cost of tobacco products purchased (other than cigarettes or small cigars) (less shipping charges if separately stated) ROUND CENTS TO THE NEAREST WHOLE DOLLAR $ ) (3 Total cost of other untaxed merchandise purchased (do not include items in lines 1 and 2) ROUND CENTS TO THE NEAREST WHOLE DOLLAR $ ) (4 Total purchases subject to use tax (add lines 1 2 and 3) ROUND CENTS TO THE NEAREST WHOLE DOLLAR $ ) (5 Use tax rate: If the tax rate in your area includes a district tax that causes the rate to be greater than the pre printed rate you must use the higher tax rate to calculate the use tax see instructions ) (6 Total use tax (multiply line 4 by line 5) ROUND CENTS TO THE NEAREST WHOLE DOLLAR $ 00) (7 PENALTY [multiply line 6 by 10% (0 10) if payment is made after due date] $ ) (8 INTEREST $ ) (8 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 ) (9 TOTAL AMOUNT DUE AND PAYABLE (add lines 6 7 and 8) $ ) (BOE USE ONLY) (checkbox) (CLEAR) CLEAR (DATE) (DUE ON OR BEFORE) (EMAIL ADDRESS) (PRINT NAME AND TITLE) (PRINT) PRINT (TELEPHONE (AREA CODE)) (TELEPHONE) (text) (text) (text) (YOUR ACCOUNT NO ) [ FOID 0 07375 If you don't know your sales and use tax rate visit our website at www boe ca gov 1 $ 00 2 $ 00 2 Total cost of tobacco products purchased (other than cigarettes or small cigars) (less shipping charges if separately stated) 2 3 $ 00 3 Total cost of other untaxed merchandise purchased (do not include items in lines 1 and 2) 3 4 $ 00 4 Total purchases subject to use tax (add lines 1 2 and 3) 4 5 Use tax rate: If the tax rate in your area includes a district tax that causes the rate to be greater than the pre 6 $ 00 6 Total use tax (multiply line 4 by line 5) 6 7 Penalty [multiply line 6 by 10% (0 10) if payment is made after due date] 8 Interest: One month's interest is due on tax for each month or fraction of a month that payment 9 $ 00 9 TOTAL AMOUNT DUE AND PAYABLE (add lines 6 7 and 8) 9 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 10 percent penalty is due Multiply line 6 by 0 10 and enter the result on line 7 Always write your account number on your check or money order Make a copy of this document for your records any quantity of untaxed cigarettes tobacco products accessories or other untaxed merchandise shipped to a BEFORE PREPARING BOARD OF EQUALIZATION BOE 501 UI (BACK) REV 16 (4 13) BOE 501 UI (FRONT) REV 16 (4 13)STATE OF CALIFORNIA BOE USE ONLY cigar cutters etc Do not include items in lines 1 and 2 CIGARETTE AND TOBACCO PRODUCTS USE TAX RETURN completed first DUE ON OR BEFORE EMAIL ADDRESS Everyone who purchases untaxed cigarettes tobacco products accessories or other untaxed merchandise examined by me and to the best of my knowledge and belief is a true correct and complete return FILING REQUIREMENTS for one month's interest Then multiply your result by the number of months the return is late Enter from the main menu select the option Special Taxes and Fees GENERAL INFORMATION 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 Special Taxes and Fees P O Box 942879 Sacramento CA INSTRUCTIONSCIGARETTE AND TOBACCO PRODUCTS USE TAX RETURN INTEREST 8 $ 00 is delayed after the due date The adjusted monthly interest rate is Line 1 Total cost of cigarettes Enter the total cost of the cigarettes you purchased Do not include Line 2 Total cost of tobacco products Enter the total purchase price of the tobacco products Line 3 Total cost of other untaxed merchandise purchased such as cigarette papers lighters pipes Line 4 Total purchases subject to use tax Add lines 1 2 and 3 Line 5 Enter the use tax rate in effect where the cigarettes or tobacco products are used stored or Line 6 Total use tax Multiply line 4 by the rate entered on line 5 Line 7 Penalty If your return and/or tax payment is filed after the due date shown at the top of this return Line 8 Interest If your return and/or tax payment is filed after the due date shown at the top of this return Line 9 Total amount due and payable Add lines 6 7 and 8 Make check or money order payable to State Board of Equalization month or portion of a month the payment is overdue For example if your payment is one month and NEAREST WHOLE DOLLAR NOTE:must Figures from the excise tax return will be entered on this return The excise tax return be otherwise consumed Use the decimal equivalent; for example 7 25% is 0 0725 7 375% is our 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 Payments: You can make your payment by paper check Online ACH Debit (ePay) or by credit card To use ePay go to PENALTY 7 $ 00 PO BOX 942879 printed rate you must use the higher tax rate to calculate the use tax see instructions 5 Use tax rate: If the tax rate in your area includes a district tax that causes the rate to be greater than 8 25 percent you must use the higher tax rate to calculate the use tax see instructions 5 purchased Do not include shipping charges if they are separately stated on your invoice pursuant to sections 6451 and 6452 of the Revenue and Taxation Code must file a return with the BOE quarter in which the product was received and must be submitted with the amount of tax due The tax applies to RA B/A AUDREG READ INSTRUCTIONS reporting the costs of products received The return is due on or before the last day of the month following the RETURN PREPARATION ROUND CENTS TO THE RR QS FILEREF SACRAMENTO CA 94279 2074 shipping charges if they are separately stated on your invoice SIGNATURE PRINT NAME AND TITLE SPECIAL Tax Law TAXES TELEPHONE The California State Board of Equalization (BOE) is responsible for administering the California Sales and Use the result on line 8 two weeks overdue you owe two months' interest Multiply line 6 by the interest rate shown on line 8 user or consumer in California from a seller outside of California you must pay interest charges in addition to penalty charges You owe one month's interest for each YOUR ACCOUNT NO your return