(City State Zip Code)
(CLEAR) CLEAR
(Customer Name)
(name)
(PRINT) PRINT
(Street Address)
an authorized representative If tax is owed on your purchase please remit the tax to us and not to
Auditors of the California State Board of Equalization (BOE) are currently examining our records in
BOARD OF EQUALIZATION
BOE 504 B1 (9 11)
clear button
connection with the California Sales and Use Tax Law They have questioned certain non taxed sales
courtesy copy to my email [sender's email address] so that I am notified when BOE has received your
made to you as covered by the invoices listed on the attached sheet
Please indicate the disposition of this property by checking the appropriate box and completing the
print button
Requesting Purchaser s Statement
SAMPLE LETTER
Sincerely
STATE OF CALIFORNIA
statement
statement The BOE will not accept the statement if it is not filled out completely and signed by
statement within 10 days by forwarding the completed form to [auditor s email address] with a
the mailing address
these forms Please contact the auditor whose contact information is on the instruction letter to obtain
Use of the email procedure will expedite processing of these requests However you may elect to mail
Your prompt response is necessary to support any claim s for exemption Please return the inquiry
