Free BOE-106 - California

BOE-106 (FRONT) REV. 13 (8-03)

STATE OF CALIFORNIA

VEHICLE/VESSEL USE TAX CLEARANCE REQUEST

BOARD OF EQUALIZATION

NAME OF CLAIMANT

TELEPHONE NO.

ADDRESS (street, city, state, zip code)

NAME OF SELLER OR TRANSFEROR

TELEPHONE NO.

ADDRESS (street, city, state, zip code)

MAKE OF:

YEAR

Vehicle

Vessel
LICENSE NO.(s)/CF NO.(s)/DECAL NO.(s) VIN/HIN NO.(s)/SERIAL NO.(s) PURCHASE OR TRANSFER DATE

DATE YOU APPLIED FOR CALIFORNIA REGISTRATION LOCATION OF PURCHASE/TRANSFER

DATE VEHICLE/VESSEL ENTERED CALIFORNIA

DATE YOU BECAME RESIDENT OF CALIFORNIA DATE EMPLOYED IN CALIFORNIA

WAS VEHICLE/VESSEL PREVIOUSLY REGISTERED TO YOU OUTSIDE THE STATE OF CALIFORNIA? IF YES, WHERE?

FOR MOBILEHOMES ONLY:

MODEL

YEAR

MOBILEHOME MANUFACTURER

PURCHASE PRICE

SIZE

I HEREBY REQUEST A CERTIFICATE OF USE TAX CLEARANCE TO ALLOW COMPLETION OF REGISTRATION AT DMV/HCD WITHOUT PAYMENT OF THE CALIFORNIA USE TAX FOR THE FOLLOWING REASON:

I hereby certify that the above statements, to the best of my knowledge and belief, are true and correct.
SIGNATURE OF CLAIMANT DATE

Please refer to BOE Publication 52 available at www.boe.ca.gov for information on the required documentation to submit with this request. Take or mail this form to a local Board office (refer to the government pages of your telephone directory or call the Board's Information Center at 800-400-7115 for the address of the office nearest you). Be sure to include any required documentation.

BOE-106 (BACK) REV. 13 (8-03)

FOR BOARD OF EQUALIZATION USE ONLY
BRIEF STATEMENT OF FACTS

EVIDENCE PRESENTED (attach copies)

CONCLUSION

Taxable Return and payment received. Include BOE-111 press number on return.
Tax to be paid at DMV/HCD.
Requesting payment plan. Copy of packet to Consumer Use Tax Section.
Exempt (Based on review of supporting documentation) Clearance Issued (For registration only)
*If the test period has already expired, a decision of taxable, exempt or denied/withdrawn must be made.
Required For Test Period Not Yet Expired: Copy of purchase agreement
Out of state delivery statement
BOE-111-AT letter provided to taxpayer
Complete copy of BOE-106 packet to HQ ­ CUTS
Additional supporting documentation (optional)
Denied/Withdrawn (Additional documentation required, all documents returned to taxpayer.)
PREPARED BY DISTRICT/UNIT DATE

APPROVED BY

DATE

CERTIFICATE OF USE TAX CLEARANCE ISSUED: Form BOE-111, Vehicle/Mobilehome/Commercial Coach Form BOE-111-B, Vessel
PRESS NO. SIGNED BY

CLEAR

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