Free PETROLEUM CARRIER REPORT - California

BOE-506-PC (S1F) REV. 3 (4-09)

STATE OF CALIFORNIA


BOARD OF EQUALIZATION


PETROLEUM CARRIER REPORT DUE ON OR BEFORE

BOE USE ONLY

RA-B/A
RR-QS
AUD FILE REG
REG REF REF


[ FOID

]

YOUR ACCOUNT NO. EFF


BOARD OF EQUALIZATION FUEL TAXES DIVISION P O BOX 942879 SACRAMENTO CA 94279-2074
READ INSTRUCTIONS
BEFORE PREPARING


As a vessel, pipeline, or train operator, you are required to report receipts and deliveries of petroleum
products into, out of, and within California terminals for the reporting period.


Please check the applicable boxes:


Carrier Receipts - Schedule 14D to report
Carrier Deliveries - Schedule 14E to report
No activity to report


CERTIFICATION

I hereby consent to disclosure and authorize the State Board of Equalization (BOE) to release, as necessary,
certain otherwise confidential transaction information regarding volumes, invoice numbers, bills-of-lading,
locations, dates, or method of delivery of reportable products to any person identified by me in this report as
being involved in a reported transaction for the sole purpose of verifying the accuracy of the reportable product
transaction information concerning my transactions with such person as reported in this report.
I hereby certify that this report, including all accompanying schedules and statements, has been examined by me
and to the best of my knowledge and belief is a true, correct, and complete report.


YOUR SIGNATURE AND TITLE


TELEPHONE NUMBER


DATE


Make a copy of this document and the accompanying schedules for your records.

Continued

BOE-506-PC (S1B) REV. 3 (4-09)


INSTRUCTIONS
PETROLEUM CARRIER REPORT


GENERAL INFORMATION
The Petroleum Carrier Report allows transport operators (vessel, barge, pipeline, and train operator) to report receipts and
deliveries of liquid petroleum product for product movements originating and/or terminating in California.
If you need help completing this form, please call us at 916-322-9669 or visit our website at www.boe.ca.gov.
FILING REQUIREMENTS
Vessel, barge, pipeline, and train operators must file a report with the BOE reporting every gallon of petroleum fuel
product received or delivered during the reporting period. Vessel, barge, and pipeline operators must report all petroleum
products received at or delivered to California terminals or refineries. Train operators must report all movements of
petroleum products that originate and/or terminate in the state. The report must be filed on or before the last day of the
calendar month following the reporting period to which it relates. You must file a report even if you have no activity for the
reporting period.
PREPARATION OF SCHEDULES 14D AND 14E
Two schedules are included with every Petroleum Carrier Report: a schedule of carrier receipts (14D) and a schedule of
carrier deliveries (14E). Report only one product code per page. (Photocopy the schedules if additional pages are needed
to permit you to report only one product code per page.) For each schedule, enter the product code in box (c) in the
header of the schedule. Your company name, account number and month/year are pre-filled when you receive monthly
paper returns from the BOE.
The most current list of product codes is available in numeric order on the BOE's website in BOE-810-FTA. The same list,
sorted by product type, is available in BOE-810-FTB.
REPORTING ORIGIN AND DESTINATION
For each bulk movement of a reportable product, please enter the point of origin on Schedule 14D and the point of
destination on Schedule 14E. When the origin or destination is a terminal, enter the IRS Terminal Control Number (TCN)
issued for that terminal. When the origin or destination is other than a terminal (that is, importation or exportation), enter
the two character U.S. Postal Service abbreviation (obtain from the Postal Abbreviations list, BOE-810-FTC, available on
our website.) Train operators should report the origination and destination city and state for each transaction when the
origination or destination is not an IRS approved terminal with a TCN.
SCHEDULES 14D - CARRIER RECEIPTS AND 14E - CARRIER DELIVERIES
Use Schedule 14D to report the origination, and Schedule 14E to report the destination of liquid petroleum product
transported by vessel, pipeline, or train received from or delivered to a location in California.
Column 1 Column 2 Column 3 Column 4 Column 5 Column 6 Enter the name of the consignor.
Enter the consignor's FEIN (Federal Employer Identification Number).
Enter the mode from the mode codes list below.
Enter the origination TCN from which product was received or the destination TCN to which product was
disbursed for each product movement.
Enter the date of the document identified in column 6 (enter as mm/dd/yy).
Enter the identifying number from the document provided by the terminal operator or refinery to the carrier
that reflects the details of the transaction. Except for train operators this should be a bill-of-lading. If there
is not a bill-of-lading, use the shipping document or manifest number. Both the carrier and the terminal
operator must report the same document number to the BOE.
Train operators should report the railcar information as prescribed by the BOE.
Column 7 Enter the net gallons for the transaction.


Mode Codes
B PL R S Barge
Pipeline
Railroad
Ship (ocean marine vessel)


This report may be filed electronically. To find out how, please contact us at 916-322-9669 or visit our website at
www.boe.ca.gov.


BOE-506-PC (S2F) REV. 3 (4-09)


STATE OF CALIFORNIA


SCHEDULE 14D - CARRIER RECEIPTS

(If additional space is needed, please photocopy the schedule before making entries.)


BOARD OF EQUALIZATION
Page
of


(a) COMPANY NAME

(b) BOE ACCOUNT NUMBER

(c) PRODUCT CODE

(d) MONTH/YEAR

(1) CONSIGNOR NAME

(2) CONSIGNOR FEIN

(3) MODE

(4) ORIGIN TERMINAL TCN

(5) DOCUMENT DATE

(6) DOCUMENT NUMBER

(7) NET GALLONS

TOTAL

BOE-506-PC (S2B) REV. 3 (4-09)


SCHEDULE 14E - CARRIER DELIVERIES

(If additional space is needed, please photocopy the schedule before making entries.)


Page
(a) COMPANY NAME (b) BOE ACCOUNT NUMBER (c) PRODUCT CODE

of

(d) MONTH/YEAR

(1) CONSIGNOR NAME

(2) CONSIGNOR FEIN

(3) MODE

(4) DESTINATION TERMINAL TCN

(5) DOCUMENT DATE

(6) DOCUMENT NUMBER

(7) NET GALLONS

TOTAL
CLEAR PRINT