Free Supplier and/or Ultimate Vendor License Application - California

BOE400fcO REV. 5 (1107)

Supplier and/or Ultimate Vendor License Application
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Where can I get help?
website fuel industry section

www.boe.ca.gov Our website includes a lot of useful information. For example, you can find out what the sales tax rate is in a particular county, or you can download numerous publications--such as laws, regulations, pamphlets, and policy manuals--that will help you understand how the law applies to your business. You can also verify sellers' permit numbers on-line, read about upcoming Taxpayers' Bill of Rights hearings, and obtain information on BOE field office addresses and telephone numbers. Another good resource--especially for starting a business--is the California Tax Service Center at www.taxes.ca.gov.
written tax advice

916-322-9669 If you need help with your application or have questions regarding the fuel taxes administered by the BOE, please call the Fuel Industry Section between 8 a.m. and 5 p.m., Pacific time Monday-Friday, except state holidays.
taxpayers' rights advocate office

If you would like to know more about your rights as a taxpayer or if you are unable to resolve an issue with us, please contact the Taxpayers' Rights Advocate office for help. Call 916-324-2798 (or toll-free, 888-324-2798). Their fax number is 916-323-3319. If you prefer, you may write to them at the following address: Taxpayers' Rights Advocate Office State Board of Equalization 450 N Street P.O. Box 942879 Sacramento, CA 94279-0070. To obtain a copy of publication 70, Understanding Your Rights as a California Taxpayer, please visit our website or call our Information Center.

It is best to get tax advice from us in writing. You may be relieved of tax, penalty, or interest charges if we determine you did not correctly report tax because you reasonably relied on our written advice regarding a specific situation. For this relief to apply, your request for advice must be in writing, identify the taxpayer to whom the advice applies, and fully describe the facts and circumstances of the situation. This protection is not available for advice we give in person or over the phone. Send your request for written advice to: Fuel Industry Section State Board of Equalization P.O. Box 942879 Sacramento, CA 94279-0030

IMPORTANT MESSAGE If you are the owner or operator of an underground storage tank, please see page 10.

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How do I apply?
Message from the Executive Director
We appreciate the fact that, as the operator of a business, you are busy and have many responsibilities. You may be responsible for income and fuel tax payments and for a variety of other obligations, such as payroll taxes, insurance, and employee benefits. For that reason, we want to make it as easy as possible for you to work with us. As you can see on page 2, we offer many services to help you with your questions. If you are unable to find the answers you need, please call our Information Center. Our trained representatives will be glad to help.

Step 1: Complete your application
Fill out the application on page 5 (perforated for easy removal). Be sure to refer to the "Tips" on page 4. If you need help filling out the form or have questions, please call our Fuel Taxes Division at 916-322-9669 or our Information Center at 800-400-7115.

Step : Send in your application and supporting documents
Make a copy of your completed application for your files, then mail the original application to: Fuel Taxes Division, Board of Equalization, P.O. Box 942879, Sacramento, CA 94279-0030. Please be sure to sign and date your application and to include copies of all required documents. We cannot process your application unless it is complete.

Step : After we approve your application
You should receive your license approximately two weeks after we receive your application, assuming it is complete and no security deposit is required. If a security deposit is required, you should allow approximately two more weeks for receipt of your license. There is no charge for the license. We will let you know whether you must file returns on a monthly, quarterly, or yearly basis. Your return is due on or before the due date printed on the return.

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Note: If you are required to obtain a license, you cannot legally make transfers of fuel in this state until you have received your license and paid any required security deposit. You are subject to a 25 percent penalty if you operate without the proper license.

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information center

Tips for Completing Your Application
Please write or print neatly. Be sure to complete both sides of the form and to sign and date it.

800-00-7115
TDD/TTY: 800-735-2929

Section I: Type of license
Indicate the type of business activity you are engaging in (see page 7 for an explanation of the listed categories).

reQUireD DocUmentS To register as a corporation, Limited Liability Company (LLC), or partnership you must include photocopies of the following documents with your completed and signed application form: Copy of corporate articles of incorporation or LLC charter. Copy of partnership agreement. Document indicating that the person signing your application is authorized to do so (see "Section IV: Certification" at right). For officers, members, partners, and sole owners listed on the application: Driver license or state ID card. For out-of-state foreign corporations and LLCs: Certificate of Qualification issued by the California Secretary of State. You may also wish to include the following: Power of Attorney form (BOE392), if you wish to designate someone to act on your behalf. You may obtain a copy from our website site or Information Center.

Section II: Ownership information
Items 1-8: All applicants. You must provide the information requested for each owner or partner (attach additional sheets if necessary).
All partnerships. Partnerships should provide a copy of their written partnership agreement, if one exists. If you file your agreement with us at the time you apply for a license and your agreement specifies that all business assets are held in the name of the partnership, the law requires the BOE to attempt to collect any delinquent tax liability from the partnership assets before it attempts to collect from the partners' personal assets. If a partnership is composed of multiple partnerships, L.L.C.'s, or corporations, a separate application is required of each member or partner. You should notify us immediately if you add or drop partners (see page 7). If you check "Corporation," "Limited Liability Company (LLC)," or "Business Trust," be sure to complete items 3-7. Note: All publicly traded companies are not required to complete items 8-28 for corporate information.

Items 10, 11, 17, 18, , 5: Driver license/social security number You must provide a copy of your driver license or other proof of identification and your social security number. This information is not made available to the public (see page 11 for privacy policy). Corporate officers are not required to provide social security numbers.

Section III: Business information
Item 1: Underground storage tanks If there is an underground storage tank at your business location, please complete this section. The tank owner is subject to the Underground Storage Tank Maintenance Fee for petroleum products placed in the tank. Call 916-322-9669 for more information. Item 15: Estimated average monthly gallons Provide an estimate for the number of gallons of motor vehicle fuel and diesel fuel you will remove, enter, or sell each month in California.

Section IV: Certification

This section must be signed by the business owner, general partner, corporate officer or LLC manager or member.

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BOE-400-FCO (FRONT) REv. 5 (11-07)

STATE OF CALIFORNIA

SUPPLIER AND/OR ULTIMATE VENDOR FUEL TAX LICENSE APPLICATION
SECTION I: TYPE OF LICENSE
1. PLEASE CHECK TYPE OF BUSINESS OPERATIONS YOU ARE ENGAGING IN AND DESCRIBE BELOW: (see page 7 for definitions)

BOARD OF EQUALIZATION FOR BOARD USE ONLY
TAX OFFICE NUMBER

Terminal Operator Position Holder Refiner

Blender Enterer Throughputter

Ultimate vendor (Diesel Fuel Only)

PLEASE DESCRIBE YOUR BUSINESS OPERATIONS (attach additional sheets if necessary)

2. CHECK TYPES OF FUEL REMOvED, ENTERED, OR SOLD

Gasoline

Diesel

Dyed Diesel

Aviation Gasoline

Other

Please explain

SECTION II: OWNERSHIP INFORMATION
1. PLEASE CHECK TYPE OF OWNERSHIP

Sole Owner Limited Partnership (provide a copy of your partnership agreement) Limited Liability Company (LLC) Business Trust Registered Domestic Partnership

General Partnership (provide a copy of your partnership agreement) Husband/Wife Co-Ownership Corporation Joint venture Other

2. DATE YOU WILL BEGIN ACTIvITIES REQUIRING A LICENSE IN CALIFORNIA (month, day & year) 3. ENTER NAME OF PARTNERSHIP, CORPORATION, LIMITED LIABILITY COMPANY (LLC), ORGANIZATION, OR OTHER (include a copy of your partnership agreement

or LLC agreement)

4. FEDERAL EMPLOYER IDENTIFICATION NUMBER (FEIN) OR SSN IF NO FEIN 5. CORPORATE OR LLC NUMBER 6. STATE OF INCORPORATION OR ORGANIZATION 7. DATE OF INCORPORATION OR ORGANIZATION

-- tear on perforation --

Each owner, partner, corporate officer or principal must provide the information requested below. If needed, please attach additional sheet(s) to provide the information requested in this application. Officers of publicly traded companies are not required to complete this section.

President

Partner

Registered Domestic Partner

Manager

Member

Owner

Trustee

8. FULL NAME (first, middle, last) 9. RESIDENCE ADDRESS (street, city, state, zip code) 10. SOCIAL SECURITY NUMBER (attach verification) (corporate officers excluded) 12. RESIDENCE TELEPHONE NUMBER 11. DRIvER LICENSE NUMBER (attach verification) 13. DAYTIME TELEPHONE NUMBER

(

)

(

)

14. SIGNATURE

vice President Co-Partner Registered Domestic Partner Co-Manager Member Co-Owner Trustee
15. FULL NAME (first, middle, last) 16. RESIDENCE ADDRESS (street, city, state, zip code) 17. SOCIAL SECURITY NUMBER (attach verification) (corporate officers excluded) 19. RESIDENCE TELEPHONE NUMBER 18. DRIvER LICENSE NUMBER (attach verification) 20. DAYTIME TELEPHONE NUMBER

(

)

(

)

-

21. SIGNATURE

Secretary

Co-Partner

Registered Domestic Partner

Co-Manager

Member

Co-Owner

Trustee

22. FULL NAME (first, middle, last) 23. RESIDENCE ADDRESS (street, city, state, zip code) 24. SOCIAL SECURITY NUMBER (attach verification) (corporate officers excluded) 26. RESIDENCE TELEPHONE NUMBER 25. DRIvER LICENSE NUMBER (attach verification) 27. DAYTIME TELEPHONE NUMBER

(

)

(

)

28. SIGNATURE

-

BOE-400-FCO (BACK) REv. 5 (11-07)

SECTION III: BUSINESS INFORMATION
1. CURRENTLY DOING BUSINESS AS [DBA] (write none if not applicable) Partnerships complete if business name different than name of partnership.

2. BUSINESS ADDRESS (do not list P.O. Box or mailing service) If two or more locations, please attach a list. DAYTIME TELEPHONE NUMBER

FAx NUMBER

(
3. MAILING ADDRESS (if different from above) (street, city, state, zip code)

)

(

)

4. WEBSITE ADDRESS

5. ADDRESS WHERE BOOKS AND RECORDS ARE MAINTAINED (street, city, state, zip code)

DAYTIME TELEPHONE NUMBER

FAx NUMBER

(
6. NAME OF PERSON TO CONTACT REGARDING ALL LICENSING ACTIvITIES

) )

(

)

DAYTIME TELEPHONE NUMBER

E-MAIL ADDRESS

(
7. NAME OF PERSON TO CONTACT REGARDING TAx REPORTING ACTIvITIES

DAYTIME TELEPHONE NUMBER

E-MAIL ADDRESS

(
8. NAME OF BANK OR FINANCIAL INSTITUTION HOLDING PRIMARY BUSINESS ACCOUNT

)

ACCOUNT NUMBER

9. BANK OR FINANCIAL INSTITUTION ADDRESS (mailing address, city, state, zip code)

TELEPHONE NUMBER

FAx NUMBER

(
10. DO YOU OWN, OPERATE OR OTHERWISE CONTROL A TERMINAL?

)

(

)

Yes No If yes, state the number of terminals: one location, please attach a list.)
TERMINAL LOCATION ADDRESS (street, city, state, zip code)

and complete the following information for each terminal location. (If more than
CAPACITY OF TANKS

11. DO YOU HAvE A LETTER OF REGISTRATION (FORM 637) FROM THE IRS?

Yes (attach a copy) Yes Yes No No

No (please explain)

12. DO YOU HAvE OTHER BOARD OF EQUALIZATION ISSUED LICENSES OR PERMITS?

If yes, please list the account numbers. If yes, please list seller's name and fuel tax account number(s) if known. No . If no, please provide the name and address of the owner of the

13. ARE YOU BUYING A BUSINESS?

14. ARE THERE UNDERGROUND STORAGE TANK(S) AT A CALIFORNIA BUSINESS LOCATION?

Yes No If yes, are you the owner? Yes If yes, please provide your account number TK MT 44 tank.
15. ESTIMATED AvERAGE MONTHLY GALLONS

Motor Vehicle Fuel Total removals, entries, or sales Minus exempt removals, entries, or sales Total taxable removals, entries, or sales gallons gallons gallons

Diesel Fuel Total removals, entries, or sales Minus exempt removals, entries, or sales Total taxable removals, entries, or sales gallons gallons gallons

SECTION IV: CERTIFICATION
I certify and declare, under penalty of perjury, that the information contained herein is correct to the best of my knowledge and that I am authorized to sign and certify this application.
NAME (typed or printed) TITLE

-

SIGNATURE

DATE

Return Application to: Board of Equalization, Fuel Taxes Division P.O. Box 942879, Sacramento, CA 94279-0030, 916-322-9669 FOR BOARD USE ONLY
SECURITY REvIEW

BOE-598 $

No Security

PUBLICATIONS FURNISHED TO TAxPAYER PUB 6-A PUB 19 EFT 89-T

RETURNS

License Issued Date
REPORTING BASIS

Monthly
BY

Yearly

Monthly Prepay
APPROvED BY

Quarterly

PUB 70

CLEAR

PRINT

7

Frequently Asked Questions
Who must obtain a license?
You must obtain a Supplier and/or Ultimate Vendor License if you engage in business in California as · A Terminal Operator You own, operate, or otherwise control a terminal. · A Position Holder You have a contractual agreement with a terminal operator for the use of storage facilities and terminaling services at a terminal with respect to motor vehicle and/or diesel fuel. · A Refiner You own, operate, or otherwise control a refinery. · A Blender You produce blended motor vehicle and/or diesel fuel in California outside the bulk transfer/terminal system. · An Enterer You import motor vehicle and/or diesel fuel into the state, or you are the importer of record under federal customs law. Note: If you are acting as an agent, the person for whom you are acting is the "enterer" and must obtain a license. · A Throughputter You own motor vehicle and/or diesel fuel within the bulk transfer/terminal system--other than in a terminal, or you are a position holder, as described above. · An Ultimate Vendor You are an ultimate vendor if you sell undyed diesel fuel to the user of the fuel--the ultimate purchaser--for use on a farm for farming purposes or for use in an exempt bus operation.

What are my responsibilities as a license holder?
You must pay taxes on any taxable transaction involving motor vehicle fuel and/or diesel fuel. Generally, the state excise tax on fuel is imposed on · The removal of motor vehicle fuel or undyed diesel fuel from a refinery rack or terminal rack in California; or · The entry of motor vehicle fuel or diesel fuel into this state; or · The sale or removal of blended motor vehicle fuel or blended diesel fuel in this state. You will receive returns for reporting your fuel transactions and tax payments. Returns are due on or before the due date printed on the return (you must file a tax return even if you have no tax due or activities to report). In addition: · You must keep records to substantiate your removals, entries, sales, imports, exports, and other activities as noted on the corresponding tax returns. You must keep your records for a minimum of four years. · You must notify the BOE if you move, change ownership, discontinue operations, or sell your business. You should notify the BOE of any change in ownership. If you do not, you could be held liable for the continuing fuel taxes. In addition, you should immediately notify us in writing if you discontinue your business. Your notification will allow us to close your account and return any available security you may have posted. · You should notify us immediately if you drop or add a partner. This may protect former partners from tax liabilities incurred by the business after the partnership change.

What type of license will I receive?
You will receive a Supplier License if you are a Terminal Operator Blender Position Holder Enterer Refiner Throughputter An ultimate vendor who is also a refiner, blender, or throughputter will usually receive a Supplier License. All other ultimate vendors will receive an Ultimate Vendor License.

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Frequently Asked Questions (continued)
Is there a charge for the license?
No. However, you may be required to post a security deposit to cover any unpaid taxes that may be owed. Security forms will be sent to you if security is warranted. Your license will be issued after the appropriate security, if required, is posted to your account. the water in a diesel fuel and water emulsion of two immiscible liquids of diesel fuel and water, which emulsion contains an additive that causes the water droplets to remain suspended within the diesel fuel, provided the diesel fuel emulsion meets standards set by the California Air Resources Board. This exclusion of the water is operative through December 31, 2006. This includes bio-diesel. Blended diesel fuel is any mixture of diesel fuel on which tax has been imposed and any other liquid (such as kerosene) on which tax has not been imposed (other than dyed diesel fuel, as described below). Blended diesel fuel also means any conversion of a liquid into diesel fuel. Conversion of a liquid into diesel fuel occurs when any liquid that is not included in the definition of diesel fuel and that is outside the bulk transfer terminal system is sold as diesel fuel, delivered as diesel fuel or represented to be diesel fuel. Blended diesel fuel includes bio-diesel and blends of bio-diesel. Dyed diesel fuel is diesel fuel that is dyed under United States Environmental Protection Agency or the Internal Revenue Service rules for high sulphur diesel fuel or low sulphur diesel fuel considered destined for off-highway use. Undyed diesel fuel is diesel fuel that is not subject to the United States Environmental Protection Agency or the Internal Revenue Service fuel dyeing requirements.

Is information regarding my account subject to public disclosure?
Generally, personal information, such as your driver license number, your social security number, and your residence address, is not disclosed to the public. However, some records are subject to disclosure, such as your BOE license number, your business name and address, and your license status. Also, for purposes of enforcing the fuel laws, personal information may be disclosed to federal agencies and other state agencies. See also the disclosure information on the back page.

Why do you need to verify my social security and driver license numbers?
This is required to ensure the accuracy of the information provided and to protect you against fraudulent use of your identification numbers. If your social security card is not readily available, you may provide other documentation.

What is motor vehicle fuel?
Motor vehicle fuel includes gasoline, aviation gasoline, gasohol and gasoline blendstocks. Note: Aviation gasoline is all special grades of gasoline that are suitable for use in aviation reciprocating engines. Blended motor vehicle fuel is any mixture of motor vehicle fuel on which tax has been imposed and any other liquid on which tax has not been imposed. Blended motor vehicle fuel also means any conversion of a liquid into motor vehicle fuel. Conversion of a liquid into motor vehicle fuel occurs when any liquid that is not included in the definition of motor vehicle fuel and that is outside the bulk transfer/terminal system is sold as motor vehicle fuel, delivered as motor vehicle fuel or represented to be motor vehicle fuel. Diesel fuel is any liquid commonly or commercially known or sold as a fuel that is suitable for a dieselpowered highway vehicle. Diesel fuel does not include

What other licenses or permits are needed?
Seller's Permit. You will also need a California Seller's Permit. Please contact a local BOE sales tax office to ask about registration requirements. To download a copy of the California Seller's Permit Application, please visit our website at www.boe.ca.gov (look under "Register for a Permit/License").

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Frequently Asked Questions (continued)
SG Accounts. If you sell, remove, or enter motor vehicle fuel (gasoline), diesel fuel, or aircraft jet fuel in California, you must prepay sales tax on those transactions in addition to excise tax. You may be reimbursed by your customer for your sales tax prepayment. Contact a local BOE office to set up this type of account. Childhood Lead Poisoning Prevention Fee. If you are issued a Motor Vehicle Fuel Supplier License, you may be required to pay the Childhood Lead Poisoning Prevention Fee. The Department of Health Services identifies those persons who are required to pay the fee.

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Other Fuel Taxes and Fees
You may also be required to register under one or more of the following tax and fee programs. These programs are administered by the Fuel Taxes Division, which can be reached at 916-322-9669.

Oil Spill Prevention and Administration Fee/Oil Spill Response Fee
You may need to be registered for one of the fee programs listed above if you operate · An oil refinery in California · A marine terminal in marine waters that transfers crude oil or petroleum products to or from tankers or barges · A pipeline across, under or through marine waters that transports crude oil · Any pipeline that transports crude oil out of California Please contact us for more information on registration and fee reporting requirements. Currently, no fees are charged for the Oil Spill Response Fee, although registrants must file a return each year.

Use Fuel Tax Law
Use fuel vendors who sell and deliver use fuel into the fuel tanks of motor vehicles must have a license and collect the state excise tax. Persons who operate vehicles powered by use fuel on California highways also need to be licensed as users. The use fuel tax is imposed on fuels other than those covered by the Motor Vehicle Fuel Tax Law and Diesel Fuel Tax Law. Some of the typical use fuels governed by the Use Fuel Tax Law are compressed natural gas (CNG), liquefied petroleum gas (LPG, or propane), liquid natural gas (LNG), ethanol, and methanol.

Aircraft Jet Fuel Tax Law
Every aircraft jet fuel dealer must register with the BOE and pay the excise tax on each gallon of jet fuel sold and placed directly into the fuel tank of an aircraft or delivered into the storage facility of a jet fuel user.

Diesel Fuel
Additional licenses issued under this tax program are as follows: Government Entity, Exempt Bus Operator, Qualified Highway Vehicle Operator, and Interstate User/IFTA. If you need one of these licenses, please contact our office.

Underground Storage Tank Maintenance Fee Law
The owner of an underground storage tank must register with the BOE and pay the underground storage tank maintenance fee for every gallon of petroleum product placed into the tank. If you own property where an underground storage tank is located, you are usually considered the owner of the tank. If you operate an underground storage tank but do not own it, you are not liable for the fee. An operator is defined as the person who controls or is responsible for the daily operation of the tank. Generally, if you lease an underground storage tank, you will be considered an operator, not an owner, unless your lease provides otherwise.

Motor Vehicle Fuel and Diesel Fuel
Additional licenses issued under these tax programs are the Train Operator license and Vessel/Pipeline Operator license. If one of these licenses is needed, please contact our office. An additional motor vehicle fuel license issued under this tax program is the Industrial User License.

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11 Motor Vehicle Fuel Tax and Diesel Fuel Tax Program Privacy Notice
Information Provided to the Board of Equalization
We ask you for information so that we can administer the state's Motor Vehicle Fuel Tax, sections 7301-8405; 1 and Diesel Fuel Tax, sections 60001-60709. We will use the information to determine whether you are paying the correct amount of tax and to collect any amounts you owe. You must provide all of the information we request, including your social security number (used for identification purposes [see Title 42 U.S. Code sec.405(c)(2)(C)(i)]). What happens if I don't provide the information? If your application is incomplete, we may not issue your license. If you do not file complete returns, you may have to pay penalties and interest. Penalties may also apply if you don't provide other information we request or that is required by law, or if you give us fraudulent information. In some cases, you may be subject to criminal prosecution. In addition, if you don't provide information we request to support your exemptions, credits, exclusions, or adjustments, we may not allow them. You may end up owing more tax or receiving a smaller refund. Can anyone else see my information? Your records are covered by state laws that protect your privacy. However, we may share information regarding your account with certain government agencies (see list in following section). We may also share certain information with companies authorized to represent local governments. Under some circumstances we may release to the public the information printed on your license, including your account start and closeout dates and names of business owners or partners. When you sell a business, we can give the buyer or other involved parties information regarding your outstanding tax liability. With your written permission, we can release information regarding your account to anyone you designate. We may disclose information to the proper officials of the following agencies, among others: · United States government agencies: U.S. Attorney's Office; Bureau of Alcohol, Tobacco and Firearms; Deptartment of Agriculture, Defense, and Justice; Federal Bureau of Investigation; General Accounting Office; Internal Revenue Service; Interstate Commerce Commission. · State of California government agencies and officials: Air Resources Board; Department of Alcoholic Beverage Control; Auctioneer Commission; Deptartment of Motor Vehicles; Employment Development Department; Energy Commission; Exposition and Fairs; Department of Food and Agriculture; Board of Forestry; Forest Products Commission; Franchise Tax Board; Department of Health Services; Highway Patrol; Department of Housing and Community Development; California Parent Locator Service · State agencies outside of California for tax enforcement purposes. · City attorneys and city prosecutors; county district attorneys, police and sheriff departments. Can I review my records? Yes. Please contact your closest BOE office (see the white pages of your phone book). If you need more information, you may contact our Disclosure Officer in Sacramento by calling 916-445-2918. You may also want to obtain publication 58-A, How to Inspect and Correct Your Records. You may download it from our website at www.boe.ca.gov (look under "Forms & Publications") or order a copy from our Information Center at 800-400-7115. Who is responsible for maintaining my records? The Deputy Director of the Property and Special Taxes Department is responsible for maintaining your records. You may contact the Deputy Director by calling 916-445-6464 or writing to the following address: Deputy Director Property and Special Taxes Department P.O. Box 942879 Sacramento, CA 94279-0063
1

All references are to California Revenue and Taxation Code unless otherwise indicated.

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