Free Terminal Operator Information Report - California

BOE-506-PO (S1) REV. 2 (4-06)

TERMINAL OPERATOR INFORMATION REPORT DUE ON OR BEFORE
[

BOARD OF EQUALIZATION BOARD USE ONLY
RA-B/A RR-QS EFF AUD REG

STATE OF CALIFORNIA

FOID

]

YOUR ACCOUNT NO.

FILE

REF

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

TCN: As a terminal operator, you are required to report your monthly receipts and disbursements of liquid products to and from your approved terminal and the ending inventory of all products in the terminal. Each terminal operator is required to file a separate form BOE-506-PO for each approved terminal. Please check the applicable schedules that are attached to this report: Terminal Operator Receipts - Schedule 15A Terminal Operator Disbursements by Position Holder - Schedule 15B Ending Inventory by Product Code - Schedule 15C No activity to report

CERTIFICATION

I hereby consent to disclose and authorize the Board 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.

BOE-506-PO (S2F) REV. 2 (4-06)

BOARD OF EQUALIZATION
BOE ACCOUNT NO. MONTH/YEAR

STATE OF CALIFORNIA

COMPANY NAME

Enter the actual physical ending inventory for each product in net gallons at the terminal. You should use this table to identify the appropriate product codes to use when reporting terminal activity on Schedule 15A and Schedule 15B.
Motor Vehicle Fuel
ENDING ENVENTORY (Net Gallons) PRODUCT DESCRIPTION PRODUCT CODE

Schedule 15C - Ending Inventory by Product Code

Aviation Gasoline Gasoline: Reformulated Gasoline with MTBE Gasohol: Gasohol 5.7% Gasohol 7.7% Gasohol 10% E-75 Gasoline Blendstocks: Butane, including butane propane mixes Ethyl Tertiary Butyl Ether (ETBE) Natural Gasoline (including condensate) Methyl Tertiary Butyl Ether (MTBE) Naphthas, including light and straight run naphtha Mixed Xylene, not including any separated isomer of xylene Pentanes, including isopentane and pentane mixtures Raffinate Tertiary Amyl Methyl Ether (TAME) Toluene Other Gasoline Blendstocks, including Alkylate, Butene, Catalytically Cracked Gasoline, Coker Gasoline, Hexane, Hydrocrackate, Isomerate, Polymer Gasoline, Reformate, Straight-Run Gasoline, Thermally Cracked Gasoline, Tertiary Butyl Alcohol (TBA - Gasoline Grade), and any other product determined to be a gasoline blendstock by IRS or BOE
Diesel Fuel
PRODUCT DESCRIPTION

125 065 071 124 140 141 139 078 055 249 061 093 126 076 059 223 121 199 122

PRODUCT CODE

ENDING ENVENTORY (Net Gallons)

Diesel Fuel - Undyed: Clear Diesel Diesel Fuel #1 Low Sulfur Undyed Diesel Fuel #2 Low Sulfur Undyed Diesel Fuel #2 Low Sulfur Undyed, with 20% Water Emulsion Fuel Oil #1 Undyed Diesel Fuel #4 Undyed Diesel Fuel #1 High Sulfur Undyed Diesel Fuel #2 High Sulfur Undyed Biodiesel - Undyed: Biodiesel - Undyed (B100) Soy Oil

160 161 167 168 150 154 282 283 170 284 285

BOE-506-PO (S2B) REV. 2 (4-06)

COMPANY NAME

BOE ACCOUNT NO.

MONTH/YEAR

PRODUCT DESCRIPTION

PRODUCT CODE

ENDING INVENTORY (Net Gallons)

Diesel Fuel - Dyed: Diesel Fuel High Sulfur Dyed Diesel Fuel Low Sulfur Dyed Diesel Fuel Low Sulfer Dyed, with 20% Water Emulsion Diesel Fuel #1 Dyed Diesel Fuel #4 Dyed Biodiesel - Dyed: Biodiesel - Dyed (B100)
Other Products
PRODUCT DESCRIPTION

226 227 228 231 153 171 290
PRODUCT CODE ENDING INVENTORY (Net Gallons)

Additives - Miscellaneous Alcohol: Ethanol Methanol Kerosene - Undyed: Kerosene Low Sulfur Undyed Kerosene High Sulfur Undyed Kerosene - Dyed: Kerosene Low Sulfur Dyed Kerosene High Sulfur Dyed Other Products: Asphalt Benzene Butylene Compressed Natural Gas (CNG) Crude (any) E-85 Ethane Ethylene Excluded Liquid (mineral spirits) Isobutane Jet Fuel Liquefied Natural Gas (LNG) Marine Diesel Oil Marine Gas Oil Methane Mineral Oils Organic Oils Propane (LPG) Propylene Undefined (Other) Products Waste Oil Transmix
CONTINUE

090 123 241 243
145 147 073 074 188 248 198 224 001 079 052 196 077 058 130 225 279 280 265 281 960 054 075 092 091 100

BOE-506-PO (S3F) REV. 2 (4-06)

General Information

INSTRUCTIONS TERMINAL OPERATOR INFORMATION REPORT

BOARD OF EQUALIZATION

STATE OF CALIFORNIA

The Terminal Operator Information Report allows terminal operators to report receipts and disbursements of liquid products to and from each approved terminal. If you are interested in filing your Terminal Operator Information Report electronically with the State Board of Equalization (Board), please contact the Fuel Taxes Division at 916-322-9669. To obtain the latest information on any product codes or if you need help completing this form, please call us at 916-322-9669 or visit the Boards website at: http://www.boe.ca.gov/sptaxprog/spftdmfuels.htm.

You must file a report with the Board and report every gallon of liquid products you received at a California terminal or disbursed at a California terminal rack for the reporting period. You must file a separate report for each approved terminal that has a unique IRS terminal control number (TCN). 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.

Filing Requirements

Preparation of the Schedules

Schedule 15C - Ending Inventory by Product Code Schedule 15A - Terminal Operator Receipts

There are three types of supporting schedules included with every Terminal Operator Information Report; an ending inventory schedule (Schedule 15C - Ending Inventory by Product Code); a receipt schedule (Schedule 15A - Terminal Operator Receipts); and a disbursement schedule (Schedule 15B - Terminal Operator Disbursements by Position Holder). Report only one product code on each schedule page for the period using the product code table (from Schedule 15C Ending Inventory by Product Code). Photocopy additional schedule pages as required to report only one product code per page. For Schedules 15A and 15B, complete the information in box (d) in the header of the schedule. Boxes (a) Company Name, (b) Account Number, (c) TCN, and (e) Month/Year are already filled in when you receive monthly paper forms from the Board. Enter the physical inventory for each product code in net gallons at the end of the reporting period.

Use this schedule to report each receipt of product (bulk and non-bulk) by the terminal operator. Column 1 Enter the name of the carrier that transported the product into the terminal. Column 2 Enter the carriers FEIN (Federal Employer Identification Number). Column 3 Enter the mode from the mode codes list. Column 4 Enter the date of the document identified in column 5 (enter as mm/dd/yy). Column 5 Enter the identifying number from the document provided by the carrier that reflects the details of the transaction. This could be a bill of lading, shipping document, or manifest. Both the carrier and terminal operator must report the same document number to the Board. Column 6 Enter the net gallons received into the terminal. For non-bulk deliveries to a terminal where net gallons are not measured, enter gross gallons.

Schedule 15B - Terminal Operator Disbursements by Position Holder Note: Two-Party Exchange Transactions

Use this schedule to report each disbursement of product (bulk and non-bulk) from your terminal by position holder. Terminal operators may not participate in two-party exchanges if they are filing paper returns. To participate in a two-party exchange, all three parties (the delivering supplier, receiving supplier, and terminal operator) must meet certain requirements, including filing electronic tax forms with us.

Position Holder (PH) Name, Position Holder FEIN

Enter the name and FEIN of the position holder whose product was disbursed at the terminal. Column 1 Enter the name of the carrier that transported the product out of the terminal. Column 2 Enter the carriers FEIN. Column 3 Enter the mode from the mode codes list. Column 4 Enter the destination state -- must be a valid, two-character U.S. Postal Service abbreviation (obtain from the Postal Abbreviations list available on our website). This information is required for non-bulk (truck or rail car) deliveries only. If a fuel transport truck is receiving fuel destined for different states, the terminal operator will issue a bill of lading, manifest, or other shipping document on behalf of the position holder for each state of destination. You are required to report each separate shipping document as a separate transaction. If the destination is a terminal, enter the TCN.

BOE-506-PO (S3B) REV. 2 (4-06)

Column 5 Enter the date of the document identified in column 6 (enter as mm/dd/yy). Column 6 Enter the identifying number from the document provided by the terminal operator to the carrier that reflects the

details of the transaction. This should be a bill of lading. (If no bill of lading, use the shipping document or manifest number.) Both the carrier and terminal operator must report the same document number to the Board. Column 7 Enter the net gallons disbursed from the terminal. Column 8 Enter the gross gallons disbursed from the terminal. Barge Book Adjustments Truck Pipeline Rail Removal from a terminal Ship (ocean marine vessel)

B *BA J PL R **RT S

Mode Codes

*BA - Book adjustments are product reclassifications or conversions of products at the terminal that result in a product code change. Examples include conversion of diesel fuel #2 undyed to diesel fuel low sulfur dyed and reclassification of jet fuel to kerosene high sulfur dyed or diesel fuel #1 undyed. Book adjustments must be reported in summary. For book adjustments, summary reporting means the combining of all book adjustment transactions by product code for the reporting period. On Schedule 15A, report the book adjustments for a product code along with the other transactions for the product code. On Schedule 15B, do not report book adjustments on any position holders schedule. Instead, use a separate Schedule 15B showing "book adjustment" as the position holder for each applicable product code. **RT - Removal from Terminal (other than by truck or rail) for sale or consumption. A Terminal Operator should use this code: when a sale or transfer is made within the bulk transfer/terminal system to an unlicensed customer; when the sale is to a licensed Industrial User and the removal is made from a vessel or pipeline; when the removal is made from a vessel and the fuel will be consumed in the operation of the vessel; when the disbursement is from a hydrant system at an airport; or when the disbursement is from qualifying truck removals at a secured airport.

BOE-506-PO (S4) REV. 2 (4-06) (If additional space is needed, please photocopy the schedule before making entries.) (a) COMPANY NAME

SCHEDULE 15A - TERMINAL OPERATOR RECEIPTS

BOARD OF EQUALIZATION Page
(b) BOE ACCOUNT NUMBER (c) TCN (d) PRODUCT CODE

STATE OF CALIFORNIA

of

(e) MONTH/YEAR

(1) CARRIER NAME

(2) CARRIER FEIN

(3) MODE

(4) DOCUMENT DATE

(5) DOCUMENT NUMBER

(6) NET GALLONS

TOTAL (add amounts in column 6 and enter the total)

BOE-506-PO (S5) REV. 2 (4-06)

BOARD OF EQUALIZATION Page
(c) TCN PH FEIN (d) PRODUCT CODE

STATE OF CALIFORNIA

(If additional space is needed, please photocopy the schedule before making entries.) (a) COMPANY NAME POSITION HOLDER (PH) NAME (enter one name per page)

SCHEDULE 15B - TERMINAL OPERATOR DISBURSEMENTS BY POSITION HOLDER
(b) BOE ACCOUNT NUMBER

of

(e) MONTH/YEAR

(1) CARRIER NAME

(2) CARRIER FEIN

(3) MODE

(4) DESTINATION STATE

(5) DOCUMENT DATE

(6) DOCUMENT NUMBER

(7) NET GALLONS

(8) GROSS GALLONS

TOTAL (add amounts in columns 7 and 8 and enter the totals)

CLEAR

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