Form CDTFA-501-LA "Occupational Lead Poisoning Prevention Fee Return for Category "a" or "b" Reporting" - California

What Is Form CDTFA-501-LA?

This is a legal form that was released by the California Department of Tax and Fee Administration - a government authority operating within California. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on November 1, 2020;
  • The latest edition provided by the California Department of Tax and Fee Administration;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form CDTFA-501-LA by clicking the link below or browse more documents and templates provided by the California Department of Tax and Fee Administration.

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Download Form CDTFA-501-LA "Occupational Lead Poisoning Prevention Fee Return for Category "a" or "b" Reporting" - California

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STATE OF CALIFORNIA
CALIFORNIA DEPARTMENT OF
TAX AND FEE ADMINISTRATION
YOUR ACCOUNT NUMBER
CALIFORNIA DEPARTMENT OF
TAX AND FEE ADMINISTRATION
EFFECTIVE DATE
PO BOX 942879
SACRAMENTO, CA 94279-6029
FILING PERIOD
DUE ON OR BEFORE
OCCUPATIONAL LEAD POISONING PREVENTION FEE RETURN
AMENDED RETURN
FOR CATEGORY “A” OR “B” REPORTING
READ INSTRUCTIONS
BEFORE PREPARING
SECTION I
Enter the total number of your employees at all California locations that worked more than 160
1.
hours from January through December of the reporting calendar year. (See Definitions in the
Instructions on the back of this return.)
If less than 10 employees, sign and date this return and mail it to the address above. If over 10 employees, please complete
Section III. Maintain a copy for your records. The filing of this return is required and does not constitute a fee waiver.
SECTION II
Complete this section to request a fee waiver. Check box 2 and box 2A or 2B to choose your filing method. A fee
waiver application and instructions will be sent to you by the California Department of Public Health (CDPH) after this
return is received and processed by the California Department of Tax and Fee Administration (CDTFA). The CDTFA
does not mail or approve fee waiver applications.
I will request a fee waiver because lead or lead-containing materials were not present or were present in de
2.
minimus amounts at any of my California business locations during the calendar year. I understand that
if I do not complete a waiver application within 180 days following the due date of this return, or if a
waiver is not granted, the fee plus applicable interest is due.
Select type of application: A.
Mail instructions for applying online
or
B.
Mail a paper application
SECTION III
Complete this section by entering the appropriate fee for your number of employee category. Fee Rates are located at
www.cdtfa.ca.gov/taxes-and-fees/tax-rates-stfd.htm. If you do not know your fee category, please contact our Customer
Service Center at 1-800-400-7115 (CRS:711).
NUMBER OF EMPLOYEES DURING CALENDAR YEAR COVERED BY THIS RETURN
AMOUNT DUE
1.
10 to 99 employees
1.
2.
100 to 499 employees
2.
3.
500 or more employees
3.
4.
Total fee due
4.
PENALTY: (multiply line 4 by 10 percent [0.10] if you file your return or your
5.
PENALTY
5. $
payment is made after the due date)
INTEREST: One month’s interest is due on the total fee for each month or
6.
fraction of a month that payment is made after the due date. The adjusted
INTEREST
6. $
monthly interest rate is
. See our website for the
Interest
Calculator.
7.
TOTAL AMOUNT DUE AND PAYABLE (add lines 4, 5, and 6)
7. $
I hereby certify that this return, including any accompanying schedules and statements,
has been examined by me and to the best of my knowledge and belief is a true, correct, and complete return.
EMAIL ADDRESS
TELEPHONE NUMBER
DATE
SIGNATURE
PRINT NAME AND TITLE
Make a copy of this document for your records.
OL
CLEAR
PRINT
CDTFA-501-LA (S1F) REV. 23 (11-20)
STATE OF CALIFORNIA
CALIFORNIA DEPARTMENT OF
TAX AND FEE ADMINISTRATION
YOUR ACCOUNT NUMBER
CALIFORNIA DEPARTMENT OF
TAX AND FEE ADMINISTRATION
EFFECTIVE DATE
PO BOX 942879
SACRAMENTO, CA 94279-6029
FILING PERIOD
DUE ON OR BEFORE
OCCUPATIONAL LEAD POISONING PREVENTION FEE RETURN
AMENDED RETURN
FOR CATEGORY “A” OR “B” REPORTING
READ INSTRUCTIONS
BEFORE PREPARING
SECTION I
Enter the total number of your employees at all California locations that worked more than 160
1.
hours from January through December of the reporting calendar year. (See Definitions in the
Instructions on the back of this return.)
If less than 10 employees, sign and date this return and mail it to the address above. If over 10 employees, please complete
Section III. Maintain a copy for your records. The filing of this return is required and does not constitute a fee waiver.
SECTION II
Complete this section to request a fee waiver. Check box 2 and box 2A or 2B to choose your filing method. A fee
waiver application and instructions will be sent to you by the California Department of Public Health (CDPH) after this
return is received and processed by the California Department of Tax and Fee Administration (CDTFA). The CDTFA
does not mail or approve fee waiver applications.
I will request a fee waiver because lead or lead-containing materials were not present or were present in de
2.
minimus amounts at any of my California business locations during the calendar year. I understand that
if I do not complete a waiver application within 180 days following the due date of this return, or if a
waiver is not granted, the fee plus applicable interest is due.
Select type of application: A.
Mail instructions for applying online
or
B.
Mail a paper application
SECTION III
Complete this section by entering the appropriate fee for your number of employee category. Fee Rates are located at
www.cdtfa.ca.gov/taxes-and-fees/tax-rates-stfd.htm. If you do not know your fee category, please contact our Customer
Service Center at 1-800-400-7115 (CRS:711).
NUMBER OF EMPLOYEES DURING CALENDAR YEAR COVERED BY THIS RETURN
AMOUNT DUE
1.
10 to 99 employees
1.
2.
100 to 499 employees
2.
3.
500 or more employees
3.
4.
Total fee due
4.
PENALTY: (multiply line 4 by 10 percent [0.10] if you file your return or your
5.
PENALTY
5. $
payment is made after the due date)
INTEREST: One month’s interest is due on the total fee for each month or
6.
fraction of a month that payment is made after the due date. The adjusted
INTEREST
6. $
monthly interest rate is
. See our website for the
Interest
Calculator.
7.
TOTAL AMOUNT DUE AND PAYABLE (add lines 4, 5, and 6)
7. $
I hereby certify that this return, including any accompanying schedules and statements,
has been examined by me and to the best of my knowledge and belief is a true, correct, and complete return.
EMAIL ADDRESS
TELEPHONE NUMBER
DATE
SIGNATURE
PRINT NAME AND TITLE
Make a copy of this document for your records.
OL
CLEAR
PRINT
CDTFA-501-LA (S1F) REV. 23 (11-20)
CDTFA-501-LA (S1B) REV. 23 (11-20)
OCCUPATIONAL LEAD POISONING PREVENTION FEE RETURN INSTRUCTIONS
Payments: To make your payment online, go to our website at
www.cdtfa.ca.gov
and select Make a Payment. You
can also pay by credit card on our website or by calling 1-855-292-8931. If paying by check or money order, be sure
to include your account number. Make your check or money order payable to the California Department of Tax and
Fee Administration.
GENERAL INFORMATION
Section 105190 of the California Health and Safety Code requires all employers with 10 or more employees in an
industry for which there is evidence of a potential for occupational lead poisoning to pay the Occupational Lead
Poisoning Prevention Fee. Those employers who do not have lead or lead-containing materials present in any amount or
who only have a de minimus amount in their business operations may request a temporary fee waiver which, if granted,
will relieve them of paying a fee for the calendar year. Waivers must be renewed each year. An employer with 10 or
more employees that is not granted a waiver is subject to the fee. These fees are used to fund the Occupational Lead
Poisoning Prevention Program in the California Department of Public Health (CDPH).
Only employers who do not have lead or lead-containing materials present or who only have a de minimus amount
present at any California site can request a fee waiver. If you are requesting a waiver, you must complete all Sections
and follow the instructions. A fee waiver application will be sent to you by CDPH.
Each year CDPH provides the California Department of Tax and Fee Administration (CDTFA) with a list of industries that
have the potential for occupational lead poisoning. The industries are designated by Standard Industrial Classification
(SIC) codes. CDPH also provides the CDTFA with a list of employers whose business operations fall within the listed
industries.
Under Revenue and Taxation Code (R&TC) section 43152.13, every employer subject to the fee is required to file an
annual return following the period for which the fee is due, along with a payment payable to the California Department of
Tax and Fee Administration. Under R&TC section 55042 in the Fee Collection Procedures Law, late payments result in a
10 percent (0.10) penalty and interest at an adjusted annual rate established under R&TC section 6591.5.
DEFINITIONS (according to section 38001 of title 17 of the California Code of Regulations [CCR])
Employee means any individual employed for at least 160 hours in the prior calendar year regardless of whether the
individual’s specific job involved potential exposure to lead or lead-containing materials.
Standard Industrial Classification (SIC) code means a system of four-digit numerical codes to designate the activities of
a business operation, set forth by the U.S. Office of Management and Budget in the Standard Industrial Classification
Manual, 1987.
Lead was not present at the place of employment means that no amount of lead or lead-containing material was present
at the place of employment, including job sites, or in the materials and processes used in the operation of the employer’s
business, with the following exceptions:
(1) Lead that was not altered or disturbed during the operation of the employer’s business and was present in a
form, or contained in such a manner, that it could not be inhaled or ingested (examples are undisturbed building
materials, unused materials and supplies, intact lead storage batteries); or
(2) Lead that was present as a result of general environmental contamination which was not the result of the
employer’s business.
De minimus amount means any of the following:
(1) Lead present in materials which are altered or disturbed and have a lead concentration less than (0.5) percent
(5000 ppm) by weight;
(2) Lead present in materials where the total weight of such materials altered or disturbed during the calendar year
is known to be 16 ounces (one pound) or less by weight; or
(3) Lead present in materials where no such material is altered or disturbed at any individual employee’s place of
employment on more than one day during the calendar year, that is, if no employee works on more than one day
during the calendar year in any location where lead-containing materials are being altered or disturbed, then the
amount is de minimus.
CDTFA-501-LA (S2) REV. 23 (11-20)
PREPARATION OF RETURN
Review the following information to determine which section on the front of the return you are required to complete.
SECTION I Enter the total number of your employees at all California locations that worked more than 160 hours from
January through December of the reporting calendar year.
SECTION II If you are requesting a fee waiver, check box 2 and 2A or 2B to choose your waiver filing method.
Persons completing this section may file the return without payment. However, if a waiver request and documentation
are not submitted as required, or a waver is not granted, the fee is due. The CDTFA will bill you for any fee due, plus
interest at the statutory rate.
If you have specific questions regarding fee waivers, contact the CDPH Occupational Lead Poisoning Prevention Program
by calling toll-free (in California only) 1-866-627-1587, or (out-of-state) 1-510-620-5740, or write to: California Department
of Public Health, OLPPP, Attention: Fee Waiver Request, 850 Marina Bay Parkway, Bldg. P, 3rd Floor, Richmond, CA
94804, or visit the CDPH website at www.cdph.ca.gov/Programs/CCDPHP/DEODC/OHB/OLPPP/Pages/OLPPP.aspx.
Sign, date, and mail the return to the California Department of Tax and Fee Administration. Fee returns and payments that
are mailed must be postmarked on or before the due date. If the due date falls on a Saturday, Sunday, or legal holiday,
returns postmarked on the next business day are considered timely. Retain a copy of the return for your records. Please
include the account number on all correspondences. Please include your email address at the bottom of the return.
For more information, visit our website at www.cdtfa.ca.gov. You may also call our Customer Service Center at
1-800-400-7115 (CRS:711); from the main menu, select the option Special Taxes and Fees. Customer service
representatives are available Monday through Friday from 8:00 a.m. to 5:00 p.m. (Pacific time), except state holidays.
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