DTSC Form CDTFA-507-TEA "Emergency Telephone Users Surcharge" - California

What Is DTSC Form CDTFA-507-TEA?

This is a legal form that was released by the California Department of Toxic Substances Control - 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 September 1, 2017;
  • The latest edition provided by the California Department of Toxic Substances Control;
  • 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 DTSC Form CDTFA-507-TEA by clicking the link below or browse more documents and templates provided by the California Department of Toxic Substances Control.

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Download DTSC Form CDTFA-507-TEA "Emergency Telephone Users Surcharge" - California

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STATE OF CALIFORNIA
CALIFORNIA DEPARTMENT OF TAX AND FEE ADMINISTRATION
CDTFA-507-TEA REV. 1 (9-17)
EMERGENCY TELEPHONE USERS SURCHARGE
Page _____ of _____
GENERAL INFORMATION: This schedule is required to be filled out by service suppliers/direct sellers and submitted to the CDTFA as mandated by Revenue and Taxation Code (R&TC)
41024 of the Emergency Telephone Users Surcharge Law. Use this schedule to report any service users/retail consumers who refused to pay a cumulative total of $3.00 or more in surcharges.
You must include the name and address of every service user/retail consumer who refused to pay, the amount they owe and their reason for refusing to pay the surcharge if known (R&TC
41024). Enclose the completed schedule with your CDTFA-501-TE, Emergency Telephone Users Surcharge Return, submit via email or mail to the address indicated on this form.
ACCOUNT NAME:
ACCOUNT NUMBER:
REPORTING PERIOD:
NAME
MAILING ADDRESS
CITY
STATE
ZIP
AMOUNT REFUSED
REASON FOR REFUSAL TO PAY
TO BE PAID
(IF KNOWN)
1
$
2
$
3
$
4
$
5
$
6
$
7
$
8
$
9
$
10
$
11
$
12
$
13
$
14
$
15
$
16
$
17
$
18
$
19
$
20
$
$
TOTAL
0.00
Mail the completed schedule to: CALIFORNIA DEPARTMENT OF TAX AND FEE ADMINISTRATION, RETURN PROCESSING BRANCH
MIC:88, PO BOX 942879, SACRAMENTO CA 94279-0088
or email to BTFDPCDETUSSched@cdtfa.ca.gov.
CLEAR
PRINT
Make a copy of this document for your records.
STATE OF CALIFORNIA
CALIFORNIA DEPARTMENT OF TAX AND FEE ADMINISTRATION
CDTFA-507-TEA REV. 1 (9-17)
EMERGENCY TELEPHONE USERS SURCHARGE
Page _____ of _____
GENERAL INFORMATION: This schedule is required to be filled out by service suppliers/direct sellers and submitted to the CDTFA as mandated by Revenue and Taxation Code (R&TC)
41024 of the Emergency Telephone Users Surcharge Law. Use this schedule to report any service users/retail consumers who refused to pay a cumulative total of $3.00 or more in surcharges.
You must include the name and address of every service user/retail consumer who refused to pay, the amount they owe and their reason for refusing to pay the surcharge if known (R&TC
41024). Enclose the completed schedule with your CDTFA-501-TE, Emergency Telephone Users Surcharge Return, submit via email or mail to the address indicated on this form.
ACCOUNT NAME:
ACCOUNT NUMBER:
REPORTING PERIOD:
NAME
MAILING ADDRESS
CITY
STATE
ZIP
AMOUNT REFUSED
REASON FOR REFUSAL TO PAY
TO BE PAID
(IF KNOWN)
1
$
2
$
3
$
4
$
5
$
6
$
7
$
8
$
9
$
10
$
11
$
12
$
13
$
14
$
15
$
16
$
17
$
18
$
19
$
20
$
$
TOTAL
0.00
Mail the completed schedule to: CALIFORNIA DEPARTMENT OF TAX AND FEE ADMINISTRATION, RETURN PROCESSING BRANCH
MIC:88, PO BOX 942879, SACRAMENTO CA 94279-0088
or email to BTFDPCDETUSSched@cdtfa.ca.gov.
CLEAR
PRINT
Make a copy of this document for your records.