Form CDTFA-770-DV "Diesel Fuel Ultimate Vendor Report/Claim for Refund" - California

What Is Form CDTFA-770-DV?

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 September 1, 2017;
  • 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;

Download a fillable version of Form CDTFA-770-DV 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-770-DV "Diesel Fuel Ultimate Vendor Report/Claim for Refund" - California

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CDTFA-770-DV (S1F) REV. 10 (9-17)
STATE OF CALIFORNIA
CALIFORNIA DEPARTMENT OF TAX AND FEE ADMINISTRATION
DIESEL FUEL ULTIMATE VENDOR REPORT/CLAIM FOR REFUND
CDTFA USE ONLY
RA-B/A
AUD
REG
CLAIM PERIOD
RR-QS
FILE
REF
YOUR ACCOUNT NO.
[
]
FOID
EFF
CALIFORNIA DEPARTMENT OF
TAX AND FEE ADMINISTRATION
APPEALS AND DATA ANALYSIS BRANCH
PO BOX 942879
SACRAMENTO, CA 94279-2050
READ INSTRUCTIONS
BEFORE PREPARING
As an ultimate vendor of diesel fuel in California, you are required to file this report listing your diesel fuel transactions for the
period stated above. This form is also used for filing a claim for refund of tax paid on undyed diesel fuel. Where required to
support your report/claim, you must submit completed Schedules 1A, 2A, 12A through 12C, and 13A through 13J with your
claim. All transactions supporting the amount claimed must be reported on CDTFA-810-FTG, Receipt Schedule, or
CDTFA-810-FTF, Disbursement Schedule.
Note: Do not include on this form sales listed on previously filed claims for refund (CDTFA-770-DV or CDTFA-770-DVW). If you
qualify to claim ultimate vendor sales on a weekly basis (CDTFA-770-DVW), any exempt sales for the last week of the period or
claimed at a prior tax rate must be claimed on this form.
REPORT WHOLE
GALLONS ONLY
(A)
(B)
Diesel Fuel at
Diesel Fuel at
Current Rate
Prior Rate
1. Gallons of tax-paid diesel fuel claimed for refund of tax (enter from Refund
Computation Worksheet section A, line 7, columns A and B)
2. Rates of tax per gallon
$
$
3. Subtotal of refund amount (multiply line 1 by line 2 for columns A and B)
$
$
4. Amount of refund claimed (add columns A and B of line 3)
$
CERTIFICATION
I hereby consent to disclose and authorize the California Department of Tax and Fee Administration (CDTFA) 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 return 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 return.
I, the undersigned, certify that, to the best of my knowledge, all information on this report/claim and any accompanying
documents is true, correct, and complete. I further certify that the diesel fuel covered by this claim did not show any visible
evidence of dye and, further, that the diesel fuel tax was not included in the sales price of the diesel fuel covered by this claim and
was not collected from the purchasers. In addition, I certify that I have in my possession valid exemption certificates from train
operators for transactions covered by this claim and that, to the best of my knowledge, all the information on the certificates is
true and correct.
SIGNATURE
DATE
TELEPHONE
(
)
PRINT NAME AND TITLE
EMAIL ADDRESS
CONTINUED
CDTFA-770-DV (S1F) REV. 10 (9-17)
STATE OF CALIFORNIA
CALIFORNIA DEPARTMENT OF TAX AND FEE ADMINISTRATION
DIESEL FUEL ULTIMATE VENDOR REPORT/CLAIM FOR REFUND
CDTFA USE ONLY
RA-B/A
AUD
REG
CLAIM PERIOD
RR-QS
FILE
REF
YOUR ACCOUNT NO.
[
]
FOID
EFF
CALIFORNIA DEPARTMENT OF
TAX AND FEE ADMINISTRATION
APPEALS AND DATA ANALYSIS BRANCH
PO BOX 942879
SACRAMENTO, CA 94279-2050
READ INSTRUCTIONS
BEFORE PREPARING
As an ultimate vendor of diesel fuel in California, you are required to file this report listing your diesel fuel transactions for the
period stated above. This form is also used for filing a claim for refund of tax paid on undyed diesel fuel. Where required to
support your report/claim, you must submit completed Schedules 1A, 2A, 12A through 12C, and 13A through 13J with your
claim. All transactions supporting the amount claimed must be reported on CDTFA-810-FTG, Receipt Schedule, or
CDTFA-810-FTF, Disbursement Schedule.
Note: Do not include on this form sales listed on previously filed claims for refund (CDTFA-770-DV or CDTFA-770-DVW). If you
qualify to claim ultimate vendor sales on a weekly basis (CDTFA-770-DVW), any exempt sales for the last week of the period or
claimed at a prior tax rate must be claimed on this form.
REPORT WHOLE
GALLONS ONLY
(A)
(B)
Diesel Fuel at
Diesel Fuel at
Current Rate
Prior Rate
1. Gallons of tax-paid diesel fuel claimed for refund of tax (enter from Refund
Computation Worksheet section A, line 7, columns A and B)
2. Rates of tax per gallon
$
$
3. Subtotal of refund amount (multiply line 1 by line 2 for columns A and B)
$
$
4. Amount of refund claimed (add columns A and B of line 3)
$
CERTIFICATION
I hereby consent to disclose and authorize the California Department of Tax and Fee Administration (CDTFA) 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 return 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 return.
I, the undersigned, certify that, to the best of my knowledge, all information on this report/claim and any accompanying
documents is true, correct, and complete. I further certify that the diesel fuel covered by this claim did not show any visible
evidence of dye and, further, that the diesel fuel tax was not included in the sales price of the diesel fuel covered by this claim and
was not collected from the purchasers. In addition, I certify that I have in my possession valid exemption certificates from train
operators for transactions covered by this claim and that, to the best of my knowledge, all the information on the certificates is
true and correct.
SIGNATURE
DATE
TELEPHONE
(
)
PRINT NAME AND TITLE
EMAIL ADDRESS
CONTINUED
STATE OF CALIFORNIA
CDTFA-770-DV (S1B) REV. 10 (9-17)
CALIFORNIA DEPARTMENT OF TAX AND FEE ADMINISTRATION
This Page Intentionally Left Blank
CDTFA-770-DV (S2B) REV. 10 (9-17)
STATE OF CALIFORNIA
CALIFORNIA DEPARTMENT OF TAX AND FEE ADMINISTRATION
INSTRUCTIONS
DIESEL FUEL ULTIMATE VENDOR REPORT/CLAIM FOR REFUND
GENERAL INFORMATION
Ultimate vendors are persons who sell undyed diesel fuel without tax to an ultimate purchaser for use on a farm for farming
purposes or for use in an exempt bus operation. As an ultimate vendor of diesel fuel in California, you may be reimbursed for tax
you paid on undyed diesel fuel you subsequently sold without tax to ultimate purchasers, farmers who use fuel on a farm for
farming purposes, and exempt bus operators who use the fuel in exempt bus operations. You may also use this form to request
a refund of the tax paid on undyed diesel fuel you exported outside California, sold to the U.S. Government and its agencies or
instrumentalities, sold to train operators, and on tax-paid undyed diesel fuel you used for purposes other than operating
vehicles on highways in this state.
Note: Effective July 1, 2011, the diesel fuel tax rate may be adjusted annually. Due to this annual adjustment, you may have
transactions at several different rates. The effective date of any future rate change will be July 1.
If you are interested in filing your Diesel Fuel Ultimate Vendor Report/Claim for Refund electronically with the CDTFA, please visit
our website at
www.cdtfa.ca.gov
for more information.
To obtain the latest information on product codes or if you need help completing this form, please call us at 1-800-400-7115
(TTY:711) or visit our website at www.cdtfa.ca.gov.
Filing Requirements
You must file a periodic report with the CDTFA listing your total diesel fuel purchases. On the same form you may file a claim for
refund of tax you paid on diesel fuel sold or used for the exempt purposes explained above, provided you have not previously
claimed a refund for these same exempt sales on CDTFA-770-DV or CDTFA-770-DVW. You must file the report even if you
have no exempt transactions or refunds to claim for the reporting period. The report is due on or before the last day of the
month following the reporting period. Failure to file this periodic report will result in a delay in processing refunds.
Note: If you are filing a claim for refund, you must complete all appropriate schedules and submit them with this report/claim.
Failure to properly complete the schedules will result in your refund claim not being accepted and the form and all accompanying
documents will be returned to you.
Preparation of Schedules
There are two types of supporting schedules included with every Diesel Fuel Ultimate Vendor Report/Claim for Refund: a
standard Receipt Schedule and a standard Disbursement Schedule. You must select the appropriate schedule code from the
Diesel Fuel Schedule Codes list which is included with these instructions, and enter the schedule code for your activities on the
Receipt or Disbursement Schedules, as indicated. In addition to a schedule code to describe the activity covered, you must
select a product code for the type of product reported and enter the product code on the schedule. For each schedule code
there can be only one product code reported per page for the period. You will need to make a copy of the blank schedules
included with this report/claim for each schedule and product code combination you will be using. For each schedule, complete
the information in boxes (c) and (d) in the header of the schedule. Enter in (c) the schedule code from the Diesel Fuel Schedule
Codes list and, in (d), the product code from the Diesel Fuel Product Codes description table. Enter in (a) the Company Name, in
(b) the Account Number, and in (e) the month and year for which the schedule applies will be completed for you. If they are not
completed, please enter the appropriate information from the face of the report/claim form.
For detailed information regarding the use and preparation of these schedules, see CDTFA-810-FTE, Instructions for
Preparing Motor Fuels Schedules, available on our website at www.cdtfa.ca.gov.
Special Note: The following applies to Schedules 13A through 13J. Complete all columns if the fuel is delivered. If fuel is sold
through a cardlock or any retail locations, then you will only need to complete columns 3, and 5 through 11. Refer to
CDTFA-810-FTE, Instructions for Preparing Motor Fuels Schedules, for complete cardlock reporting instructions. When
preparing Schedule 13D, Fuel Sold for Use on Farms for Farming Purposes, please be sure to provide the CDTFA diesel fuel
account number for the sale for which you are claiming a refund, for example, DF STF-xxxxxx instead of the BUYER'S FEIN in
column 6 if you have that number.
CDTFA-770-DV (S2F) REV. 10 (9-17)
STATE OF CALIFORNIA
CALIFORNIA DEPARTMENT OF TAX AND FEE ADMINISTRATION
REFUND COMPUTATION WORKSHEET
Use this worksheet to help you complete your claim and calculate the refund due.
Do not send this worksheet with your claim.
(A)
(B)
DIESEL FUEL
FROM
DIESEL FUEL
SECTION A. TAX-PAID CREDITS
AT
AT
SCHEDULE
(Total Gallons)
CURRENT
PRIOR RATE
RATE
1. Tax-paid fuel exported (enter totals from column 11 on Schedule 13A)
13A
2. Tax-paid fuel sold to the United States Government (enter totals from
13C
column 11 on Schedule 13C)
3. Tax-paid fuel sold for use on farms for farming purposes (enter totals
13D
from column 11 on Schedule 13D)
4. Tax-paid fuel sold to exempt bus operators (enter totals from column 11
13E
on Schedule 13E)
5. Tax-paid fuel sold to train operators (enter totals from column 11 on
13G
Schedule 13G)
6. Tax-paid fuel used in an exempt manner not reportable on another credit
13J
schedule (enter totals from column 11 on Schedule 13J)
7. TOTAL TAX-PAID GALLONS CLAIMED FOR REFUND (add lines 1
through 6 for each column) Enter this amount in columns A and B on
line 1 on the front of the claim.
Note: Any schedules required in support of this claim (Schedules 1A, 2A, 12A through 12C, and 13A through 13J) must be
submitted with the claim. You must complete Schedules 1A and 2A, as applicable to your purchases, in support of your claim. If
you are claiming a refund at the prior tax rate, you must have reported your below the rack activities on Schedules 12A, 12B,
and 12C for all previous reporting periods from the period prior to the tax rate change forward through the period on which you
are making the claim. For example, to claim a credit transaction claimed at the prior tax rate in the September 2011 period, you
would need to report on these schedules for the June 2011 period and all subsequent periods. You must also report these
schedule activities for this reporting period.
CDTFA-810-FTE, Instructions for Preparing Motor Fuels Schedules, is available on our website at www.cdtfa.ca.gov, and
provides detailed instructions on the reporting requirements for these schedules.
CLEAR
PRINT
STATE OF CALIFORNIA
CDTFA-770-DV (S3F) REV. 10 (9-17)
CALIFORNIA DEPARTMENT OF TAX AND FEE ADMINISTRATION
Preparation of the Refund Computation Worksheet
The Refund Computation Worksheet is provided to assist you in calculating the refund claim and completing your report. (This
worksheet should be kept with your records. Do not send the worksheet with your claim.) Add the totals from column 11 on
each of the schedules to determine the total gallons to be included in each column of the worksheet. Refer to CDTFA-810-FTE,
Instructions for Preparing Motor Fuels Schedules, for detailed instructions on the use of and reporting requirements for each
schedule.
Section A. Tax-Paid Credits
Line 1.
Enter the total gallons of tax-paid diesel exported below the California terminal racks by adding the totals from column
11 for each disbursement schedule coded 13A.
Line 2.
Enter the total gallons of tax-paid diesel fuel sold to the United States Government by adding the totals from column
11 for each disbursement schedule coded 13C.
Line 3.
Enter the total gallons of tax-paid diesel fuel sold to a person who uses the fuel on a farm for farming purposes by
adding the totals from column 11 for each disbursement schedule coded 13D.
Line 4.
Enter the total gallons of tax-paid diesel fuel sold to exempt bus operators for use in exempt bus operations by adding
the totals from column 11 for each disbursement schedule coded 13E.
Line 5
Enter the total gallons of tax-paid diesel fuel sold to train operators by adding the totals from column 11 for each
disbursement schedule coded 13G.
Line 6.
Enter the total gallons of tax-paid diesel fuel used in an exempt manner not reportable on any other credit schedule by
adding the totals from column 11 for each disbursement schedule coded 13J.
Line 7.
Enter the total gallons of tax-paid diesel fuel transactions for which you are claiming a refund of tax during the reporting
period by adding lines 1 through 6 for columns A and B.
Preparation of the Report/Claim
Before completing the report/claim, prepare the applicable Receipt and Disbursement Schedules and the Refund Computation
Worksheet.
Line 1.
Enter the total gallons for which a refund of tax is due from section A, line 7, columns A and B of the Refund
Computation Worksheet.
Line 2.
These are the current and prior year tax rates for diesel fuel.
Line 3.
For columns A and B, multiply line 1 by line 2 for each column and enter the result in the appropriate column on line 3.
Line 4.
Enter the total refund claimed by adding columns A and B of line 3.
Note: Do not include any sales you have already reported on a weekly claim or any other claim for refund. Duplicate reports of
sales may result in a delay in the processing of your claim for refund. If you qualify to claim ultimate vendor sales on a weekly basis
(CDTFA-770-DVW), any exempt sales for the last week of the period or claimed at a prior tax rate must be claimed on this form.
If you are claiming a refund at the prior tax rate, you must have reported your below the rack activities on Schedules 12A, 12B, and
12C for all previous reporting periods from the period prior to the tax rate change forward through the period on which you are
making the claim. For example, to claim a credit transaction claimed at the prior tax rate in the September 2011 period, you would
need to report on these schedules for the June 2011 period and all subsequent periods. You must also report these schedule
activities for this reporting period.
CDTFA-810-FTE, Instructions for Preparing Motor Fuels Schedules, is available on our website at www.cdtfa.ca.gov, and
provides detailed instructions on the reporting requirements for these schedules.