Form CDTFA-770-DVW "Diesel Fuel Tax Claim for Refund - Sales to Ultimate Purchasers" - California

What Is Form CDTFA-770-DVW?

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-DVW by clicking the link below or browse more documents and templates provided by the California Department of Tax and Fee Administration.

ADVERTISEMENT
ADVERTISEMENT

Download Form CDTFA-770-DVW "Diesel Fuel Tax Claim for Refund - Sales to Ultimate Purchasers" - California

875 times
Rate (4.5 / 5) 61 votes
STATE OF CALIFORNIA
CDTFA-770-DVW (FRONT) REV. 7 (9-17)
CALIFORNIA DEPARTMENT OF TAX AND FEE ADMINISTRATION
DIESEL FUEL TAX CLAIM FOR REFUND - SALES TO ULTIMATE PURCHASERS
CDTFA USE ONLY
RA-B/A
AUD
REG
REG
CLAIM PERIOD
/
/
THROUGH
/
/
RR-QS
FILE
REF
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
READ INSTRUCTIONS
BEFORE PREPARING
BEFORE PREPARING
As an ultimate vendor of diesel fuel in California, you may use this form to file a claim for refund of tax you paid on undyed
diesel fuel sold without the tax reimbursement to ultimate purchasers for use on a farm for farming purposes or for use in an
exempt bus operation. Your claim must cover a period of not less than one week and total at least $200. The period covered by
your claim may include more than one week's sales if necessary to reach the $200 minimum. You must submit completed
Schedules 13D and 13E with your claim. All transactions supporting the amount claimed must be reported on CDTFA-810-FTF,
Disbursement Schedule.
Enter the beginning and ending dates of the period covered by this claim as mm/dd/yy in the box above.
REPORT WHOLE
GALLONS ONLY
(A)
Diesel Fuel at
Current Rate
1. Gallons of tax-paid diesel fuel claimed for refund of tax (enter from Refund
Computation Worksheet section A, line 3)
$
2. Rate of tax per gallon
$
3. Amount of refund claimed (multiply line 1 by line 2)
If refund amount is less than $200, do not submit claim.
You are required to file a monthly report, CDTFA-770-DV, Diesel Fuel Ultimate Vendor Report/Claim for Refund, with the
California Department of Tax and Fee Administration (CDTFA), listing your receipts and disbursements of undyed and dyed
diesel fuel. Even if you qualify to file weekly claim forms, any exempt sales to ultimate purchases for the last week of the period
must be claimed on the monthly report. If you prefer, you may claim a refund on that report instead of filing this weekly claim
form. You must file the monthly report whether or not you file separate weekly claims.
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 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 information on the certificates is true
and correct.
DATE
SIGNATURE
TELEPHONE
(
)
PRINT NAME AND TITLE
EMAIL ADDRESS
CLEAR
PRINT
STATE OF CALIFORNIA
CDTFA-770-DVW (FRONT) REV. 7 (9-17)
CALIFORNIA DEPARTMENT OF TAX AND FEE ADMINISTRATION
DIESEL FUEL TAX CLAIM FOR REFUND - SALES TO ULTIMATE PURCHASERS
CDTFA USE ONLY
RA-B/A
AUD
REG
REG
CLAIM PERIOD
/
/
THROUGH
/
/
RR-QS
FILE
REF
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
READ INSTRUCTIONS
BEFORE PREPARING
BEFORE PREPARING
As an ultimate vendor of diesel fuel in California, you may use this form to file a claim for refund of tax you paid on undyed
diesel fuel sold without the tax reimbursement to ultimate purchasers for use on a farm for farming purposes or for use in an
exempt bus operation. Your claim must cover a period of not less than one week and total at least $200. The period covered by
your claim may include more than one week's sales if necessary to reach the $200 minimum. You must submit completed
Schedules 13D and 13E with your claim. All transactions supporting the amount claimed must be reported on CDTFA-810-FTF,
Disbursement Schedule.
Enter the beginning and ending dates of the period covered by this claim as mm/dd/yy in the box above.
REPORT WHOLE
GALLONS ONLY
(A)
Diesel Fuel at
Current Rate
1. Gallons of tax-paid diesel fuel claimed for refund of tax (enter from Refund
Computation Worksheet section A, line 3)
$
2. Rate of tax per gallon
$
3. Amount of refund claimed (multiply line 1 by line 2)
If refund amount is less than $200, do not submit claim.
You are required to file a monthly report, CDTFA-770-DV, Diesel Fuel Ultimate Vendor Report/Claim for Refund, with the
California Department of Tax and Fee Administration (CDTFA), listing your receipts and disbursements of undyed and dyed
diesel fuel. Even if you qualify to file weekly claim forms, any exempt sales to ultimate purchases for the last week of the period
must be claimed on the monthly report. If you prefer, you may claim a refund on that report instead of filing this weekly claim
form. You must file the monthly report whether or not you file separate weekly claims.
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 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 information on the certificates is true
and correct.
DATE
SIGNATURE
TELEPHONE
(
)
PRINT NAME AND TITLE
EMAIL ADDRESS
CLEAR
PRINT
STATE OF CALIFORNIA
CDTFA-770-DVW (BACK) REV. 7 (9-17)
CALIFORNIA DEPARTMENT OF TAX AND FEE ADMINISTRATION
REFUND COMPUTATION WORKSHEET
Use this worksheet to help you complete your claim and calculate the refund due.
(A)
SECTION A. TAX-PAID CREDITS
FROM
DIESEL FUEL
(Total Gallons)
AT CURRENT RATE
SCHEDULE
1. Tax-paid fuel sold for use on farms for farming purposes (enter totals from
13D
column 11 on Schedule 13D)
2. Tax-paid fuel sold to exempt bus operators (enter totals from column 11
13E
on Schedule 13E)
3. TOTAL TAX-PAID CREDITS (add lines 1 and 2)
Enter this amount in column A on line 1 on the front of the claim.
Note: Even if you qualify to file weekly claim forms, any exempt sales to ultimate purchasers for the last week of the period
must be claimed on the periodic report (CDTFA-770-DV). Do not include on this form sales listed on previously filed claims for
refund (CDTFA-770-DV or CDTFA-770-DVW). Do not include claims for tax paid at prior tax rate. Claims for tax paid at a prior
tax rate must be made on your periodic report/claim for refund on (CDTFA-770-DV).
INSTRUCTIONS
DIESEL FUEL TAX CLAIM FOR REFUND - SALES TO ULTIMATE PURCHASERS
General Information
Refer to CDTFA-770-DV, Diesel Fuel Ultimate Vendor Report/Claim For Refund, that is mailed with this claim form for general
information, filing requirements, schedule preparation, and schedule, product, and mode code information applicable to this
form.
Preparation of the Refund Computation Worksheet
The Refund Computation Worksheet is provided to assist you in calculating the refund claim amount and completing your
claim. (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 for diesel fuel 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 fuel sold to a person who uses the fuel on farm for farming purposes by
adding the totals from column 11 for each disbursement schedule coded 13D.
Line 2. 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 3. Enter the total gallons of tax-paid diesel fuel transactions for which you are claiming a refund of tax during the claim
period by adding lines 1 and 2.
Preparation of the Claim
Before completing the 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 3 of the Refund Computation Worksheet.
Line 2. This is the current rate of tax for diesel fuel.
Line 3. Enter the total refund claimed by multiplying line 1 by line 2.
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 on CDTFA-770-DVW, any exempt sales for the last week of the report must be claimed on the periodic report on
CDTFA-770-DV.
For more information, visit the CDTFA website at www.cdtfa.ca.gov. You may also call the Customer Service Center
at 1-800-400-7115 (TTY:711). Customer service representatives are available weekdays from 8:00 a.m. to 5:00 p.m.
(Pacific time), except state holidays.
Page of 2