CDTFA-401-A (FRONT) REV. 116 (4-19) STATE OF CALIFORNIA CALIFORNIA DEPARTMENT OF STATE, LOCAL, AND DISTRICT SALES AND USE TAX RETURN TAX AND FEE ADMINISTRATION DUE ON OR BEFORE PERIOD BEGIN DATE PERIOD END DATE CALIFORNIA DEPARTMENT OF YOUR ACCOUNT NUMBER CDTFA USE ONLY EFF PM TAX AND FEE ADMINISTRATION READ INSTRUCTIONS PO BOX 942879 BEFORE PREPARING SACRAMENTO CA 94279-8062 Please check this box if this 037ling represents an AMENDED RETURN. ELECTRONIC FILING INFORMATION AND RETURN INSTRUCTIONS (CDTFA-401-INST) ARE AVAILABLE AT WWW.CDTFA.CA.GOV OR BY CALLING 1-800-400-7115 (TTY:711). 1 Total (gross) sales 1 $ .00 2 Purchases subject to use tax 2 .00 3 Total (add lines 1 and 2) 3 .00 IF YOU HAVE DEDUCTIONS, FILL OUT SECTIONS A AND B ON PAGE 2 OF THIS RETURN. IF YOU HAVE NO DEDUCTIONS, ENTER 2230224 ON LINE 11 AND PROCEED TO LINE 12. Total nontaxable transactions reported (enter total nontaxable transactions from 11 11 Section B, line 6) .00 American LegalNet, Inc. www.FormsWorkFlow.com CDTFA-401-A (BACK) REV. 116 (4-19) STATE OF CALIFORNIA CALIFORNIA DEPARTMENT OF TAX AND FEE ADMINISTRATION STATE, LOCAL, AND DISTRICT SALES AND USE TAX RETURN YOUR ACCOUNT NUMBER REPORTING PERIOD SECTION A. Full Deductions 4 Sales to other retailers for purposes of resale 28 $ .00 5 Nontaxable sales of food products 29 .00 6 Nontaxable labor (repair and installation) 30 .00 7 Sales to the United States government 31 .00 8 Sales in interstate or foreign commerce 32 .00 9 Sales tax (if any) included on line 1 33 .00 10 Other (clearly explain) 34 .00 11 Total full deductions (add lines 4 through 10) 35 $ .00 SECTION B. Current Period Tax Recoveries and Deductions. The amount reported is for current period only, and therefore, the original transaction needs to be included in line 1. (For all other prior period tax recovery items, complete CDTFA-531-Q, Schedule Q227Tax Recovery, to claim your credit.) 1 Bad debt losses on taxable sales 36 $ .00 2 Cost of tax-paid purchases resold prior to use 37 .00 3 Returned taxable merchandise 38 .00 4 Cash discounts on taxable sales (see instructions on how to calculate this deduction) 39 .00 5 Total Section B (add lines 1 through 4) 40 .00 6 Total nontaxable transactions (add the total from Section A, line 11, and Section B, line 5, and enter total here and on page 1, line 11) 41 $ .00 SECTION C. Current Period Partial Tax Exemptions (do not include Partial Exemptions in line 11 total) 1 Teleproduction equipment 42 $ .00 2 Farm equipment and machinery 43 .00 3 Diesel fuel used in farming and food processing 44 .00 4 Timber harvesting equipment and machinery 45 .00 5 Racehorse breeding stock 46 .00 6 Total current period partial exemptions (enter sum of lines 1 through 5) 47 .00 7 Partial exemption rate 48 .05 8 Total Section C (multiply the total from Section C, line 6 by rate listed in Section C, line 7) 49 $ .00 SECTION D. Current Period Partial Tax Exemption for Manufacturing and Research and Development Equipment 1 Sales made subject to the manufacturing and research and development equipment exemption 50 $ .00 2 Partial exemption rate 51 .039375 3 Total Section D (multiply line 1 by line 2) 52 $ .00 Total Current Period Partial Exemptions (add the totals from Section C, line 8, and 4 Section D, line 3, and enter here and on page 1, line 20a) 53 $ .00 American LegalNet, Inc. www.FormsWorkFlow.com Page 1 CDTFA-531-A2 (S1F) REV. 33 (4-19) STATE OF CALIFORNIACALIFORNIA DEPARTMENT OF TAX AND FEE ADMINISTRATION SCHEDULE A2 - COMPUTATION SCHEDULE FOR DISTRICT TAX - Long Form SUBTOTAL A11a (Add amounts in column A10 on this page. Enter the total here and on line A11a below.)$ .00 Continued on page 2 A11aSUBTOTAL DISTRICT TAX (Page 1, enter the total from line A11a above.)$ .00 A11bSUBTOTAL DISTRICT TAX (Page 2, enter the total from line A11b on page 2.) .00 A11cSUBTOTAL DISTRICT TAX (Page 3, enter the total from line A11c on page 3.) .00 A11dSUBTOTAL DISTRICT TAX (Page 4, enter the total from line A11d on page 4.) .00 A11eSUBTOTAL DISTRICT TAX (Page 5, enter the total from line A11e on page 5.) .00 A11fSUBTOTAL DISTRICT TAX (Page 6, enter the total from line A11f on page 6.) .00 A11gSUBTOTAL DISTRICT TAX (Page 7, enter the total from line A11g on page 7.) .00 A11hSUBTOTAL DISTRICT TAX (Page 8, enter the total from line A11h on page 8.) .00 A11iSUBTOTAL DISTRICT TAX (Page 9, enter the total from line A11i on page 9.) .00 A11jSUBTOTAL DISTRICT TAX (Page 10, enter the total from line A11j on page 10.) .00 A11kSUBTOTAL DISTRICT TAX (Page 11, enter the total from line A11k on page 11.) .00 TOTAL DISTRICT TAX (Add lines A11a, A11b, A11c, A11d, A11e, A11f, A11g, A11h, A11i, A11j, and A11k. A11 Enter here and on line 16 of CDTFA-401-A or CDTFA-401-GS , or on line 5 on CDTFA-401-E .) $ .00 DUE ON OR BEFORE YOUR ACCOUNT NUMBER A1 ENTER amount from line 12 on CDTFA-401-A or CDTFA-401-GS , or from line 1 on CDTFA-401-E $ .00 A2/A3 ENTER all transactions subject to only the state rate of 7.25% (see instructions) 226 .00 A4 SUBTRACT line A2/A3 from line A1 (Allocate this amount to the correct district tax areas in column A5.) $ .00 PLEASE READ THE INSTRUCTIONS ON PAGE 12 BEFORE COMPLETING THIS SCHEDULE DISTRICT TAX AREAS A5 ALLOCATE LINE A4 TO CORRECT DISTRICT(S) A6/A7 ADD ( + ) / DEDUCT ( - ) ADJUSTMENTS A8TAXABLE AMOUNT A5 plus/minus A6/A7 A9 TAX RATE A10DISTRICT TAX DUEMultiply A8 by A9 ALAMEDA COUNTY 378 .02 $ .00 City of Alameda (Eff. 4-1-19) 648 .025 .00 City of Albany 429 .025 .00 City of Hayward 430 .025 .00 City of Newark (Eff. 4-1-17) 451 .025 .00 City of San Leandro 380 .025 .00 City of Union City 428 .025 .00 AMADOR COUNTY 194 .005 .00 BUTTE COUNTY City of Oroville (Eff. 4-1-19) 649 .01 .00 Town of Paradise 381 .005 .00 CALAVERAS COUNTY City of Angels Camp (Eff. 4-1-19) 650 .005 .00 COLUSA COUNTY City of Williams 139 .005 .00 American LegalNet, Inc. www.FormsWorkFlow.com Page 2 CDTFA-531-A2 (S1B) REV. 33 (4-19) SCHEDULE A2 - COMPUTATION SCHEDULE FOR DISTRICT TAX - Long Form ACCOUNT NUMBER REPORTING PERIOD DISTRICT TAX AREAS A5 ALLOCATE LINE A4 TO CORRECT DISTRICT(S) A6/A7 ADD ( + ) / DEDUCT ( - ) ADJUSTMENTS A8 TAXABLE AMOUNT A5 plus/minus A6/A7 A9 TAX RATE A10 DISTRICT TAX DUE Multiply A8 by A9 CONTRA COSTA COUNTY 025 .01 $ .00 City of Antioch (Exp. 3-31-19) 350 Discontinued .015 .00 City of Antioch (Eff. 4-1-19) 652 .02 .00 City of Concord 242 .015 .00 City of El Cerrito 383 .025 .00 City of Hercules 286 .015 .00 City of Martinez (Exp. 3-31-19) 453 Discontinued .015 .00 City of Martinez (Eff. 4-1-19) 654 .02 .00 Town of Moraga 301 .02 .00 City of Orinda 303 .015 .00 City of Pinole 385 .02 .00 City of Pittsburg 288 .015 .00 City of Pleasant Hill (Eff. 4-1-17) 455 .015 .00 City of Richmond 387 .02 .00 City of San Pablo (Exp. 9-30-17) 368 Discontinued .0175 .00 City of San Pablo (Eff. 10-1-17) 609 .015 .00 DEL NORTE COUNTY 388 .0025 .00 EL DORADO COUNTY City of Placerville (Exp. 3-31-17) 246 Discontinued .005 .00 City of Placerville (Eff. 4-1-17) 457 .01 .00 City of So. Lake Tahoe 097 .005 .00 FRESNO COUNTY 099 .00725 .00 City of Coalinga (Eff. 4-1-19) 656 .01725 .00 City of Fowler (Eff. 4-1-19) 658 .01725 .00 City of Huron 352 .01725 .00 City of Kerman (Eff. 4-1-19) 660 .01725 .00 City of Kingsburg (Eff. 10-1-18) 636 .01725 .00 City of Reedley 177 .01225 .00 City of Sanger 179 .01475 .00 City of Selma 169 .01225 .00 GLENN COUNTY City of Orland (Eff. 4-1-17) 458 .005 .00 HUMBOLDT COUNTY 389 .005 .00 City of Arcata 425 .0125 .00 City of Eureka 427 .0125 .00 City of Fortuna (Eff. 4-1-17) 460 .0125 .00 City of Rio Dell 391 .015 .00 City of Trinidad 426 .0125 .00 SUBTOTAL A11b (Add amounts in column A10 on this page. Enter the total here and on line A11b on page 1 of Schedule A2.) $ .00 Continued on page 3 American LegalNet, Inc. www.FormsWorkFlow.com Page 3 CDTFA-531-A2 (S2F) REV. 33 (4-19) SCHEDULE A2 - COMPUTATION SCHEDULE FOR DISTRICT TAX - Long Form ACCOUNT NUMBER REPORTING PERIOD DISTRICT TAX AREAS A5 ALLOCATE LINE A4 TO CORRECT DISTRICT(S) A6/A7 ADD ( + ) / DEDUCT ( - ) ADJUSTMENTS A8 TAXABLE AMOUNT A5 plus/minus A6/A7 A9 TAX RATE A10 DISTRICT TAX DUE Multiply A8 by A9 IMPERIAL COUNTY 029 .005 $ .00 City of Calexico 230 .01