CDTFA-549-L (FRONT) REV. 3 (6-21)                                                                         STATE OF CALIFORNIA
CLAIMED INCORRECT DISTRIBUTION OF                       CALIFORNIA DEPARTMENT OF TAX AND FEE ADMINISTRATION
LOCAL TAX — LONG FORM
Instructions: This claim must contain sufficient factual data to support the probability that local tax has been 
erroneously allocated and distributed. Sufficient factual data must include, at a minimum, all of the information below 
for each business location being questioned. Please submit the completed claim via email to:  
LRB-PetitionInquiry@cdtfa.ca.gov. 
1) Taxpayer name, including owner name and fictitious business name or DBA (doing business as) designation.  
2) Taxpayer’s permit number or a notation stating: “no permit number.” 3) Taxpayer’s business address. 4) Complete 
description of taxpayer’s business activity(ies). 5) Specific reasons and evidence why the taxpayer’s allocation is 
questioned. In cases where it is reported that the location of the sale is an unregistered location, evidence must be 
submitted that the unregistered location is a selling location, as explained by Regulation 1699, or is a place of sale, as 
determined under Regulation 1802. In cases that involve shipments from an out-of-state location and a claim that the 
tax is sales tax and not use tax, evidence must be submitted that there was participation by an in-state office of the 
out-of-state retailer and that title to the goods passed in this state. 6) Name, title, and telephone number for a contact 
person. 7) The tax reporting period(s) involved.

NAME OF JURISDICTION                                                      ALLOCATION PERIOD(S) IN QUESTION

REASON FOR QUESTIONING THE ALLOCATION

                                               SECTION I — GENERAL BUSINESS INFORMATION
OWNER NAME                                              BUSINESS NAME

BUSINESS ADDRESS (street, city, state ZIP code)

CALIFORNIA SELLER’S PERMIT NUMBER              DATE BUSINESS STARTED      CURRENTLY OPERATING
                                                                           Yes                 No
DESCRIPTION OF OPERATION OF BUSINESS

                     Contact person for more information regarding the taxpayer’s allocation of local tax:
NAME                                                    TITLE

DAYTIME TELEPHONE NUMBER                                                  BEST TIME TO CALL

MAILING ADDRESS (street, city, state ZIP code)          EMAIL ADDRESS

                                               SECTION II — QUESTIONS ABOUT THE BUSINESS
Is merchandise sold at this location?           Yes  No
Are sales of tangible personal property negotiated at this location?  Yes  No
If yes, what is sold? 
If no, what activities occur at the above business? 
Has this business changed locations?            Yes   No
If yes, list previous address and dates of operation:
ADDRESS (street, city, state ZIP code)

DATES OF OPERATION
From:                                   To: 

CDTFA-549-L (BACK) REV. 3 (6-21)

Does the business have other selling locations in California?  Yes      No
Please give the business address(es) below or attach a list:

Are sales made at temporary locations (fairs, swap meets, etc.)?    Yes      No
If yes, please describe:

Are sales made by employees of the business?          Yes    No
Are sales made through independent agents?       Yes       No
Is merchandise delivered to customers from out-of-state inventory?      Yes       No
Is merchandise delivered to customers from California inventory?        Yes  No
Other:

If merchandise is shipped directly to customers from an out-of-state inventory, do sales contracts contain a specific title 
clause allowing title to pass in California?     Yes  No
Is the merchandise shipped with a Free on Board (FOB) destination or FOB shipping point provision?  Yes  No
Are sales negotiated at a location outside of California?    Yes    No
Is the merchandise delivered from an in-state warehouse or inventory?        Yes  No
WAREHOUSE ADDRESS (street, city, state ZIP code)

Is the taxpayer a construction contractor affixing property to realty?  Yes       No
If yes, is the property classified as materials, fixtures, or machinery and equipment? 

PREPARER’S NAME

SUBMITTED BY (name)                                                              DATE

                                                Send acknowledgment and future correspondence to:
NAME

ADDRESS (street, city, state ZIP code)                                           EMAIL ADDRESS

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