CDTFA-324-OIC (FRONT) REV. 2 (8-17)	                                                            STATE OF CALIFORNIA 
                                                          CALIFORNIA DEPARTMENT OF TAX AND FEE ADMINISTRATION 

                                     Annual Privacy Notice 

                                     Information Provided to the
               California Department of Tax and Fee Administratio

We will use the information you provide to determine      You may contact the Offer in Compromise Section at 
whether you are eligible for relief of liability as an    1-916-322-7931 or by writing to: 
innocent spouse or whether you are eligible for an        OFFER IN COMPROMISE SECTION, MIC:52  
offer in compromise.  To process your request for         SETTLEMENT AND TAXPAYER SERVICES BUREAU 
relief of liability as an innocent spouse or your offer   CALIFORNIA DEPARTMENT OF TAX 
in compromise request, you must provide all of the        AND FEE ADMINISTRATION 
information we request, including your social security    PO BOX 942879 
number (used for identification purposes [see Title 42    SACRAMENTO, CA 94279-0052 
Code section 405(c)2(C)(i)]). 
                                                          We must collect information in order to administer 
What happens if I don’t provide the information?          the state laws listed below. 
If you fail to provide the requested information, we will Code sections are from the California Revenue and 
be unable to determine the outcome of your request for    Taxation Code unless otherwise noted. 
relief of liability as an innocent spouse or your request 
for an offer in compromise.                                 •	 California Tire Fee (sections 55001-55381, Public
                                                          Resources Code sections 42860-42895
Can anyone else see my information? 
                                                            •	  Cannabis Tax (sections 34010-34021.5, 55001-55381) 
Your records are covered by state laws that protect your 
privacy. However, we may share information regarding        •	  Childhood Lead Poisoning Prevention Fee (sections  
your account with certain government agencies (see list   43001-43651, Health and Safety Code section 105310) 
on reverse).  We may also share certain information with    •	 Cigarette and Tobacco Products Tax (sections
companies authorized to represent local governments.      30001-30483, Health and Safety Code sections
With your written permission, we can release information  104555-104558
regarding your account to anyone you designate.             •	 Cigarette and Tobacco Products Licensing Act of
Can I review my records?                                  2003 (Business and Professions Code sections
                                                          22970-22995, Government Code section 15618.5,
Yes. Please contact the Offer in Compromise Section at    Penal Code section 830.11
1-916-322-7931. If you need more information, you may 
contact our Disclosure Officer in Sacramento by calling     •	 Diesel Fuel Tax (sections 60001-60708) 
1-916-445-2918. You may also want to obtain publication     •	 Electronic Waste Recycling Fee (sections
58A, How to Inspect and Correct Your Records. You may     55001-55381, Health and Safety Code sections
download it from the Internet at www.cdtfa.ca.gov (look   25214.10-25214.10.2, Public Resources Code
under “Forms and Publications”) or order a copy from our  sections 42463-42485
Customer Service Center at 1-800-400-7115. 
                                                            •	 Emergency Telephone Users Surcharge (sections
Who is responsible for maintaining my records?            41001-41176
The manager of the Offer in Compromise Section is           •	  Energy Resources Surcharge (sections 40001-40216) 
responsible for maintaining your records. 
                                                            •	 Fire Prevention Fee (Public Resources Code sections 
                                                          4210-4228) 
                                                            •	 Hazardous Substances Tax (sections 43001-43651, 
                                                          Health and Safety Code sections 25174-25174.11, 
                                                          25205.1-25205.23) 

CDTFA-324-OIC (BACK) REV. 2 (8-17) 

•	 Integrated Waste Management Fee (sections                We may disclose information to the proper officials 
    45001-45984, Public Resources Code sections             of the following agencies, among others: 
    48000-48008) 
                                                            •	 United States government agencies: U.S. Attorney’s 
•	  International Fuel Tax Agreement (sections 9401-9433)       Office; Bureau of Alcohol, Tobacco, Firearms and 
•	  Lead-Acid Battery Fees (Health and Safety Code              Explosives; Departments of Agriculture, Defense, 
    section 25215-25215.75)                                     and Justice; Federal Bureau of Investigation; General 
                                                                Accounting Office; Internal Revenue Service; 
•	 Lumber    Products Assessment Fee (sections 
                                                                Interstate Commerce Commission 
    55001-55381, Public Resources Code sections 
    4629-4629.13)                                           •	 State of California government agencies and officials:  
                                                                Air Resources Board; Department of Alcoholic 
•	 Marine Invasive Species (Ballast Water) Fee 
                                                                Beverage Control; Department of Child Support 
    (sections 44000-44008, 55001-55381, Public 
                                                                Services; Department of Consumer Affairs; State 
    Resources Code sections 71200-71271) 
                                                                Controller’s Office; Employment Development 
•	  Motor Vehicle Fuel Tax, including Aircraft Jet Fuel Tax     Department; Energy Commission; Department 
    (sections 7301-8526)                                        of Fish and Wildlife; Department of Food and 
•	 Natural Gas Surcharge (sections 55001-55381,                 Agriculture; Forest Products Commission; Board of 
    Public Utilities Code sections 890-900)                     Forestry and Fire Protection; Franchise Tax Board; 
                                                                Department of Public Health; California Highway 
•	 Occupational   Lead Poisoning Prevention Fee 
                                                                Patrol; Department of Housing and Community 
    (sections 43001-43651, Health and Safety Code 
                                                                Development; Integrated Waste Management Board; 
    sections 105190, 105195) 
                                                                State Lands Commission; Department of Motor 
•	 Oil Spill Response, Prevention, and Administrative           Vehicles; California Public Utilities Commission; 
    Fees (sections 46001-46751, Government Code                 Department of Toxic Substances Control; State Water 
    sections 8670.40, 8670.48)                                  Resources Control Board 
•	 Prepaid   Mobile Telephony Services Surcharge            •	 State agencies outside of California for tax
    (sections 55001-55381, sections 42001-42024,                enforcement purpose
    sections 42100-42111) 
                                                            •	 City attorneys and prosecutors; county district
•	 Regional  Railroad Accident Preparedness and                 attorneys, police and sheriff department
    Immediate Response Fee (sections 55001-55381, 
                                                            •	 Any  agency authorized to enforce local tobacco
    Government Code sections 8574.30-8574.48) 
                                                                control ordinance
•	 Sales and Use Tax (sections 6001-7176, 7200-7226, 
    7251-7279.6, 7285-7288.6) 
•	 Underground    Storage Tank Maintenance Fee 
    (sections 50101-50162, Health and Safety Code 
    sections 25299.10-25299.51) 
•	 Use Fuel Tax (sections 8601-9355) 
•	 Water Rights Fee (sections 55001-55381, Water 
    Code sections 1525-1560)