CDTFA-401-GS (S1F) REV. 85 (5-21)                                                                     STATE OF CALIFORNIA
STATE, LOCAL, AND DISTRICT SALES AND USE TAX RETURN                                           CALIFORNIA DEPARTMENT OF  
                                                                                             TAX AND FEE ADMINISTRATION
                                                                                                      CDTFA USE ONLY
DUE ON OR BEFORE                      PERIOD BEGIN DATE          PERIOD END DATE                      EFF
                                                            YOUR ACCOUNT NUMBER                       PM

  CALIFORNIA DEPARTMENT OF                                                                            READ INSTRUCTIONS 
  TAX AND FEE ADMINISTRATION                                                                          BEFORE PREPARING
  PO BOX 942879
  SACRAMENTO CA 94279-8009                                                                               GS
o Please check this box if this filing represents an AMENDED RETURN.
ELECTRONIC FILING INFORMATION AND RETURN INSTRUCTIONS (CDTFA-401-GSIN)
ARE AVAILABLE AT WWW.CDTFA.CA.GOV OR BY CALLING 1-800-400-7115 (CRS:711).
  1 Total sales                                                                                  1  $    .00
  2 Purchases subject to use tax                                                                 2       .00
  3 Total (add line 1 and 2)                                                                     3       .00
    IF YOU HAVE DEDUCTIONS, FILL OUT SECTIONS A AND B ON THE BACK PAGE OF THIS RETURN. 
                 IF YOU HAVE NO DEDUCTIONS, ENTER “0” ON LINE 11 AND PROCEED TO LINE 12.
11  Total nontaxable transactions reported (enter the total from Section B, line 6)             11       .00
12  Transactions subject to tax (subtract line 11 from line 3)                                  12       .00
13a State tax 6.00 percent (multiply line 12 by 0.0600)                                         13a      .00
                                          (Diesel Sales)            Multiply by 5.75 percent 
13b Additional state tax on diesel sales  $                         (0.0575)                    13b      .00
14  County tax 1/4 percent (multiply line 12 by 0.0025)                                         14       .00
15  Local tax 1 percent (multiply line 12 by 0.01; additional schedules may apply—              15       .00
    see line 15 instructions)

16  District tax (from Schedule A2, total district tax) You must complete CDTFA-531-A2 if       16       .00
    you are engaged in business in a transaction and use tax district
17  Total state, county, local, and district tax (add lines 13a, 13b, 14, 15, and 16)           17       .00
18  Excess tax collected (enter excess tax collected, if any)                                   18       .00
19  Total tax amount (add lines 17 and 18)                                                      19       .00
20a Credit for current period partial tax exemptions (enter the total from Section D, line 6)   20a      .00
20b Credit for prior period tax recovery (enter the total tax recovery amount from CDTFA-531-Q) 20b      .00
20c Credit for tax paid to other state(s) (enter the credit as calculated from CDTFA-531-P)     20c      .00
20d Credit for sales tax prepaid to fuel suppliers (enter amount from line G2 of CDTFA-531-G)   20d      .00
20e Total credit (add lines 20a, 20b, 20c, and 20d)                                             20e      .00
21  Net tax (subtract line 20e from line 19)                                                    21       .00
                                  1st prepayment (tax only)      2nd prepayment (tax only)
22  Less tax prepayments          $                              $                              22       .00
    (see line 22 instructions)    o   No taxable transactions    o  No taxable transactions
23  Net Tax Less Prepayments (subtract line 22 from line 21)                                    23       .00
24  Sales tax paid to DMV (enter the total amount from column C from CDTFA-531-MV)              24       .00
25  Remaining tax (subtract line 24 from line 23)                                               25       .00
                                                                                   PENALTY
26  PENALTY (multiply line 23 by 10 percent [0.10] if payment made or                           26       .00
    your tax return is filed after the due date shown above)

27  Penalty paid to DMV for late payments of sales tax (enter the total amount from             27       .00
    column D from CDTFA-531-MV)
28  PENALTY Due (subtract line 27 from line 26. If line 28 is less than 0, enter 0)             28       .00
    INTEREST: One month’s interest is due on tax for each month or 
29  fraction of a month that payment is delayed after the due date. The            INTEREST     29       .00
    adjusted monthly interest rate is                INTEREST RATE CALCULATOR
30  TOTAL AMOUNT DUE AND PAYABLE (add lines 25, 28, and 29)                                     30  $    .00
31  Sales at state-designated fairgrounds (see instructions)                                    31  $    .00

CDTFA-401-GS (S1B) REV. 85 (5-21)                                                                                                 STATE OF CALIFORNIA
                                                           CALIFORNIA DEPARTMENT OF TAX AND FEE ADMINISTRATION

                 I hereby certify that this return, including any accompanying schedules and statements, has been examined by me  
                                  and to the best of my knowledge and belief is a true, correct, and complete return.
SIGNATURE                             PRINT NAME AND TITLE                                                           DATE
EMAIL ADDRESS                                                                                                        TELEPHONE
 PAID PREPARER’S PAID PREPARER’S NAME                                                                                PAID PREPARER’S TELEPHONE NUMBER
 USE ONLY
              Make check or money order payable to California Department of Tax and Fee Administration.
              Write your account number on your check or money order. Make a copy of this document for your records.

                                  California Department of Tax and Fee Administration
                                      PO Box 942879
                                      Sacramento, CA 94279-8009 

CDTFA-401-GS (S2) REV. 85 (5-21)                                                             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. Nontaxable Sales (deductions)

4  Sales to other retailers for purposes of resale                                      32 $                         .00
5  Nontaxable sales of food products                                                    33                           .00
6  Nontaxable labor (repair and installation)                                           34                           .00
7  Sales to the United States government                                                35                           .00
8  Sales in interstate or foreign commerce                                              36                           .00
9  Sales tax included on line 1 (if any)                                                37                           .00
10 Other (clearly explain)                                                              38                           .00
11 Total Section A (add lines 4 through 10)                                             39 $                         .00
SECTION B. Current Period Tax Recoveries and Deductions The amount reported is for the current period only.  
The original transaction needs to be included in line 1 on page 1. (To claim a credit for all other prior period tax 
recovery items, complete CDTFA-531-Q, Schedule Q — Tax Recovery.)
1  Bad debt losses on taxable sales                                                     40 $                         .00
2  Cost of tax-paid purchases resold prior to use                                       41                           .00
3  Returned taxable merchandise                                                         42                           .00
4  Cash discounts on taxable sales                                                      43                           .00
5  Total Section B (add lines 1 through 4)                                              44                           .00

6  Total nontaxable transactions (add the total from Section A, line 11, and Section B, 45 $                         .00
   line 5, and enter the total here and on page 1, line 11)
SECTION C. Current Period Partial Tax Exemptions at .05 Partial Exemption Rate (do not include partial  
exemptions in Section A, line 11) 

1  Farm equipment and machinery                                                         46 $                         .00
2  Diesel fuel used in farming and food processing                                      47                           .00
3  Timber harvesting equipment and machinery                                            48                           .00
4  Motor vehicle fuel (MVF) transactions                                                49                           .00
5  Subtotal Section C (add lines 1 through 4)                                           50                           .00
6  Partial tax exemption rate                                                           51                           .05
7  Total Section C (multiply line 5 by line 6)                                          52 $                         .00
SECTION D. Current Period Partial Tax Exemptions at .039375 Partial Exemption Rate (do not include partial 
exemptions in Section A, line 11)

1  Manufacturing and research & development equipment                                   53 $                         .00
2  Zero-emission transit bus                                                            54                           .00
3  Subtotal Section D (add line 1 and 2)                                                55                           .00
4  Partial tax exemption rate                                                           56   .039375
5  Total Section D (multiply line 3 by line 4)                                          57 $                         .00

6  Total Current Period Partial Exemptions (add the total from Section C, line 7 and    58 $                         .00
   Section D, line 5, and enter here and on page 1, line 20a)