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Information Update
You may now file a claim for refund using the California Department of Tax and Fee Administration (CDTFA) online
services at onlineservices.cdtfa.ca.gov.
To submit a claim for refund, simply log in using your username and password, and click on the account for which you want to
request a refund. The claim for refund is located under the I Want To section, More subsection. Simply select the Submit a Claim for
Refund link, and follow the prompts.
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CDTFA-101 (FRONT) REV. 19 (7-22) STATE OF CALIFORNIA
CLAIM FOR REFUND OR CREDIT CALIFORNIA DEPARTMENT OF TAX AND FEE ADMINISTRATION
(Instructions on back)
NAME OF TAXPAYER(S) CDTFA ACCOUNT NUMBER (only list one account number per claim)
SOCIAL SECURITY NUMBER(S)* OR EMPLOYER IDENTIFICATION NUMBER GENERAL PARTNER(S) (if applicable)
BUSINESS NAME (if applicable) BUSINESS LOCATION ADDRESS (if applicable)
MAILING ADDRESS (if applicable)
Please select the tax or fee program that applies to your claim for refund or credit.
Sales and Use Tax Alcoholic Beverage Tax Natural Gas Surcharge
Lumber Assessment California California Electronic Cigarette Excise Occupational Lead Poisoning
Tax Prevention Fee
Prepaid Mobile Telephony
Services (MTS) Surcharge California Tire Fee Oil Spill Response, Prevention, and
Administration Fees
For overpayments of use tax by a Cannabis Taxes
purchaser of a vehicle or undocumented Regional Railroad Accident
Childhood Lead Poisoning
vessel to the Department of Motor Preparedness and Immediate
Prevention Fee
Vehicles (DMV), please complete Response Fee
CDTFA-101-DMV, Claim for Refund or Cigarette and Tobacco Products Tax Tax on Insurers
Credit for Tax Paid to DMV.
Covered Electronic Waste Recycling Timber Yield Tax
Fee
Underground Storage Tank
Diesel Fuel Tax Maintenance Fee
Emergency Telephone Users Use Fuel Tax
For the above tax/fee programs, Surcharge Water Rights Fee
Energy Resources (Electrical)
mail your completed form to:
Surcharge For the above tax/fee programs,
California Department of
Fire Prevention Fee mail your completed form to:
Tax and Fee Administration
California Department of
Audit Determination and
Hazardous Substances Tax Tax and Fee Administration
Refund Section MIC:39
Integrated Waste Management Fee Appeals and Data Analysis Branch
PO Box 942879
MIC:33
Sacramento, CA 94279-0039
Lead-Acid Battery Fee PO Box 942879
Or email to: BTFD-ADRS@cdtfa.ca.gov Marine Invasive Species Fee Sacramento, CA 94279-0033
Motor Vehicle and Jet Fuel Taxes Or email to: adab@cdtfa.ca.gov
The undersigned hereby makes a claim for refund or credit of $ , or such other amounts as may be established, in
tax, interest, and penalty in connection with:
Return(s) filed for the period through
Determination(s)/billing(s) dated and paid
Other (describe fully):
Basis for refund (required):
Supporting documentation, including amended return(s), is attached. will be provided upon request.
SIGNATURE DATE SIGNED
PRINT NAME CONTACT PERSON (if other than signatory)
TITLE OR POSITION TELEPHONE NUMBER TITLE OR POSITION OF CONTACT PERSON TELEPHONE NUMBER
EMAIL ADDRESS EMAIL OF CONTACT PERSON
*See CDTFA-324-GEN, Privacy Notice, regarding disclosure of the applicable social security number.
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CDTFA-101 (BACK) REV. 19 (7-22)
INSTRUCTIONS FOR COMPLETING CLAIM FOR REFUND
When submitting a claim for refund or credit, you must provide the time period covered by the claim, the specific grounds upon
which the claim is based, and documentation that supports the claim. The documentation should include amended returns, be
sufficient in detail, and provide proof of the overpayment. Please include your documentation with your claim for refund or credit or,
if the documentation is extensive, please have it readily available upon request.
What You Need to Know How You Can Submit Your Claim
• Your claim must be filed within the statute of limitations for the • Log in with your username and password on our
tax/fee program*. website at onlineservices.cdtfa.ca.gov. Click on the
• Compliance with the statute of limitations is based on the filing account for which you want to request a refund, and
date of your claim. select the More link under the I Want To section.
Then select the Submit a Claim for Refund link, and
• Your filing date is the date of mailing (postmark), the electronic follow the prompts.
transmittal date (when applicable), or the date that you personally
deliver your claim to your nearest CDTFA office. This date may differ • Mail, email, or fax as applicable to the appropriate
from the date signed. location listed on the front page.
• You may only list one account number per claim form. If you are • Hand-deliver to any CDTFA office (for a list of CDTFA
claiming a refund for multiple tax or fee programs, a separate offices, please visit our website at
form is needed for each account. www.cdtfa.ca.gov).
• If your claim is for a refund of a partial payment or installment For More Information
payment, your claim will cover all future payments applied to a single • Call our Customer Service Center at
determination. (Prior to January 1, 2017, a separate claim was required 1-800-400-7115 (CRS:711) to be directed to the
for each partial payment or installment payment.) If you have been specific office responsible for your tax or fee account.
issued more than one Notice of Determination (determination), you need
to file a claim for refund for each separate determination to ensure that • See publication 117, Filing a Claim for Refund.
all future payments associated with that determination are covered. • See publication 17, Appeals Procedures: Sales and
Use Taxes and Special Taxes and Fees.
How to Complete the Claim Form
• Taxpayer Name and Account Number: Enter the name(s) and account number as registered with CDTFA. Enter the name(s) shown
on the documents that support the claim for refund if the claimant is not registered with CDTFA. Do not enter the business name
(DBA) unless it is also the name that is registered with CDTFA.
• Social Security Number/Employer Identification Number: Disclosure of the applicable social security number(s) is required (see
CDTFA-324-GEN, Privacy Notice) even if the claimant is not registered with CDTFA, as there are instances where a refund or portion
thereof may be disclosed to the Internal Revenue Service. Enter the social security numbers of both spouses if the claimant is a
married couple. Enter the social security number(s) of the general partner(s) and the name(s) of the partner(s) if the claimant is a
partnership. Enter the employer identification number for all other business entities.
• Refund Amount: Enter the amount of your claim.
• Overpayment Type: Check the appropriate box to indicate if your claim is for a return filing payment, determination/billing payment,
or any other type of overpayment, and enter the applicable dates. If you select “other,” fully explain the circumstances of your claim.
• Basis for Refund: Provide the basis or grounds for the claim, or describe the circumstances that caused the overpayment. Claims
for refund cannot be considered unless this field is completed.
• Business Name: Enter the name of the business. For example, if the claimant’s name is John Doe and the DBA is XYZ Auto Repair,
XYZ Auto Repair should be entered.
• Signature and Title or Position: The preparer of the claim form must sign their name. The preparer must also include their title or
position (for example, bookkeeper, attorney, accountant, taxpayer, among others).
• Date Signed: Enter the date the claim form is signed.
• Contact Person (if other than signatory): This line may be used to designate a person (other than the signatory) to contact, should
CDTFA have questions or require additional information. Such persons may be employees, consultants, accountants, attorneys,
among others, as designated by the taxpayer.
• Telephone Number: Please include your telephone number (and contact person’s telephone number, if applicable).
• Email: Please include your email address (and contact person’s email address, if applicable).
* The time period for filing a claim for refund will vary depending on a number of factors, particularly the type of overpayment and the
tax or fee program for which you are filing a claim for refund. Please check the appropriate laws and regulations for the specific tax
or fee program for which you are filing a claim. You may also refer to publication 117 or publication 17 referenced above.
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