DRS: Excise/Public Services Tax Forms

Excise/Public Services Tax Forms

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Prior Years' Forms

Excise Taxes

Alcohol Beverage Tax/ Alcohol Distributor Tax

Paper Form
Form Title
Date Added
AU-933 Alcoholic Beverages Tax, Alcoholic Beverages Shipped into Connecticut [size 23KB, 2 pages, PDF Format] 06/29/01
BT-4-BW
 
 Monthly Report of Custom Bonded Warehouses [size 62KB, 1 page, PDF Format] 03/11/05
BT-5 Schedule A Alcoholic Beverages Tax, Receipt of Tax Free Purchases and Tax Free Returns [size 31KB, 2 pages, PDF Format] 04/23/01
BT-5A Schedule A1 Alcoholic Beverages Tax in Transit Items [size 25KB, 2 pages, PDF Format] 06/29/01
BT-6 Schedule B Alcoholic Beverages Tax Receipt of Tax Paid Purchases and Tax Paid Returns [size 30KB, 2 pages, PDF Format] 07/20/00
BT-7 Schedule C Alcoholic Beverages Tax Alcoholic Beverages Shipped Outside of Connecticut [size 31KB, 2 pages, PDF Format] 04/24/01
BT-8 Schedule D Alcoholic Beverage Tax, Tax Free Sales in Connecticut and Sales to Other Licensed Distributors [size 31KB, 2 pages, PDF Format] 04/24/01

BT-18

 Alcoholic Beverages Tax Customs Clearance Certificate [size 22KB, 2 pages, PDF Format]

06/29/01

BT-20 Alcoholic Beverages Tax - Sealed Neck Bottle Destruction Certificate [size 26KB, 2 pages, PDF Format] 09/24/01
BT-21 Alcoholic Beverages Tax - Exemption Certificate [size 19KB, 2 pages, PDF Format] 09/24/01
BT-22 Alcoholic Beverages Tax Summary of Inventory of Wholesalers and Manufacturers  [size 28KB, 1 page, PDF Format] 03/31/05
BT-22(1) Alcoholic Beverage Tax Inventory Report of Alcohol in Excess of 100 Proof [size 18KB, 1 page, PDF Format] 09/06/01
BT-22(2) Alcoholic Beverages Tax Inventory Report of Alcoholic Beverages [size 14KB, 1 page, PDF Format] 08/17/01
BT-22(3) Alcoholic Beverages Tax Inventory Report of Alcoholic Beverages [size 17KB, 1 page, PDF Format] 08/30/01
BT-22(4) Alcoholic Beverage Tax Inventory Report of Alcoholic Beverages Distilled Liquors [size 17KB, 1 page, PDF Format] 10/01/01
BT-22(5) Alcoholic Beverage Tax Inventory Report of Alcoholic Beverages  [size 17KB, 1 page, PDF Format] 10/02/01
BT-22(6) Alcoholic Beverage Tax Inventory Report of Alcoholic Beverages [size 18KB, 1 page, PDF Format] 09/27/01
BT-22(7) Alcoholic Beverage Tax Inventory Report of Alcoholic Beverages  [size 16KB, 1 page, PDF Format] 10/02/01
BT-100 Application for Permission to Import Into Connecticut Alcoholic Beverages From Within the United States for Personal Consumption [size 59KB, 1 page, PDF Format]

03/03/05

BT-101 Application for Permission to Import Into Connecticut Alcoholic Beverages From Outside the United States for Personal Consumption [size 62KB, 1 page, PDF Format]

03/10/05

BT-FW Schedule C - (Farm Wineries) Alcoholic Beverages Tax Wine Shipped Outside of Connecticut  [size 16KB, 1 page, PDF Format] 11/08/01
BW-1 Alcoholic Beverages Tax Merchandise Placed in a Custom Bonded Warehouse [size 16KB, 2 pages, PDF Format] 05/06/02
BW-2 Alcoholic Beverages Tax Merchandise Withdrawn From a Custom Bonded Warehouse [size 17KB, 2 pages, PDF Format] 05/06/02
Form S&BT Alcoholic Beverages Tax - Payment of Taxes Due on the Importation of Alcoholic Beverages [size 75KB, 2 pages, PDF Format] 05/03/05
O-255 Wholesale Alcoholic Beverage Tax Return [size 47KB, 3 pages, PDF Format]

12/06/06

 
 

Attorney Occupational Tax Return

 
Paper Form 
Form Title
Date Added
Form 472 2009 Attorney Occupational Tax Return [size 314KB, 3 pages, PDF Format] 

File electronically. Use the TSC-BUS. 

 10/15/09

Form 472

2008 Attorney Occupational Tax Return [size 41KB, 2 pages, PDF Format] 

File electronically. Use the TSC-BUS. 
 10/09/08
Form 472

2007 Attorney Occupational Tax Return [size 48KB, 2 pages, PDF Format] 

File electronically. Use the TSC-BUS. 

  10/27/07
 
 

Cigarette Tax

Paper Form
Form Title
Date Added
AU-75 Tax Return for Persons in Possession of Unstamped Cigarettes  [size 252KB, 1 page, PDF Format]   10/1/09
AU-930 Cigarette Inventory Report [size 25KB, 1 page, PDF Format]
03/12/03
CT-15 Monthly Tax Stamp and Cigarette Report Resident Distributor [size 287KB, 2 pages, PDF Format]
10/1/09
CT-15A Monthly Tax Stamp and Cigarette Report Nonresident Distributor [size 280KB, 2 pages, PDF Format] 10/1/09
CT-19 Sch. A Record of Unstamped Cigarettes Manufactured, Purchased, or Otherwise Acquired  [size 55KB, 2 pages, PDF Format] 10/05/05
CT-19A Sch. A-1 Cigarettes Purchased with Connecticut Decals or Stamps Already Affixed  [size 55KB, 2 pages, PDF Format] 10/05/05
CT-23 Sch. B Shipments or Unstamped Cigarettes Made to Agencies of the Federal Government or Connecticut State Government  [size 60KB, 2 pages, PDF Format]  06/01/07
CT-24 Sch. D Unstamped Cigarettes Transferred to Another Distributor Within Connecticut  [size 60KB, 2 pages, PDF Format] 06/01/07
CT-25 Sch. C Sales and Transfers of Unstamped Cigarettes Outside of Connecticut  [size 60KB, 2 pages, PDF Format] 06/01/07
CT-27 Sch. E Sales and Transfers of Connecticut-Stamped Cigarettes Into Connecticut [size 59KB, 2 pages, PDF Format] 06/01/07
CT-28 Sch. F Sales and Transfers of Connecticut-Stamped Cigarettes Outside of Connecticut [size 62KB, 2 pages, PDF Format] 06/01/07
CT-29 Schedule G Sales and Transfers of Unstamped Cigarettes to Other Connecticut Distributors [size 61KB, 2 pages, PDF Format] 06/01/07
CT-30 Cigarette Tax Refund Claim Stamps Affixed to Packages [size 106KB, 2 pages, PDF Format] 07/11/07
CT-31 Cigarette and Unaffixed Stamp Inventory Report for Resident Distributors [size 200KB, 2 pages, PDF Format] 10/1/09
CT-31A Cigarette and Unaffixed Stamp Inventory Report for Nonresident Distributors  [size 219KB, 2 pages, PDF Format] 10/1/09
CT-38 Record of Cigarette Stamps Purchased Nonresident Distributor  [size 135KB, 2 pages, PDF Format] 10/1/09
CT-39 Record of Cigarette Stamps Purchased Resident Distributor  [size 133KB, 2 pages, PDF Format] 10/1/09
CT-40 Sales and Transfers of Connecticut Stamped Cigarettes Outside of Connecticut Resident Distributor  [size 21KB, 2 pages, PDF Format] 01/10/02
CT-50 Certificate of Cigarette Tax Re-Stamping Credit  [size 15KB, 1 page, PDF Format] 04/04/05
Form TPM-5 Stamper E-Mail Registration Form [size 68KB, 1 page, PDF Format] 03/29/06
O-252 Order Form For Connecticut Cigarette Tax Stamps [size 265KB, 2 pages, PDF Format]
10/1/09
OR-318 Cigarette Vending Machine Location Change [size 139KB, 1 page, PDF Format] 09/08/09
Schedule H Cigarette Packages Stamped During the Month [size 84KB, 6 pages, PDF Format]

03/07/07

 
 
 
Form Name
 
Form Title
Date Added
Form TPM-1
Certification of Compliance and Affidavit by Nonparticipating Manufacturer [size 59KB, 2 pages, PDF Format]
03/30/09
Form TPM-2
Certification for Listing in the Connecticut Directory as of July 1, 2009 [size 82KB, 12 pages, PDF Format]
04/1/09
Instructions to TPM-2
Instructions to Certification for Listing in the Connecticut Directory as of July 1, 2009 [size 65KB, 4 pages, PDF Format]
   04/1/09
Form TPM-3
Brand Families Unit Sales Schedule - Sales Made During the Calendar Year 2008 [size 90KB, 2 pages, PDF Format]
03/26/09
Form TPM-4
Notice of Appointment of Registered Agent and Registered Agent's Statement [size 73KB, 2 pages, PDF Format]
03/29/06
 
 

Controlling Interest Transfer Tax

Paper Form
 
Form Title
Date Added
AU-330  Controlling Interest Transfer Taxes [size 44KB, 3 pages, PDF Format]
08/27/09
AU-330I Instructions for the Controlling Interest Transfer Taxes [size 29KB, 3 pages, PDF Format]
08/27/09
AU-331 Controlling Interest Transfer Taxes Informational Return [size 32KB, 1 page, PDF Format]
08/27/09
 
 

Diesel Fuel Tax Returns

Paper Form
 
Form Title
Date Added
OP-216 Special Fuel Tax Return [size 264KB, 2 pages, PDF Format] 06/15/09
MF-R Motor Vehicle Fuels Tax Schedule of Receipts [size 196KB, 2 pages, PDF Format] This form replaces DF-1A
05/20/09
MF-D Motor Vehicle Fuels Tax Schedule of Disbursements [size 196KB, 2 pages, PDF Format] This form replaces and DF-1B and DF-1B(10A)
06/03/09
 
 

Electric Companies

Paper Form
 
Form Title
Date Added
UCT-212 EDC Electric Distribution Companies Gross Earnings Tax Return [size 36KB, 2 pages, PDF Format]

 09/03/08

 
 
 
 

Gross Earnings

 
Paper Form
Form Title
Date Added
211 CATV Community Antenna Television System Companies Gross Earnings Tax Return [size 41KB, 2 pages, PDF Format]
12/03/08
211 CCV Certified Competitive Video Service Companies Gross Earnings Tax Return [size 40KB, 2 pages, PDF Format]
12/09/08
211 CSV Cable, Satellite, and Video Gross Earnings Tax Return [size 40KB, 2 pages, PDF Format]  
12/09/08
211 SATV Satellite Companies Gross Earnings Tax Return [size 38KB, 2 pages, PDF Format]
12/03/08
Gross Earnings Tax on Railroad Companies [size 48KB, 4 pages, PDF Format] 01/08/09
TCT 211-2 Telegraph and Cable Gross Earnings Tax Return [size 42KB, 1 page, PDF Format] 02/02/00
UCT-212 Municipal Gas Utilities, Gas Suppliers and Local Gas Distribution Companies Gross Earnings Tax Return [size 35KB, 2 pages, PDF Format] 09/03/08
UCT-212I
 
 Instructions for Municipal Gas Utilities Gas Suppliers and Local Gas Distribution Companies Gross Earnings Tax Return [size 31KB, 2 pages, PDF Format]
09/03/08
 
 

International Fuel Tax Agreement (IFTA)

Paper Form
Form Title
Date Added
CT-IFTA-2 2009 Application for International Fuel Tax Agreement (IFTA) License - Connecticut Carrier [size 40KB, 2 pages, PDF Format]

 12/23/08

CT-IFTA Forms CT-IFTA Forms Page
N/A
 
 

Insurance/Health Care

Paper Form
 
Form Title
Date Added
CT-IRF 2008 Insurance Reinvestment Fund Credit [size 31KB, 2 pages, PDF Format]
01/15/09
Form 115A 2008 Premium Tax Return Tax on Premiums Charged by Unauthorized Insurers [size 37KB, 2 pages, PDF Format]
01/08/09
Form 115AR Report of Procurement, Continuance or Renewal of Insurance with Unauthorized Insurer [size 26KB, 1 page, PDF Format]
01/08/09
Form 207 2008 Insurance Premiums Tax Return Domestic Companies [size 43KB, 2 pages,  PDF Format]
01/08/09
Form 207 ESA, ESB, ESC and ESD 2009 Estimated Insurance Premiums Tax Payment Coupon Domestic Insurance Companies [size 40KB, 2 pages, PDF Format]
01/08/09
Form 207F 2008 Insurance Premiums Tax Return Nonresident and Foreign Companies [size 45KB, 2 pages, PDF Format]
01/08/09
Form 207F-5 2008 Insurance Premiums Tax Return Nonresident and Foreign Companies Initial Five-Year Return [size 36KB, 2 pages, PDF Format]
01/08/09
Form 207F ESA, ESB, ESC and ESD 2009 Estimated Insurance Premiums Tax Payment Coupon Foreign and Non-Resident Insurance Companies [size 48KB, 2 pages, PDF Format]
01/08/09
Form 207F EXT 2008 Application For Extension of Time To File Nonresident and Foreign Insurance Premiums Tax Return [size 31KB, 2 pages, PDF Format]
01/08/09
Form 207HCC 2008 Health Care Center Tax Return [size 51KB, 2 pages, PDF Format] 
01/08/09
Form 207 HCC ESA, ESB, ESC and ESD 2009 Estimated Health Care Centers Tax Payment Coupons [size 35KB, 2 pages, PDF Format]
01/08/09
Form 207/207HCC EXT
2008 Application for Extension of Time to File Domestic Insurance Premiums Tax Return or Health Care Center Tax Return [size 33KB, 2 pages, PDF Format]
01/08/09
Form 207 I 2008 Underpayment of Estimated Insurance Premiums Tax or Health Care Center Tax [size 33KB, 2 pages, PDF Format]
01/08/09
Form GAA-1 2008 Transfer of CIGA Assessment Credit [size 23KB, 1 page, PDF Format] 
02/06/09
2008 Transfer of CLHIGA Assessment Credit [size 23KB, 1 page, PDF Format] 
02/06/09
2008 Insurance Guaranty Association Credit [size 27KB, 2 pages, PDF Format] 
02/06/09
 
 

Motor Carrier Road Tax

Paper Form
Form Title
Date Added
REG-3MC 2008 Application Motor Carrier Road Tax [size 38KB, 2 pages, PDF Format]

12/15/08

 
 

Motor Vehicle Fuels Exporter

Paper Form
Form Title
Date Added
AU-726 Motor Vehicle Fuels Exporter Monthly Report [size 18KB, 2 pages, PDF Format] Form AU-726 replaces forms AU-726a and AU-726b

 03/16/06

 
 

 Motor Vehicle Fuels Tax Refunds - 2009

Paper Form 
Fillable Form
Form Title
Date Added
                         AU-724
                         AU-724
 2009 Motor Vehicle Fuels Tax Refund Claim Off Highway, Governmental, & School Bus Use [size 321KB, 2 pages, PDF Format] 10/1/09
AU-725 AU-725
2009 Motor Vehicle Fuels Tax Refund Claim - Farm Use [size 312KB, 2 pages, PDF Format]
 10/1/09
AU-736 AU-736 2009 Motor Vehicle Fuels Tax Refund Claim - Motor Bus, Taxicab and Livery [size 314KB, 2 pages, PDF Format] 10/1/09
AU-737 AU-737 2009 Motor Vehicle Fuels Tax Refund Claim - Airport Service (Motor Bus) [size 282KB, 2 pages, PDF Format] 10/1/09
AU-738 AU-738
2009 Motor Vehicle Fuels Tax Refund Claim - Nutrition Program [size 284KB, 2 pages, PDF Format]
 10/1/09
AU-741 AU-741 2009 Motor Vehicle Fuels Tax Refund Claim - Commuter Vans [size 305KB, 2 pages, PDF Format] 10/1/09
 

 Motor Vehicle Fuels Tax Refunds - 2008

Paper Form 
Fillable Form
Form Title
Date Added
                         AU-724
                         AU-724
 2008 Motor Vehicle Fuels Tax Refund Claim Off Highway, Governmental, & School Bus Use [size 296KB, 2 pages, PDF Format] 08/01/08
AU-725 AU-725
2008 Motor Vehicle Fuels Tax Refund Claim - Farm Use [size 313KB, 2 pages, PDF Format]
 08/01/08
AU-736 AU-736 2008 Motor Vehicle Fuels Tax Refund Claim - Motor Bus, Taxicab and Livery [size 291KB, 2 pages, PDF Format] 07/02/08
AU-737 AU-737 2008 Motor Vehicle Fuels Tax Refund Claim - Airport Service (Motor Bus) [size 286KB, 2 pages, PDF Format] 07/02/08
AU-738 AU-738
2008 Motor Vehicle Fuels Tax Refund Claim - Nutrition Program [size 284KB, 2 pages, PDF Format]
 07/02/08
AU-741 AU-741 2008 Motor Vehicle Fuels Tax Refund Claim - Commuter Vans [size 306KB, 2 pages, PDF Format] 07/02/08
 
 

Motor Vehicle Fuels Tax

Paper Form
Form Title
Date Added
O-MF Motor Vehicle Fuels Tax Return [size 72KB, 2 pages, PDF Format]
04/19/06
MF-R
Motor Vehicle Fuels Tax Schedule of Receipts [size 196KB, 2 pages, PDF Format] This form replaces MVF-1A and MF-3A.
05/20/09
MF-D
Motor Vehicle Fuels Tax Schedule of Disbursements [size 196KB, 2 pages, PDF Format] This form replaces MVF-1B,  MVF-1B(10A) and MF-3B.
06/03/09
MVF-3 Terminal Operator's Monthly Gasoline Activity Schedule [size 29KB, 3 pages, PDF Format] 09/24/01
 

Tax Paid Motor Vehicle Fuels Tax Return

Paper Form
 
Form Title
Date Added
O-MF 1  Tax Paid - Motor Vehicle Fuel Tax Return [size 65KB, 2 pages, PDF Format] This form replaces OMF-1 (51).
05/09/06
MF-R
Motor Vehicle Fuels Tax Schedule of Receipts [196KB, 2 pages, PDF Format] This form replaces MVF-1A and MF-3A.
05/20/09
MF-D
Motor Vehicle Fuels Tax Schedule of Disbursements [size 196KB, 2 pages, PDF Format] This form replaces MVF-1B,  MVF-1B(10A) and MF-3B.
 06/03/09
 

Motor Vehicle Fuels Tax Exemption

Paper Form
Form Title
Date Added
AU-302 Farmer Declaration Motor Vehicle Fuels Tax Exemption [size 54KB, 1 page, PDF Format] 06/12/08
AU-477 Aircraft Owner or Operator Declaration Motor Vehicle Fuels Tax Exemption [size 19KB, 1 page, PDF Format] 01/16/02
 
Monthly Report of Motor Fuel Carrier [size 96KB, 2 pages, PDF Format] Form AU-750 replaces forms AU-750IM, AU-750 CON and AU-750 EX

03/22/05

 
 
 

Petroleum Products Gross Earnings Tax

Paper Form
Form Title
Date Added

OP-161

 Petroleum Products Gross Earnings Tax Return [size 306KB, 4 pages, PDF Format] 

07/03/08

Exempt Petroleum Products Certificate [size 72KB, 2 pages, PDF Format]
07/05
OP-218  Petroleum Products Gross Earnings Tax Certificate [size 87KB, 1 page, PDF Format] 07/11/07
OP-219 Petroleum Products Gross Earnings Tax - Out-of-State Affidavit with Reference to the Sales of Petroleum Products Sold Exclusively for Sale or Use in Another State [size 62KB, 1 page, PDF Format] 07/23/07
AU-550 Application for Credit for Reduced Rate Petroleum Products [size 23KB, 1 page, PDF Format]

10/21/02

 
 

Solid Waste Assessment

Paper Form
Form Title
Date Added

OP-271

Connecticut Solid Waste Assessment Return [size 19KB, 1 page, PDF Format] 04/19/05
 
 

Tobacco Products Tax

 Paper Form
 
Form Title
Date Added
OP-300 Tobacco Products Tax Return [size 275KB, 2 pages, PDF Format] 10/1/09
Schedule A-1 Tobacco Products Tax - Resident Distributor [size 150KB, 1 page, PDF Format] 05/12/09
Schedule A-2 Tobacco Products Tax - Nonresident Distributor [size 149KB, 1 page, PDF Format]  05/12/09 
Schedule A-3 Tobacco Products Tax - Resident Distributor, Record of snuff tobacco products purchased, imported, received or acquired in Connecticut [size 132KB, 1 page, PDF Format]
05/12/09
Schedule A-4 Tobacco Products Tax - Nonresident Distributor, Record of snuff tobacco products purchased, imported, received or acquired in Connecticut [size 132KB, 1 page, PDF Format]
05/12/09
Schedule B Tobacco Products Tax - Record of Tobacco products excluding snuff tobacco products manufactured in Connecticut [size 149KB, 1 page, PDF Format] 05/14/09
Schedule C Tobacco Products Tax - Record of tobacco products excluding snuff tobacco products exported out of Connecticut [size 152KB, 1 page, PDF Format] 05/14/09
Schedule C-1 Tobacco Products Tax - Record of snuff tobacco products exported out of Connecticut or sold to the federal government [size 132KB, 1 page, PDF Format]
05/14/09
Schedule D Tobacco Products Tax - Record of Tobacco products excluding snuff tobacco products sold to the Federal government [size 128KB,1 page, PDF Format]  
05/14/09 
Schedule E Roll-Your-Own Tobacco - Purchased, Acquired or Shipped into Connecticut During the Month [size 244KB, 6 pages, PDF Format]
11/20/08
AU-686 Roll-Your-Own Cigarette Tobacco Product Declaration [size 17KB, 1 page, PDF Format]
09/10/01