Connecticut State Department of Revenue Services

Walk-in services at all DRS branch office locations remain suspended. Email DRS at drs@po.state.ct.us. Email the Priority One Taxpayer Assistance Program: DRSPriorityOne_CollectionsAssist@po.state.ct.us. Please check our Frequently Asked Questions page.

2009 Excise Tax Forms
All forms and some DRS publications are in Adobe Acrobat format.  Before viewing or printing these documents you will need Adobe Acrobat Reader 7.0 or higher.    For additional assistance or if you are have trouble downloading a form, visit our Adobe Information page.

Name

Type

Description

Alcohol Beverage Tax/ Alcohol Distributor Tax

AU-933

Form & Inst.

Alcoholic Beverages Tax, Alcoholic Beverages Shipped into Connecticut

BT-4-BW

Form & Inst.

Monthly Report of Custom Bonded Warehouses

BT-5 Schedule A

Form & Inst.

Alcoholic Beverages Tax, Receipt of Tax Free Purchases and Tax Free Returns

BT-5A Schedule A1

Form & Inst.

Alcoholic Beverages Tax in Transit Items

BT-6 Schedule B

Form & Inst.

Alcoholic Beverages Tax Receipt of Tax Paid Purchases and Tax Paid Returns

BT-7 Schedule C

Form & Inst.

Alcoholic Beverages Tax Alcoholic Beverages Shipped Outside of Connecticut

BT-8 Schedule D

Form & Inst.

Alcoholic Beverage Tax, Tax Free Sales in Connecticut and Sales to Other Licensed Distributors

BT-18

Form & Inst.

Alcoholic Beverages Tax Customs Clearance Certificate

BT-20

Form & Inst.

Alcoholic Beverages Tax - Sealed Neck Bottle Destruction Certificate

BT-21

Form & Inst.

Alcoholic Beverages Tax - Exemption Certificate

BT-22

Form & Inst.

Alcoholic Beverages Tax Summary of Inventory of Wholesalers and Manufacturers

BT-22(1)

Form & Inst.

Alcoholic Beverage Tax Inventory Report of Alcohol in Excess of 100 Proof

BT-22(2)

Form & Inst.

Alcoholic Beverages Tax Inventory Report of Alcoholic Beverages

BT-22(3)

Form & Inst.

Alcoholic Beverages Tax Inventory Report of Alcoholic Beverages

BT-22(4)

Form & Inst.

Alcoholic Beverage Tax Inventory Report of Alcoholic Beverages Distilled Liquors

BT-22(5)

Form & Inst.

Alcoholic Beverage Tax Inventory Report of Alcoholic Beverages

BT-22(6)

Form & Inst.

Alcoholic Beverage Tax Inventory Report of Alcoholic Beverages

BT-22(7)

Form & Inst.

Alcoholic Beverage Tax Inventory Report of Alcoholic Beverages

BT-100

Form & Inst.

Application for Permission to Import Into Connecticut Alcoholic Beverages From Within the United States for Personal Consumption

BT-101

Form & Inst.

Application for Permission to Import Into Connecticut Alcoholic Beverages From Outside the United States for Personal Consumption

BT-FW

Form & Inst.

Schedule C - (Farm Wineries) Alcoholic Beverages Tax Wine Shipped Outside of Connecticut

BW-1

Form & Inst.

Alcoholic Beverages Tax Merchandise Placed in a Custom Bonded Warehouse

BW-2

Form & Inst.

Alcoholic Beverages Tax Merchandise Withdrawn From a Custom Bonded Warehouse

Form S&BT

Form & Inst.

Alcoholic Beverages Tax - Payment of Taxes Due on the Importation of Alcoholic Beverages

O-255

Form & Inst.

Wholesale Alcoholic Beverage Tax Return

 
 
Name Type Description

CIGARETTE TAX

Form & Inst. Tax Return for Persons in Possession of Unstamped Cigarettes
AU-930 Form & Inst. Cigarette Inventory Report
CT-15 Form & Inst. Monthly Tax Stamp and Cigarette Report Resident Distributor
CT-15A Form & Inst. Monthly Tax Stamp and Cigarette Report Nonresident Distributor
CT-19 Sch. A Form & Inst. Record of Unstamped Cigarettes Manufactured, Purchased, or Otherwise Acquired
CT-19A Sch. A-1 Form & Inst. Cigarettes Purchased with Connecticut Decals or Stamps Already Affixed
CT-23 Sch. B Form & Inst. Shipments or Unstamped Cigarettes Made to Agencies of the Federal Government or Connecticut State Government
CT-24 Sch. D Form & Inst. Unstamped Cigarettes Transferred to Another Distributor Within Connecticut
CT-25 Sch. C Form & Inst. Sales and Transfers of Unstamped Cigarettes Outside of Connecticut
CT-27 Sch. E Form & Inst. Sales and Transfers of Connecticut-Stamped Cigarettes Into Connecticut
CT-28 Sch. F Form & Inst. Sales and Transfers of Connecticut-Stamped Cigarettes Outside of Connecticut
CT-29 Sch. G Form & Inst. Sales and Transfers of Unstamped Cigarettes to Other Connecticut Distributors
CT-30 Form & Inst. Cigarette Tax Refund Claim Stamps Affixed to Packages
CT-31 Form & Inst. Cigarette and Unaffixed Stamp Inventory Report for Resident Distributors
CT-31A Form & Inst. Cigarette and Unaffixed Stamp Inventory Report for Nonresident Distributors
CT-38 Form & Inst. Record of Cigarette Stamps Purchased Nonresident Distributor
CT-39 Form & Inst. Record of Cigarette Stamps Purchased Resident Distributor
CT-40 Form & Inst. Sales and Transfers of Connecticut Stamped Cigarettes Outside of Connecticut Resident Distributor
CT-50 Form & Inst. Certificate of Cigarette Tax Re-Stamping Credit
Form TPM-5 Form & Inst. Stamper E-Mail Registration Form
O-252 Form & Inst. Order Form For Connecticut Cigarette Tax Stamps
OR-318 Form & Inst. Cigarette Vending Machine Location Change
Schedule H Form & Inst. Cigarette Packages Stamped During the Month
Name Type Description

CIGARETTEmanufacturers

Form TPM-1 Form & Inst. Certification of Compliance and Affidavit by Nonparticipating Manufacturer
Form TPM-2 Form Certification for Listing in the Connecticut Directory as of July 1, 2009
TPM-2 Instructions Instructions to Certification for Listing in the Connecticut Directory as of July 1, 2009
Form TPM-3 Form & Inst. Brand Families Unit Sales Schedule - Sales Made During the Calendar Year 2009
Form TPM-4 Form & Inst. Notice of Appointment of Registered Agent and Registered Agent's Statement
 
Name Type Description

Diesel Fuel Tax Returns

OP-216 Form & Inst. Special Fuel Tax Return
MF-R Form & Inst. Motor Vehicle Fuels Tax Schedule of Receipts - This form replaces DF-1A
MF-D Form & Inst. Motor Vehicle Fuels Tax Schedule of Disbursements  This form replaces and DF-1B and DF-1B(10A)
 
 
 
 
Name Type Description

motor carrier road tax

REG-3MC Form & Inst. 2008 Application Motor Carrier Road Tax
 
 
Name Type Description

motor vehicle fuels tax

O-MF Form & Inst. Motor Vehicle Fuels Tax Return
MF-R Form & Inst. Motor Vehicle Fuels Tax Schedule of Receipts - This form replaces MVF-1A and MF-3A.
MF-D Form & Inst. Motor Vehicle Fuels Tax Schedule of Disbursements - This form replaces MVF-1B,  MVF-1B(10A) and MF-3B
MVF-3 Form & Inst. Terminal Operator's Monthly Gasoline Activity Schedule
 
 
Name Type Description

motor vehicle fuels tax refunds

Form & Inst.
2009 Motor Vehicle Fuels Tax Refund Claim Off Highway, Governmental, & School Bus Use
Form & Inst.
2009 Motor Vehicle Fuels Tax Refund Claim - Farm Use
Form & Inst.
2009 Motor Vehicle Fuels Tax Refund Claim - Motor Bus, Taxicab and Livery
Form & Inst.
2009 Motor Vehicle Fuels Tax Refund Claim - Airport Service (Motor Bus)
Form & Inst.
2009 Motor Vehicle Fuels Tax Refund Claim - Nutrition Program
Form & Inst. 2009 Motor Vehicle Fuels Tax Refund Claim - Commuter Vans
 
Name Type Description

motor vehicle fuels exporter

AU-726 Form & Inst. Motor Vehicle Fuels Exporter Monthly Report - Form AU-726 replaces forms AU-726a and AU-726b
 
Name Type Description

motor vehicle fuels tax exemption

AU-302 Form & Inst. Farmer Declaration Motor Vehicle Fuels Tax Exemption
AU-477 Form & Inst. Aircraft Owner or Operator Declaration Motor Vehicle Fuels Tax Exemption
AU-750 Form & Inst. Monthly Report of Motor Fuel Carrier - Form AU-750 replaces forms AU-750IM, AU-750 CON and AU-750 EX
 
Name Type Description

TOBACCO PRODUCTS TAX

OP-300

 Form & Inst. Tobacco Products Tax Return
Schedule A-1 Form & Inst. Tobacco Products Tax - Resident Distributor
Schedule A-2 Form & Inst. Tobacco Products Tax - Nonresident Distributor
Schedule A-3 Form & Inst. Tobacco Products Tax - Resident Distributor, Record of snuff tobacco products purchased, imported, received or acquired in Connecticut
Schedule A-4 Form & Inst. Tobacco Products Tax - Nonresident Distributor, Record of snuff tobacco products purchased, imported, received or acquired in Connecticut
Schedule B Form & Inst. Tobacco Products Tax - Record of Tobacco products excluding snuff tobacco products manufactured in Connecticut
Schedule C Form & Inst. Tobacco Products Tax - Record of tobacco products excluding snuff tobacco products exported out of Connecticut
Schedule C-1 Form & Inst. Tobacco Products Tax - Record of snuff tobacco products exported out of Connecticut or sold to the federal government
Schedule D Form & Inst. Tobacco Products Tax - Record of Tobacco products excluding snuff tobacco products sold to the Federal government
Schedule E Form & Inst. Roll-Your-Own Tobacco - Purchased, Acquired or Shipped into Connecticut During the Month
Name Type Description

petroleum products gross earnings tax

OP-161

 Form & Inst. Petroleum Products Gross Earnings Tax Return
Form & Inst. Exempt Petroleum Products Certificate
OP-218 Form & Inst. Petroleum Products Gross Earnings Tax Certificate
OP-219 Form & Inst. 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
AU-550 Form & Inst. Application for Credit for Reduced Rate Petroleum Products
Name Type Description

tax paid motor vehicle fuels tax

O-MF 1 Form & Inst. Tax Paid - Motor Vehicle Fuel Tax Return - This form replaces OMF-1 (51)
MF-R Form & Inst. Motor Vehicle Fuels Tax Schedule of Receipts - This form replaces MVF-1A and MF-3A
MF-D Form & Inst. Motor Vehicle Fuels Tax Schedule of Disbursements - This form replaces MVF-1B,  MVF-1B(10A) and MF-3B