2012 Excise Tax Forms
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| Name | Type | Description | Revised |
|---|---|---|---|
| AU-933 | Form & Inst. | Alcoholic Beverages Tax, Alcoholic Beverages Shipped into Connecticut | 06/1991 |
| BT-4-BW | Form & Inst. | Monthly Report of Custom Bonded Warehouses | 03/2005 |
| BT-5 Schedule A | Form & Inst. | Alcoholic Beverages Tax, Receipt of Tax Free Purchases and Tax Free Returns | 04/2001 |
| BT-5A Schedule A1 | Form & Inst. | Alcoholic Beverages Tax in Transit Items | 06/2001 |
| BT-6 Schedule B | Form & Inst. | Alcoholic Beverages Tax Receipt of Tax Paid Purchases and Tax Paid Returns | 07/2000 |
| BT-7 Schedule C | Form & Inst. | Alcoholic Beverages Tax Alcoholic Beverages Shipped Outside of Connecticut | 04/2001 |
| BT-8 Schedule D | Form & Inst. | Alcoholic Beverage Tax, Tax Free Sales in Connecticut and Sales to Other Licensed Distributors | 04/2001 |
| BT-18 | Form & Inst. | Alcoholic Beverages Tax Customs Clearance Certificate | 06/2001 |
| BT-20 | Form & Inst. | Alcoholic Beverages Tax - Sealed Neck Bottle Destruction Certificate | 09/2001 |
| BT-21 | Form & Inst. | Alcoholic Beverages Tax - Exemption Certificate | 09/2001 |
| BT-22 | Form & Inst. | Alcoholic Beverages Tax Summary of Inventory of Wholesalers and Manufacturers | 03/2005 |
| BT-22(1) | Form & Inst. | Alcoholic Beverage Tax Inventory Report of Alcohol in Excess of 100 Proof | 09/2001 |
| BT-22(2) | Form & Inst. | Alcoholic Beverages Tax Inventory Report of Alcoholic Beverages | 08/2001 |
| BT-22(3) | Form & Inst. | Alcoholic Beverages Tax Inventory Report of Alcoholic Beverages | 08/2001 |
| BT-22(4) | Form & Inst. | Alcoholic Beverage Tax Inventory Report of Alcoholic Beverages Distilled Liquors | 10/2001 |
| BT-22(5) | Form & Inst. | Alcoholic Beverage Tax Inventory Report of Alcoholic Beverages | 10/2001 |
| BT-22(6) | Form & Inst. | Alcoholic Beverage Tax Inventory Report of Alcoholic Beverages | 09/2001 |
| BT-22(7) | Form & Inst. | Alcoholic Beverage Tax Inventory Report of Alcoholic Beverages | 10/2001 |
| BT-100 | Form & Inst. | Application for Permission to Import Into Connecticut Alcoholic Beverages From Within the United States for Personal Consumption | 03/2005 |
| BT-101 | Form & Inst. | Application for Permission to Import Into Connecticut Alcoholic Beverages From Outside the United States for Personal Consumption | 03/2005 |
| BT-FW | Form & Inst. | Schedule C - (Farm Wineries) Alcoholic Beverages Tax Wine Shipped Outside of Connecticut | 11/2001 |
| BW-1 | Form & Inst. | Alcoholic Beverages Tax Merchandise Placed in a Custom Bonded Warehouse | 05/2002 |
| BW-2 | Form & Inst. | Alcoholic Beverages Tax Merchandise Withdrawn From a Custom Bonded Warehouse | 05/2002 |
| Form S&BT | Form & Inst. | Alcoholic Beverages Tax - Payment of Taxes Due on the Importation of Alcoholic Beverages | 07/2011 |
| O-255 |
Form &
Inst.
|
Wholesale Alcoholic Beverage Tax Return | 07/2011 |
| Name | Type | Description | Revised |
|---|---|---|---|
| AU-75 | Form & Inst. | Tax Return for Persons in Possession of Unstamped Cigarettes | 07/2011 |
| AU-930 | Form & Inst. | Cigarette Inventory Report | 03/2003 |
| CT-15 | Form & Inst. | Monthly Tax Stamp and Cigarette Report Resident Distributor | 07/2011 |
| CT-15A | Form & Inst. | Monthly Tax Stamp and Cigarette Report Nonresident Distributor | 07/2011 |
| CT-19 Sch. A | Form & Inst. | Record of Unstamped Cigarettes Manufactured, Purchased, or Otherwise Acquired | 10/2005 |
| CT-19A Sch. A-1 | Form & Inst. | Cigarettes Purchased with Connecticut Decals or Stamps Already Affixed | 10/2005 |
| CT-23 Sch. B | Form & Inst. | Shipments or Unstamped Cigarettes Made to Agencies of the Federal Government or Connecticut State Government | 06/2007 |
| CT-24 Sch. D | Form & Inst. | Unstamped Cigarettes Transferred to Another Distributor Within Connecticut | 06/2007 |
| CT-25 Sch. C | Form & Inst. | Sales and Transfers of Unstamped Cigarettes Outside of Connecticut | 06/2007 |
| CT-27 Sch. E | Form & Inst. | Sales and Transfers of Connecticut-Stamped Cigarettes Into Connecticut | 06/2007 |
| CT-28 Sch. F | Form & Inst. | Sales and Transfers of Connecticut-Stamped Cigarettes Outside of Connecticut |
06/2007 |
| CT-29 Schedule G | Form & Inst. | Sales and Transfers of Unstamped Cigarettes to Other Connecticut Distributors | 07/2007 |
| CT-30 | Form & Inst. | Cigarette Tax Refund Claim Stamps Affixed to Packages | 07/2007 |
| CT-31 | Form & Inst. | Cigarette and Unaffixed Stamp Inventory Report for Resident Distributors | 07/2011 |
| CT-31A | Form & Inst. | Cigarette and Unaffixed Stamp Inventory Report for Nonresident Distributors | 07/2011 |
| CT-38 | Form & Inst. | Record of Cigarette Stamps Purchased Nonresident Distributor | 07/2011 |
| CT-39 | Form & Inst. | Record of Cigarette Stamps Purchased Resident Distributor | 07/2011 |
| CT-40 | Form & Inst. | Sales and Transfers of Connecticut Stamped Cigarettes Outside of Connecticut Resident Distributor | 01/2002 |
| CT-50 | Form & Inst. | Certificate of Cigarette Tax Re-Stamping Credit | 04/2005 |
| Form TPM-5 | Form & Inst. | Stamper E-Mail Registration Form | 03/2006 |
| O-252 | Form & Inst. | Order Form For Connecticut Cigarette Tax Stamps | 07/2011 |
| OR-318 | Form & Inst. | Cigarette Vending Machine Location Change | 09/2009 |
| Schedule H | Form & Inst. | Cigarette Packages Stamped During the Month | 03/2007 |
| Name | Type | Description | Revised |
|---|---|---|---|
| Form TPM-1 | Form & Inst. | 2012 Certification of Compliance and Affidavit by Nonparticipating Manufacturer | 04/2013 |
|
Form & Inst.
|
Certification for Listing in the Connecticut Directory as of July 1, 2013
|
04/2013
|
|
| Form TPM-3 | Form & Inst. | 2012 Brand Families Unit Sales Schedule - Sales Made During the Calendar Year 2012 | 04/2013 |
| Form TPM-4 | Form & Inst. | Notice of Appointment of Registered Agent and Registered Agent's Statement | 03/2006 |
| Name | Type | Description | Revised |
|---|---|---|---|
| OP-216 | Form & Inst. | Special Fuel Tax Return | 07/2011 |
| OP-216 | Form & Inst. | Special Fuel Tax Return | 07/2012 |
| MF-R | Form & Inst. | Motor Vehicle Fuels Tax Schedule of Receipts | 05/2009 |
| MF-D | Form & Inst. | Motor Vehicle Fuels Tax Schedule of Disbursements | 06/2009 |
|
Gasoline Tax - See Motor Vehicle Fuels Tax |
| Name | Type | Description | Revised |
|---|---|---|---|
| O-MF | Form & Inst. | Motor Vehicle Fuels Tax Return | 12/2010 |
| MF-R | Form & Inst. | Motor Vehicle Fuels Tax Schedule of Receipts | 05/2009 |
| MF-D | Form & Inst. | Motor Vehicle Fuels Tax Schedule of Disbursements | 06/2009 |
| MVF-3 | Form & Inst. | Terminal Operator's Monthly Gasoline Activity Schedule | 11/2010 |
| Name | Type | Description | Revised |
|---|---|---|---|
| Form & Inst. | 2012 Motor Vehicle Fuels Tax Refund Claim Off Highway, Governmental, & School Bus Use | 1/2013 | |
| AU-725 | Form & Inst. | 2012 Motor Vehicle Fuels Tax Refund Claim - Farm Use | 7/2012 |
| AU-736 | Form & Inst. | 2012 Motor Vehicle Fuels Tax Refund Claim - Motor Bus, Taxicab and Livery | 7/2012 |
| AU-737 | Form & Inst. | 2012 Motor Vehicle Fuels Tax Refund Claim - Airport Service (Motor Bus) | 7/2012 |
| AU-738 | Form & Inst. | 2012 Motor Vehicle Fuels Tax Refund Claim - Nutrition Program | 7/2012 |
| AU-741 | Form & Inst. | 2012 Motor Vehicle Fuels Tax Refund Claim - Commuter Vans | 7/2012 |
| Name | Type | Description | Revised |
|---|---|---|---|
| AU-726 | Form & Inst. | Motor Vehicle Fuels Exporter Monthly Report | 03/2006 |
| Name | Type | Description | Revised |
|---|---|---|---|
| AU-302 | Form & Inst. | Farmer Declaration Motor Vehicle Fuels Tax Exemption | 06/2008 |
| AU-477 | Form & Inst. | Aircraft Owner or Operator Declaration Motor Vehicle Fuels Tax Exemption | 01/2002 |
| Form & Inst. | |||
| Name | Type | Description | Revised |
|---|---|---|---|
| OP-161 | Form & Inst. | Petroleum Products Gross Earnings Tax Return | 05/2012 |
| OP-161 Schedule A | Form & Inst. | Schedule to use when the sales price is in excess of $3.00 per gallon | 04/2012 |
| OP-161 Schedule B | Form & Inst. | Schedule to use when the sales price is in excess of $3.225 per gallon | 04/2012 |
| CERT-116 | Form & Inst. | Exempt Petroleum Products Certificate | 7/2008 |
| OP-218 | Form & Inst. | Petroleum Products Gross Earnings Tax Certificate | 10/2010 |
| OP-219 | Form & Inst. | Petroleum Products Gross Earnings Tax - Gross Earnings - Out-of-State Declaration With Reference to the Sales of Petroleum Products Sold Exclusively for Sale or Use in Another State | 10/2010 |
| Name | Type | Description | Revised |
|---|---|---|---|
| O-MF 1 | Form & Inst. | Tax Paid - Motor Vehicle Fuel Tax Return | 05/2006 |
| MF-R | Form & Inst. | Motor Vehicle Fuels Tax Schedule of Receipts | 05/2009 |
| MF-D | Form & Inst. | Motor Vehicle Fuels Tax Schedule of Disbursements | 06/2009 |
| Name | Type | Description | Revised |
|---|---|---|---|
| OP-300 | Form & Inst. | Tobacco Products Tax Return | 10/2011 |
| Schedule A-1 | Form | Tobacco Products Tax - Resident Distributor | 08/2011 |
| Schedule A-2 | Form | Tobacco Products Tax - Nonresident Distributor | 08/2011 |
| Schedule A-3 | Form | Tobacco Products Tax - Resident Distributor, Record of snuff tobacco products purchased, imported, received or acquired in Connecticut | 05/2009 |
| Schedule A-4 | Form | Tobacco Products Tax - Nonresident Distributor, Record of snuff tobacco products purchased, imported, received or acquired in Connecticut | 05/2009 |
| Schedule A-5 | Form | Tobacco Products Tax - Record of cigars purchased, imported, received or acquired in Connecticut | 10/2011 |
| Schedule C | Form | Tobacco Products Tax - Record of tobacco products excluding snuff tobacco products exported out of Connecticut | 08/2011 |
| Schedule C-1 | Form | Tobacco Products Tax - Record of snuff tobacco products exported out of Connecticut or sold to the federal government | 05/2009 |
| Schedule C-2 | Form | Tobacco Product Tax - Cigars | 08/2011 |
| Schedule D | Form | Tobacco Products Tax - Record of Tobacco products excluding snuff tobacco products sold to the Federal government | 08/2011 |
| Schedule E | Form | Roll-Your-Own Tobacco - Purchased, Acquired or Shipped into Connecticut During the Month | 11/2008 |