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2010 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
05/2005  
O-255 Form & Inst. Wholesale Alcoholic Beverage Tax Return 12/2006
  

 
Name Type Description Revised

CIGARETTE  TAX

AU-75 Form & Inst. Tax Return for Persons in Possession of Unstamped Cigarettes 10/2009
CT-15 Form & Inst. Monthly Tax Stamp and Cigarette Report Resident Distributor 10/2009
CT-15A Form & Inst. Monthly Tax Stamp and Cigarette Report Nonresident Distributor 10/2009
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 10/2009
CT-31A Form & Inst. Cigarette and Unaffixed Stamp Inventory Report for Nonresident Distributors 10/2009
CT-38 Form & Inst. Record of Cigarette Stamps Purchased Nonresident Distributor 10/2009
CT-39 Form & Inst. Record of Cigarette Stamps Purchased Resident Distributor 10/2009
CT-40 Form & Inst. Sales and Transfers of Connecticut Stamped Cigarettes Outside of Connecticut Resident Distributor 01/2002
O-252 Form & Inst. Order Form For Connecticut Cigarette Tax Stamps 10/2009
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

CIGARETTE manufacturers

Form TPM-1 Form & Inst. 2010 Certification of Compliance and Affidavit by Nonparticipating Manufacturer  03/2011
Form & Inst.
Certification for Listing in the Connecticut Directory as of July 1, 2011
03/2011
Form TPM-3 Form & Inst. 2010 Brand Families Unit Sales Schedule - Sales Made During the Calendar Year 2010 03/2011
Form TPM-4 Form & Inst. Notice of Appointment of Registered Agent and Registered Agent's Statement 03/2006

Name Type Description Revised

Diesel Fuel Tax Returns

OP-216 Form & Inst. Special Fuel Tax Return 06/2009
OP-216 Form & Inst. Special Fuel Tax Return 06/2010
MF-R Form & Inst. Motor Vehicle Fuels Tax Schedule of Receipts - This form replaces DF-1A 05/2009
MF-D Form & Inst. Motor Vehicle Fuels Tax Schedule of Disbursements  This form replaces and DF-1B and DF-1B(10A) 06/2009

 
 
 
Name Type Description Revised

motor carrier road tax

REG-3MC Form & Inst. 2010 Application Motor Carrier Road Tax 12/2010

 
Name Type Description Revised

motor vehicle fuels tax

O-MF Form & Inst. Motor Vehicle Fuels Tax Return 12/2010
MF-R Form & Inst. Motor Vehicle Fuels Tax Schedule of Receipts - This form replaces MVF-1A and MF-3A. 05/2009
MF-D Form & Inst. Motor Vehicle Fuels Tax Schedule of Disbursements - This form replaces MVF-1B,  MVF-1B(10A) and MF-3B 06/2009
MVF-3 Form & Inst. Terminal Operator's Monthly Gasoline Activity Schedule 11/2010
 
Name Type Description Revised

motor vehicle fuels tax refunds

AU-724 Form & Inst. 2010 Motor Vehicle Fuels Tax Refund Claim Off Highway, Governmental, & School Bus Use 7/2010
AU-725 Form & Inst. 2010 Motor Vehicle Fuels Tax Refund Claim - Farm Use 7/2010
AU-736 Form & Inst. 2010 Motor Vehicle Fuels Tax Refund Claim - Motor Bus, Taxicab and Livery 7/2010
AU-737 Form & Inst. 2010 Motor Vehicle Fuels Tax Refund Claim - Airport Service (Motor Bus) 7/2010
AU-738 Form & Inst. 2010 Motor Vehicle Fuels Tax Refund Claim - Nutrition Program 7/2010
AU-741 Form & Inst. 2010 Motor Vehicle Fuels Tax Refund Claim - Commuter Vans 7/2010
 
 
Name Type Description Revised

motor vehicle fuels exporter

AU-726 Form & Inst. Motor Vehicle Fuels Exporter Monthly Report - Form AU-726 replaces forms AU-726a and AU-726b 03/2006
 
Name Type Description Revised

motor vehicle fuels tax exemption

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
AU-750
 
Form & Inst. Monthly Report of Motor Fuel Carrier - Form AU-750 replaces forms AU-750IM, AU-750 CON and AU-750 EX 10/2010

 
Name Type Description Revised

petroleum products gross earnings tax

OP-161 Form & Inst. Petroleum Products Gross Earnings Tax Return 10/2010
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

tax paid motor vehicle fuels tax

O-MF 1 Form & Inst. Tax Paid - Motor Vehicle Fuel Tax Return - This form replaces OMF-1 (51) 05/2006
MF-R Form & Inst. Motor Vehicle Fuels Tax Schedule of Receipts - This form replaces MVF-1A and MF-3A 05/2009
MF-D Form & Inst. Motor Vehicle Fuels Tax Schedule of Disbursements - This form replaces MVF-1B,  MVF-1B(10A) and MF-3B 06/2009

Name Type Description Revised

TOBACCO PRODUCTS TAX

Form & Inst. Tobacco Products Tax Return 09/2009
Schedule A-1 Form & Inst. Tobacco Products Tax - Resident Distributor 05/2009
Schedule A-2 Form & Inst. Tobacco Products Tax - Nonresident Distributor 05/2009
Schedule A-3 Form & Inst. Tobacco Products Tax - Resident Distributor, Record of snuff tobacco products purchased, imported, received or acquired in Connecticut 05/2009
Schedule A-4 Form & Inst. Tobacco Products Tax - Nonresident Distributor, Record of snuff tobacco products purchased, imported, received or acquired in Connecticut 05/2009
Schedule B Form & Inst. Tobacco Products Tax - Record of Tobacco products excluding snuff tobacco products manufactured in Connecticut 05/2009
Schedule C Form & Inst. Tobacco Products Tax - Record of tobacco products excluding snuff tobacco products exported out of Connecticut 05/2009
Schedule C-1 Form & Inst. Tobacco Products Tax - Record of snuff tobacco products exported out of Connecticut or sold to the federal government 05/2009
Schedule D Form & Inst. Tobacco Products Tax - Record of Tobacco products excluding snuff tobacco products sold to the Federal government 05/2009
Schedule E Form & Inst. Roll-Your-Own Tobacco - Purchased, Acquired or Shipped into Connecticut During the Month 11/2008