If you are a Connecticut taxpayer and have been doing business in the state, you may need to file Form AU 738. This form is used to report income from sources within and outside of Connecticut, including income from businesses, investments, and rentals. The deadline for filing this form is April 15th, so be sure to get started on it as soon as possible. Make sure you understand all the requirements for filing Form AU 738 so that you can submit the information correctly and on time. For more information, consult a tax professional or check out the instructions for Form AU 738 online.
| Question | Answer |
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| Form Name | Connecticut Form Au 738 |
| Form Length | 2 pages |
| Fillable? | No |
| Fillable fields | 0 |
| Avg. time to fill out | 30 sec |
| Other names | au 738 dept of revenue services excise taxes unit ct form |
Department of Revenue Services |
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Fuel Type |
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State of Connecticut |
Motor Vehicle Fuels Tax Refund Claim |
Diesel |
(Gasoline - Gasohol) |
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Excise Taxes Unit |
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Motor Vehicle Fuels |
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25 Sigourney Street |
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Nutrition Program |
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Claim Type |
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You must check the appropriate fuel type box on the right. |
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Hartford CT |
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Refund claims must be filed on or before May 31, 2005, for |
Nutrition Program |
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(Rev. 09/04) |
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fuel used during calendar year 2004. |
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Name of Claimant (Type or print) |
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Period of Claim in Calendar Year |
2004 |
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____/____ through ____/____ |
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Telephone Number |
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CT Tax Registration Number |
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Number and Street |
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FEIN |
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City or Town |
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SSN |
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State |
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ZIP+4 |
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Due on or before |
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May 31, 2005 |
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Type of Business |
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Location of Records (if different from above) |
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DRS use only |
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Schedule A Statement of Motor Vehicle Fuel Purchases. Receipts must be attached. |
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Date |
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Name of Supplier |
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Gallons of Fuel |
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Name of Supplier |
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Gallons of Fuel |
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Total (Round to the nearest whole gallon.) |
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Schedule B Computation of net refund. |
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1. |
Total miles for period |
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1. |
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2. |
Total fuel gallons for period (Enter the total number of fuel gallons from Schedule A) |
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Average miles per gallon (Divide Line 1 by Line 2) |
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3. |
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4. |
Total miles in delivery vehicles that are used exclusively for the delivery of meals to senior citizens |
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5. |
Refund gallons (Divide Line 4 by Line 3) |
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5. |
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6. |
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Tax refund claimed (Multiply Line 5 by _____ per gallon. (See refund rate table on reverse side for appropriate rate) |
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$ |
.00 |
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I declare under penalty of law that I have examined this return (including any accompanying schedules and statements) and, to the best of my knowledge and belief, it is true, complete, and correct. I understand the penalty for willfully delivering a false return to DRS is a fine of not more than $5,000, or imprisonment for not more than five years, or both. The declaration of a paid preparer other than the taxpayer is based on all information of which the preparer has any knowledge.
Taxpayer Signature |
Title |
Date |
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Paid Preparer Signature |
Telephone Number |
Date |
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Print Preparer Name |
Preparer’s Address |
Preparer’s SSN or PTIN |
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Instructions
Your motor vehicle fuels tax refund claim for fuel used during calendar year 2004 must:
1.Be filed with Department of Revenue Services (DRS) on or before May 31, 2005; and
2.Involve at least 200 gallons of fuel eligible for tax refund.
The appropriate fuel type box must be marked on the front of this form in order to process this claim. You must file a separate Form
Be sure to provide a telephone number where you can be contacted.
You must indicate your Connecticut tax registration number or Social Security Number in the space provided.
For all purchases of fuel listed, you must attach a copy of each numbered slip or invoice issued at the time of the purchase. The slip or invoice may be the original or a photocopy and must show the:
•Date of purchase;
•Name and address of the seller (which must be printed or rubber stamped on the slip or invoice);
•Name and address of the purchaser (which must be the name and address of the person or entity filing the claim for refund);
•Number of gallons of fuel purchased;
•Price per gallon;
•Total amount paid; and
•If payment is made within a discounted period, provide proof of amount paid.
You must retain records to substantiate your refund claim for at least three years following the filing of the claim and make them
Table of Motor Vehicle Fuels Tax Refund Rates for 2004
for Nutrition Program
Diesel January 1, 2004 |
through |
December 31, 2004 |
26¢ |
per Gallon |
Motor Vehicle Fuels |
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January 1, 2004 |
through |
December 31, 2004 |
25¢ |
per Gallon |
Note: You must file a separate Form
available to DRS upon request.
Rounding Off to Whole Dollars: You must round off cents to the nearest whole dollar on your motor vehicle fuels tax refund claim. Round down to the next lowest dollar all amounts that include 1 through 49 cents. Round up to the next highest dollar all amounts that include 50 through 99 cents. However, if you need to add two or more amounts to compute the total to enter on a line, include cents and round off only the total.
Example: Add two amounts ($1.29 + $3.21) to compute the total ($4.50) to enter on a line. $4.50 is rounded to $5.00 and entered on the line.
You must attach a copy of your contract with your local area agency on aging as evidence of your eligibility to provide Title
Mail the completed refund application to: Department of Revenue Services State of Connecticut
Excise Taxes Unit
25 Sigourney Street Hartford CT
Additional Information
If you need additional information or assistance, please call the Excise Taxes Unit at
www.ct.gov/DRS
Your refund will be applied against any outstanding DRS tax liability.
Form