Ct Ifta 2 Form – Fill Out and Use This PDF

6. Name and home address of owner, partner, corporate offi cer, or LLC member

ZIP plus 4

SSN

7. Names and home addresses of other partners, corporate offi cers, or LLC members

ZIP plus 4

SSN

Name

Address

Application for Motor Carrier Road Tax.

Qualified motor vehicles are those used, designed, or maintained for transportation of persons or property and:

•Have two axles and a gross vehicle weight or registered gross vehicle weight exceeding 26,000 pounds or 11,797 kilograms;

•Have three or more axles regardless of weight; or

•Are used in combination and the combined gross vehicle weight or registered gross vehicle weight exceeds 26,000 pounds or 11,797 kilograms.

The term qualified motor vehicle does not include recreational vehicles.

You may not transfer International Fuel Tax Agreement (IFTA) decals to another person or from one vehicle to another.

Line Instructions

Line 1: Check the appropriate box for a new account, registration of additional vehicles, or other reasons such as, renewal, replacement decals, or change of ownership. If there has been a change of identity, form of ownership, or organization, you must apply for a new CT-IFTA number. If you are registered with the Connecticut Department of Revenue Services (DRS), enter your Connecticut Tax Registration Number in the upper right corner of this form.

Line 2: Print the name of the owner, partnership, corporation, limited liability company (LLC) and enter its Federal Employer Identification Number (FEIN). Enter proprietor’s name if a sole proprietorship. If it is a sole proprietorship with no employees and is not required to have a FEIN, enter the proprietor’s Social Security Number (SSN).

Line 3: Print the trade or registered name if different from Line 2. A trade or registered name is the name under which business is done, but not necessarily the owner’s name. Example: If John Travel is the proprietorship entered on Line 2, but John T. Trucker Co. is the name chosen by John Travel for his business, then John T. Trucker Co. is the name he would enter on Line 3.

Line 4: Print the physical location of the business. Do not use PO Boxes or rural route numbers. Indicate where the business is actually located.

Line 5: Print the mailing address of the business if different from Line 4. Complete only if mailing and business addresses are different.

Line 6: Print the name and home address of the proprietor, partner, corporate officer, or LLC member. Identify the proprietor if a sole proprietorship, partners if a partnership, or offi cers if a corporation.

Line 7: Print the names and home addresses of other partners, corporate offi cers, or LLC members.

Line 8: Check the appropriate box to indicate the type of business. If Other, attach an explanation.

Line 8a: Enter the name of the state under the laws of which the business is organized.

Line 9: Check the appropriate box to indicate whether you are currently or were previously registered with another jurisdiction for IFTA. If you check Yes, enter the name of the jurisdiction you are currently or were previously registered in for IFTA.

Line 10: Provide details of your business operations or activities.

Line 11: Check the appropriate box to indicate if you store fuel in bulk. If you check Yes, list the city and state where the fuel is stored.

Line 11a: Enter an X next to the type(s) of fuel used in your qualifi ed motor vehicles.

Line 12: Enter the name(s) and address(es) of the lessor(s) who lease vehicles to you. Attach a list if needed.

Line 13: Enter an X next to each jurisdiction in which you are likely to operate.

Line 14: Indicate the number of IFTA qualified motor vehicles requiring decals. Two numbered decals will be issued for each qualified motor vehicle. One decal must be placed on the lower rear exterior of the passenger side cab door and the matching decal must be placed on the lower rear exterior of the driver side cab door of each vehicle.

This application must be signed by an owner, partner, corporate offi cer, or LLC member.

Failure to complete all items on this application may result in a delay in processing your application.

Make your check payable to Commissioner of Revenue Services. DRS may submit your check to your bank electronically.

Return the completed application with full payment to:

Department of Revenue Services

Registration Section

PO Box 2937

Hartford CT 06104-2937

If you need assistance or additional information about applications or registering your vehicle(s), call the DRS Registration Section at 860-297-4870, Monday through Friday, 8:30 a.m. to 4:30 p.m.

For More Information

Call DRS during business hours, Monday through Friday:

•1-800-382-9463 (Connecticut calls outside the Greater Hartford calling area only); or

•860-297-5962 (from anywhere).

TTY, TDD, and Text Telephone users only may transmit inquiries anytime by calling 860-297-4911.

Forms and Publications: Visit the DRS website at www.ct.gov/DRS to download and print Connecticut tax forms and publications.