Form CT-3911 at a glance
What it is: Form CT-3911, Taxpayer Statement Regarding State of Connecticut Tax Refund, is a form of the Department of Revenue Services, State of Connecticut.
Where and when to file: File Form CT-3911 using myconneCT at portal.ct.gov/DRS-myconneCT.
A filled-in Form CT-3911 example: a refund check that never arrived
How to fill out Form CT-3911, box by box
Type of return filed
Prior to completing Part 1, verify with your bank that the refund has not been deposited.
Under Part 1 Refund Information, box 1 is the Type of return filed: Individual, Business or Other. Fill in Form, Tax period and Date filed.
Type of refund requested
Box 2 is the Type of refund requested: Direct Deposit or Check.
If Direct Deposit, enter your bank information: Bank name and Account #.
If Check, identify if the refund check was: Never received; or Lost, stolen or destroyed.
Your name and TIN, and the spouse on a joint return
Print your name, Taxpayer Identification Number (TIN), and mailing address. For individuals, the TIN is your Social Security Number (SSN); for businesses, the TIN is your Connecticut Tax Registration Number or Federal Employer Identification Number (FEIN). Check the box to indicate which TIN you are listing. If you filed a joint return, you must complete Lines 1, 2, and 3. Box 1 is Your name (or business name); enter your TIN and check the appropriate box: SSN, CT Reg. No. or FEIN.
Box 2 is Spouse's name (if joint return) and Spouse's SSN.
Address and telephone number
Box 3 is Address (number and street), Apt. no., PO Box, City, State, ZIP Code and Home/cell telephone number.
Part 3 Signature
In Part 3 Signature, sign exactly as you signed the original return. For a joint return, both you and your spouse must sign. For business returns, the signature must be of the person authorized to sign the check.
Under Part 3 Signature, sign Your signature and fill in Title (if business return) and Date; sign Spouse's signature (if joint return) and fill in Date.
Declaration: the penalty for willfully delivering a false return or document to DRS is a fine of not more than $5,000, or imprisonment for not more than five years, or both. (checked November 2, 2026)
More rules for Form CT-3911
Use Form CT-3911 to report a missing or stolen Connecticut tax refund that was a direct deposit or issued as a check.
Attach copies of any correspondence received from DRS concerning this refund to Form CT-3911.
The Department of Revenue Services (DRS) will provide information in writing concerning your refund. If DRS determines that your refund check was cashed, a copy of the cashed check will be mailed to you. If DRS determines that your refund check was not cashed, a stop payment will be placed on the original check and a replacement check will be mailed to you.
If you do not receive any information from DRS within six weeks after filing Form CT-3911, call DRS Monday through Friday, 8:30 a.m. to 4:30 p.m. at 800-382-9463 (Connecticut calls outside the Greater Hartford calling area only) or 860-297-5962 (from anywhere).
Common questions about Form CT-3911
Where do I file it?
File Form CT-3911 using myconneCT at portal.ct.gov/DRS-myconneCT.
Sources
[1] Form CT-3911 (Rev. 12/23), Taxpayer Statement Regarding State of Connecticut Tax Refund, Department of Revenue Services, State of Connecticut (the Official source link on this page).