Form Reg 3 Mc PDF Details

In order to protect investors, the SEC has put in place Form REG 3. This form is used to collect information about the officers and directors of a company. By completing and submitting this form, you are providing important information about your company's management that will be used by the SEC in their oversight of the market. It is important to remember that this form must be completed accurately and fully in order to avoid potential penalties.

QuestionAnswer
Form NameForm Reg 3 Mc
Form Length2 pages
Fillable?No
Fillable fields0
Avg. time to fill out30 sec
Other namesct motor carrier road tax, IFTA, Connecticut, proprietorship

Form Preview Example

Department of Revenue Services

REG-3-MC

State of Connecticut

 

PO Box 2937

Application for

Hartford CT 06104-2937

Motor Carrier Road Tax

(Rev. 10/10)

 

Do not use this application to request International Fuel Tax Agreement (IFTA) decals. Complete CT-IFTA-2 for IFTA decals.

Use this application to register new accounts or to register additional vehicles on existing accounts. Complete this application in blue or black ink only. Type or print all entries clearly.

Read the instructions printed on the back before completing this application.

Calendar Year 2011

If registered, enter

Connecticut Tax Registration Number

Check if your mailing address has changed and indicate new address.

1.Reason for applying

New account

Registration of additional vehicles

Other (Explain)

2.

Owner’s name, partnership name, corporate name, or limited liability company (LLC) name

 

Federal Employer ID Number (FEIN)

 

 

 

 

 

 

 

3.

Trade name or registered name (if different from Line 2)

 

 

 

Social Security Number (SSN)

 

 

 

 

 

 

 

 

 

4.

Physical location of this business: PO Box is not acceptable.

ZIP code

 

Telephone number

 

 

 

 

 

 

(

)

 

 

 

 

 

 

 

 

5.

Business mailing address (if different from Line 4)

 

ZIP code

 

United States DOT Number

 

 

 

 

 

 

 

6.

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

ZIP code

 

SSN

 

 

 

 

 

 

 

 

 

 

 

7.

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

ZIP code

 

SSN

 

 

 

 

 

 

 

 

 

 

 

8.

Type of ownership (If other, attach explanation.)

Other

 

 

 

 

 

 

Sole proprietor

General partnership

Limited partnership

Corporation

S corporation

 

Limited liability company (LLC)

Single member LLC

 

 

 

 

 

 

8a. Organized under laws of what state?

 

Check if taxed as a corporation

Check if taxed as a corporation

 

 

 

 

 

 

 

 

 

 

 

9.

Are you currently registered with the Connecticut Department of Revenue Services (DRS)?

Yes

No

 

 

 

If Yes, enter your Connecticut Tax Registration Number in the space provided in the upper right corner of this application.

 

 

 

 

 

 

 

10. Describe in detail the type of business you operate.

 

 

 

 

 

 

You are applying for identifi cation decals for calendar year 2011. Your decals will expire December 31, 2011.

11. List lessors who lease vehicles to you. Attach additional sheets if needed.

Name

Address

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Fees: This section must be

completed by all applicants. 12. Enter total number of decal sets requested.

Number of qualifi ed vehicles

Fee

X $10 =

Amount due

Make check payable to Commissioner of Revenue Services.

Declaration: The undersigned represents that: (1) All of the applicant’s qualified motor vehicles will be operated solely within Connecticut during calendar year 2011;

(2)All of the motor fuel to be used in operating such vehicles will be purchased solely within Connecticut during calendar year 2011; and (3) Connecticut motor vehicle fuels tax will be paid on all such purchases during calendar year 2011. The undersigned agrees to report immediately to DRS if any of these three representations are no longer true or accurate. I declare under penalty of law that I have examined this application (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 or document to DRS is a fine of not more than $5,000, or imprisonment for not more than five years, or both. I understand motor carrier road tax decals may not be transferred by me to another person or from one vehicle to another.

Signature of owner, partner, LLC member, or corporate officer

Title

Date

Decals are not transferable from vehicle to vehicle or from company to company

REG-3-MC

Instructions

Complete this application blue or black ink only.

Complete form REG-3-MC, Application for Motor Carrier Road Tax, to apply for calendar year 2011 motor carrier 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 for each vehicle.

QUALIfiED MOTOR VEHICLES subject to the Connecticut motor carrier road tax 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.

For Connecticut motor carrier road tax purposes, the term qualified motor vehicle does not include recreational vehicles not used in connection with any trade or business.

Do not use this motor carrier road tax application to request International Fuel Tax Agreement (IFTA) decals. To request IFTA decals, complete CT-IFTA-2, Application for International Fuel Tax Agreement (IFTA) License Connecticut Carrier.

Instructions

Line 1. Indicate new account, registration of additional vehicles, or other reason (renewal, replacement decals, or change of ownership). If there has been any change of identity or form of ownership or organization, such as the addition of a new partner or the incorporation of the business, you must use form REG-3-MC to apply for a new Connecticut Tax Registration 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, limited liability company (LLC), or corporate name. Enter proprietor’s name if a sole proprietorship.

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. PO boxes are not acceptable. Indicate where the business is actually located.

Line 5. Printthemailingaddressofthebusinessif differentfrom Line 4. Only complete this if different from the business address listed above.

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

Line 7. Print the home address of partner, LLC member, or corporate officer.

Line 8. Indicate the type of business and enter its Federal Employer Identification Number (FEIN) in the spaces provided on Line 2. 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) in the spaces provided on Line 6 and Line 7. If Other, attach an explanation.

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

Line 9. Indicate whether you are registered with DRS. If you checked Yes on Line 9, enter your Connecticut Tax Registration Number in the space provided in the upper right hand corner of this form.

Line 10. Provide details of your business operations.

Line 11. Provide the names and addresses of the lessors you lease vehicles from.

Line 12. Indicate the number of qualified motor vehicles requiring decals and multiply by $10. Enter the amount due.

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 check payable to Commissioner of Revenue Services. DRS may submit your check to your bank electronically. Do not send cash. Return the completed application with full payment.

Mail 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 DRS Registration Section at 860-297-4870, Monday through Friday, 8:30 a.m. to 4:30 p.m.

REG-3-MC Back (Rev. 10/10)

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2011 conclusion process detailed (step 1)

2. Once your current task is complete, take the next step – fill out all of these fields - S corporation, Type of ownership If other attach, Other Limited partnership, Sole proprietor Limited, General partnership, Corporation, a Organized under laws of what, Yes No, If Yes enter your Connecticut Tax, Describe in detail the type of, You are applying for identifi, List lessors who lease vehicles, Name Address, Fees This section must be, and Number of qualifi ed vehicles with their corresponding information. Make sure to double check that everything has been entered correctly before continuing!

Stage # 2 for completing 2011

A lot of people often make mistakes while filling in Describe in detail the type of in this area. Ensure that you review what you enter right here.

3. Within this stage, look at Fees This section must be, Enter total number of decal sets, Number of qualifi ed vehicles, Fee, Amount due, Make check payable to Commissioner, Declaration The undersigned, Signature of owner partner LLC, Title, Date, and Decals are not transferable from. Each one of these need to be taken care of with greatest precision.

Guidelines on how to fill out 2011 portion 3

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