Form Au-331 - Controlling Interest Transfer Taxes Informational Return
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1Department of Revenue Services
Form AU-331
Received by DRS
State of Connecticut
Controlling Interest Transfer Taxes
PO Box 5031
Hartford CT 06102-5031
Informational Return
(Rev. 08/10)
Complete this return in blue or black ink only.
Check if this is an amended return.
Read instructions below before completing this return.
Part I - Information concerning the entity in which controlling interest was transferred
1. Name
2. Federal Employer Identifi cation Number (FEIN)
3. Address
4. Date controlling interest transferred
5. Interest transferred
Part II - Information concerning the transferor(s)
6. Name
7. FEIN or Social Security Number (SSN)
8. Address
Part III - Information concerning the transferee(s)
9. Name
10. FEIN or SSN
11. Address
Declaration: 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 or document to the Department of Revenue
Services (DRS) is a fi ne of not more than $5,000, or imprisonment for not more than fi ve 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.
Signature of principal offi cer
Title
Date
Sign Here
Print name of principal offi cer
Telephone number
Keep a copy
(
)
of this return
Paid preparer’s signature
Date
Preparer’s SSN or PTIN
for your
records.
Firm name and address
FEIN
Instructions
Complete this return in blue or black ink only.
Line 7: If the transferor is an individual, enter his or her SSN. If the
transferor is other than an individual, enter its FEIN.
Form AU-331, Controlling Interest Transfer Taxes Informational Return,
Line 8: If the transferor is an individual, enter his or her home
must be fi led by any entity in which a controlling interest is transferred
address. If the transferor is other than an individual, enter its
if the transfer is subject to the controlling interest transfer tax or taxes.
mailing address.
The transferor of a controlling interest is subject to the tax or taxes and
must fi le Form AU-330, Controlling Interest Transfer Taxes Return. See
Line 9: Enter name of transferee. If more than one transferee,
Special Notice 2003(11), 2003 Legislation Affecting the Controlling
attach a schedule providing the name, address, and FEIN of each
Interest Transfer Taxes.
transferee.
A controlling interest is more than 50% of the total combined voting power
Line 10: If the transferee is an individual, enter his or her SSN. If
of all classes of stock in the case of a corporate entity and more than 50%
a transferee is other than an individual, enter its FEIN.
of the capital, profi ts, or benefi cial interest in the case of a noncorporate
entity such as a partnership, limited liability company, or trust. A controlling
Line 11: If the transferee is an individual, enter his or her home
interest may be transferred in one transfer or in a series of transfers.
address.
Line 4: Enter the date on which the interest was transferred. This return
Mail to: Department of Revenue Services
is due on or before the last day of the month following the month in which
State of Connecticut
the controlling interest was transferred. When the controlling interest is
25 Sigourney St Ste 2
transferred in a series of transfers, enter the date in which the interest
PO Box 5031
transferred, in the aggregate, is more than 50%.
Hartford CT 06102-5031
Line 6: Enter name of transferor. If more than one transferor, attach a
schedule providing the name, address, and FEIN of each transferor.
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