Form Au-725a - Motor Vehicle Fuels Tax Refund Claim - 2002 Page 2
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1
2Instructions
Your motor vehicle fuels tax refund claim for gasoline
•
Name and address of the purchaser (which must
used during calendar year 2002 must:
be the name and address of the person or entity
filing the claim for refund);
1.
Be filed with DRS on or before May 31, 2003; and
•
Number of gallons of gasoline purchased;
2.
Include at least 200 gallons of fuel eligible for tax
refund.
•
Price per gallon; and
•
Total amount paid.
Be sure to provide a telephone number where you can
be contacted.
You must retain records that substantiate your refund
claim for at least three years following the filing of the
You must indicate your Connecticut tax registration
claim and make them available to DRS upon request.
number or Social Security Number in the space
provided.
You must include a copy of your current Form
OR-248, Farmer Tax Exemption Permit . Failure to
For all purchases of gasoline listed, you must attach
do so will result in your refund claim being
a copy of each numbered slip or invoice that was issued
reduced by your Connecticut business use tax
at the time of the purchase. The slip or invoice may be
liability.
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);
Additional Information
If you need additional information or assistance, please
Your refund will be applied against any
call the Excise/Public Services Taxes Subdivision at
outstanding DRS tax liability.
860-541-3225, Monday through Friday, 8:00 a.m. to
5:00 p.m. Forms may be downloaded from our Web site
at:
Form AU-725a Back (Rev. 11/02)
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