Form Reg-14 - Application For Commercial Fisherman Tax Exemption Permit
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1Form REG-14
Department of Revenue Services
For DRS Use Only
State of Connecticut
Application for Commercial Fisherman
Connecticut Tax Registration Number
25 Sigourney St Ste 2
Hartford CT 06106-5032
Tax Exemption Permit
(Rev. 03/10)
Reset Form
Taxpayer Services Number
Conn. Gen. Stat. §12-412 (40)
Print Form
Commercial Fisherman Tax Exemption Permit valid
from _________________ until _________________
Complete the application in blue or black ink only.
Social Security Number (Individual)
Please correct
name and
— — — — — — — —
address if
Federal Employer ID Number (Other)
shown
incorrectly.
Check one:
Check one:
New
Individual
Renewal
Partnership
Name of vessel
Telephone number
Corporation
Start-up
LLC
Business
Home port
structure
LLP
changed
Fiduciary
DMV vessel registration
U.S. Coast Guard documentation number
DEP license number
Form REG-14, Application for Commercial Fisherman Tax Exemption
•
For the second year or, on average, for the two years after
Permit, must be completed and filed with the Department of
the tax exemption permit is issued, not less than 50% of the
Revenue Services (DRS) by June 1 so that DRS can make a
fi sherman’s gross income as reported for federal income tax
determination and issue a permit by the effective date. Your 2009
purposes will be derived from commercial fi shing.
Fisherman Tax Exemption Permit is valid from July 1, 2009, until
If the start-up fi sherman does not meet all of these requirements,
June 30, 2011. If this application is submitted after June 1, the permit
the fi sherman is liable for the sales or use tax that would have been
is valid on the date indicated on the permit. The expiration date for
due without the exemption.
a permit issued to a start-up fi sherman is 24 months from the
date the permit is issued.
A start-up fi sherman is a person who:
•
Was not engaged in commercial fi shing as a trade or business
To qualify for a fi sherman tax exemption permit, an applicant engaged
in the preceding taxable year; or
in commercial fi shing as a trade or business must certify that:
•
For the immediately preceding taxable year or, on average, for
•
At least 50% of last year’s gross income was derived from
the two immediately preceding taxable years, less than 50% of
commercial fi shing; or
the fi sherman’s gross income as reported for federal income tax
•
On average, for the two preceding taxable years, at least 50%
purposes was derived from commercial fi shing.
of your gross income was derived from commercial fi shing.
See Informational Publication 2009(14), Fisherman’s Guide to
Enclose a copy of the applicant’s federal income tax return and all
Sales and Use Taxes and Estimated Income Tax. Visit the DRS
accompanying schedules for the prior year; or
website at to download and print Connecticut
If you meet the 50% gross income requirement by using the
tax forms and publications.
average of the prior two years, enclose copies of the federal
Return this application to Department of Revenue Services, State
income tax returns and all accompanying schedules for the prior
two years.
of Connecticut, Taxpayer Services Division, 25 Sigourney St Ste 2,
Hartford CT 06106-5032.
To qualify for a fi sherman tax exemption permit, a start-up fi sherman
If you operate more than one vessel, attach a separate sheet listing
must satisfy the following requirements:
the name, home port, Department of Motor Vehicles (DMV) vessel
•
A tax exemption permit as a start-up fi sherman must not have
registration, and Department of Environmental Protection (DEP)
been issued previously;
license number for each vessel. If you are not a Connecticut resident
•
The fi sherman intends to carry on commercial fi shing as a trade
and not required to have a DMV vessel registration or a DEP license
or business for at least two years after the exemption permit is
number, leave these lines blank and enter your U.S. Coast Guard
issued; and
documentation number.
Declaration: 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 fi ne of not more than $5,000, or imprisonment for not more than fi ve years, or both.
Applicant’s signature
Title
Date
For DRS Use Only
Commissioner’s
Approved
authorized agent ______________________________________________________________
Disapproved
Title
__________________________________________ Date ______________
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