Form Drs-Ewvr - Electronic Filing And Payment Waiver Request Form (Page 2 of 2) in pdf

Form Drs-Ewvr - Electronic Filing And Payment Waiver Request Form Page 2

Declaration

DECLARATION – I declare under the penalty of law that:

•

I have read and understand the provisions of PS 2011(3);

•

I have answered each question to the best of my knowledge and belief;

•

I have attached all documentation that supports my electronic ﬁ ling and electronic payment waiver request; and

•

I understand that the penalty for willfully delivering a false application to DRS is a ﬁ ne of not more than $5,000, or impris-

onment for not more than ﬁ ve years, or both.

Signature

Print name

Date

Sign

Here.

Title

Additional Information

Before submitting a waiver request, it is important that taxpayers understand that the telephone may be used for the ﬁ ling and

payment of certain taxes. Four types of tax returns may be ﬁ led electronically using the DRS Teleﬁ le system:

Form CT-WH, Withholding Tax Payment Form;

Form CT-941, Connecticut Quarterly Reconciliation of Withholding;

Form OS-114, Sales and Use Tax Return; and

Form OP-210, Room Occupancy Tax Return.

In addition, the Teleﬁ le system may be used to make payment for the following taxes:

• Admission and Dues

• Domestic Insurance

• Room Occupancy

• Alcoholic Beverage

• Dry Cleaning

• Sales & Use

• Attorney Occupational

• Electric Distribution

• Solid Waste

• Business Entity

• Foreign Insurance

• Tobacco Products

• Business Use

• Gas Utilities

• Tourism

• Cable, Satellite, Video

• Health Care Center

• Unrelated Business

• Certiﬁ ed Competitive Video

• Motor Vehicle Fuel

• Payroll Withholding

• Community Antenna

• Petroleum Products

• Nonpayroll Withholding

• Corporation Business

• Railroad

• Diesel Fuel

• Rental Surcharge

For Further Information

Call the DRS during business hours, Monday through Friday:

1-800-382-9463 (Connecticut calls outside the Greater Hartford calling area only); or

860-297-5962 (from anywhere).

TTY, TDD, and Text Telephone users only may transmit inquiries anytime by calling 860-297-4911.

For More Information on EFT

Contact the DRS Electronic Filing Unit:

Online at ct.eft@po.state.ct.us; or

Call 860-297-4973 during business hours, Monday through Friday.

Form DRS-EWVR Back (New 09/11)

Form Drs-Ewvr - Electronic Filing And Payment Waiver Request Form Page 2

Related Articles

Related forms

Related Categories