Form Au-932 - Inventory Report For Diesel Fuel Form - State Of Connecticut

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Department of Revenue Services
Form AU-932
State of Connecticut
Excise/Public Services Taxes Subdivision
Retail Dealer’s
PO Box 2990
Inventory Report for Diesel Fuel
CT Tax Registration Number
Hartford CT 06104-2990
This form must show the number of gallons of diesel
Gasoline License Number
fuel in the Retail Dealer’s inventory as of close of
business on July 31, 2002.
Federal Employer ID Number
Please see the instructions on the reverse side of this form for
(Rev. 07/02)
information on how to remit payment of tax that may be due.
Please change name and address if shown incorrectly below.
This report is to be filed by
each person licensed
under Section 14-319 of the
Connecticut General Statutes
to sell diesel fuel
and must be filed by
September 1, 2002
This inventory report for diesel fuel must be completed, signed, and filed with the Department of Revenue Services (DRS) by
September 1, 2002. Failure to file this report and pay the tax due shall be sufficient reason to revoke any state license or permit
held by the retail dealer. All retail dealers of diesel fuel must retain a copy of this report and make such report available for
inspection by DRS agents. Please see SN 2002(7), Motor Vehicle Fuels Tax on Diesel Fuel Inventory as of July 31, 2002, or
contact the Excise/Public Services Taxes Subdivision of the Audit Division at 860-541-3225, Monday through Friday, 8:00 a.m. to
5:00 p.m. for additional information or assistance.
1.
Number of Diesel Fuel Pumps:
_______________________
2.
Number of Diesel Fuel Storage Tanks:
_______________________
3.
Tank Capacities:
(1) _________________ (2) _______________ (3) _________________ (4) ___________________
(5) _________________ (6) _______________ (7) _________________ (8) ___________________
4.
Name of Supplier(s): _____________________________________________________________________________________
5.
Schedule of Tank Inventories as of July 31, 2002
Tank
Gauges
Gallons of Diesel Fuel
1
2
3
4
5
6
7
8
6.
Total number of gallons of diesel fuel subject to tax ...................................................................................
7.
Tax due (Multiply Line 6 by 8¢ (.08)) ............................................................................................................
$
8.
If late, interest payment at 1% per month (see instructions) ......................................................................
$
9.
Penalty for late filing (10% of the tax due, or $50, whichever is greater) ....................................................
$
10.
Total amount due (add Lines 7, 8, and 9) ...................................................................................................
$

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