Form Op-182 - Vending Machine Report Cigarette Distributors And Dealers - Department Of Revenue Services

ADVERTISEMENT

Department of Revenue Services
Form OP-182
State of Connecticut
For Period Ended
PO Box 5034
Vending Machine Report
Hartford CT 06102-5034
Connecticut Tax Registration Number
Cigarette Distributors and Dealers
(Rev. 12/01)
Instructions
– Original –
1. You must file a report even if no machines were acquired or disposed of during this reporting period.
File this copy with the
Department of Revenue Services
2. Penalty: Late filing $50.
For Department Use Only
3. Due Date: 15 days after the filing period shown on this return.
The return must be postmarked on or before the due date.
4. Make check or money order payable to: Commissioner of Revenue Services.
Please check here if your
name or mailing address
has changed and make the
necessary changes.
Number of
Information to Be Reported
Machines
1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6
1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6
1.
Vending machines owned, operated, or stored in Connecticut at the close of the
1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6
1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6
preceding month (Line 5, previous month’s report)
1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6
1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6
1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6
2.
Vending machines purchased, acquired, or brought into Connecticut during the month
1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6
1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6
covered by this report (Enter detail on Schedule A)
1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6
1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6
1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6
1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6
3.
Total accountable machines for month covered by this report (Line 1 plus Line 2)
1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6
1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6
1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6
4.
Vending machines sold or otherwise disposed of during the month covered by this
1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6
1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6
report (Enter detail on Schedule B)
1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6
1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6
1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6
5.
Vending machines owned, operated, or stored in Connecticut at the end of the month
1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6
1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6
covered by this report (Line 3 minus Line 4)
1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8
1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6
1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8
1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8
1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8
1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8
6.
Penalty for late filing ($50 - Add if applicable)
1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6
1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6
1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6
7.
Number of machines reported on Line 5 which were not being operated on location at
1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6
1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6
the end of the month covered by this report
1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6
Declaration: I declare under penalty of law that I have examined this return or document (including any accompanying schedules and
statements) and, to the best of my knowledge and belief, it is true, complete, and correct. I understand that the penalty for willfully
delivering a false return or document to DRS is a fine of not more than $5,000, or imprisonment for not more than five 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.
Taxpayer’s Signature
Title
Date
X
Important: Schedules A and B on reverse side must be filled out if any entries appear on Lines 2 or 4 above.

ADVERTISEMENT

00 votes

Related Articles

Top 20 Happy Easter Cards And Gift Tags To Download For Free
Top Ten Easter Arts And Crafts Activities For Your Kids
Free Easter Coloring Pages And Easter Printables For Your Kids

Related forms

Form Op-424 (drs/n) - Business Entity Tax Return - Connecticut Department Of Revenue Services - 2003 Form Op-424 (drs/n) - Business Entity Tax Return - Connecticut Department Of Revenue Services - 2003 Financial
Form 207-est - Estimated Tax Payment Coupon - First Installment - Connecticut Department Of Revenue Services Form 207-est - Estimated Tax Payment Coupon - First Installment - Connecticut Department Of Revenue Services Financial
Form 207hcc-esa - Estimated Payment Coupon Health Care Center - Connecticut Department Of Revenue Services Form 207hcc-esa - Estimated Payment Coupon Health Care Center - Connecticut Department Of Revenue Services Financial
Form Reg-8 - Application For Farmer Tax Exemption Permit - Ct Department Of Revenue Services Form Reg-8 - Application For Farmer Tax Exemption Permit - Ct Department Of Revenue Services Financial
Form O-252 - Order Form For Connecticut Cigarette Tax Stamps - Connecticut Department Of Revenue Services Form O-252 - Order Form For Connecticut Cigarette Tax Stamps - Connecticut Department Of Revenue Services Financial
Form Wv/cig-709 - Monthly Report For Distributors And/or Wholesalers Of Cigaretts Form Wv/cig-709 - Monthly Report For Distributors And/or Wholesalers Of Cigaretts Financial
Form Wv/cig-709 - Monthly Report For Distributors And/or Wholesalers Of Cigarettes - Internal Auditing Division - Excise Tax Unit Form Wv/cig-709 - Monthly Report For Distributors And/or Wholesalers Of Cigarettes - Internal Auditing Division - Excise Tax Unit Financial
Form Op-424 (drs/n) - Business Entity Tax Return - Connecticut Department Of Revenue - 2013-2014 Form Op-424 (drs/n) - Business Entity Tax Return - Connecticut Department Of Revenue - 2013-2014 Financial
Form Ct-706 - Connecticut Estate Tax Return - Inheritance Tax Section - Department Of Revenue Services - 1997 Form Ct-706 - Connecticut Estate Tax Return - Inheritance Tax Section - Department Of Revenue Services - 1997 Financial
Form Ct-4802 - Transmittal Of Informational Returns Reported Magnetically - Connecticut Department Of Revenue Services Form Ct-4802 - Transmittal Of Informational Returns Reported Magnetically - Connecticut Department Of Revenue Services Financial

Related Categories

Parent category: Financial
Download
Go
Page of 2