Form Op-186 - Connecticut Individual Use Tax Return
ADVERTISEMENT
1State of Connecticut
Department of Revenue Services
For Calendar Year
____
PO Box 2973
Hartford CT 06104-2973
Connecticut Individual Use Tax Return
(Rev. 11/99)
For the year January 1 -
December 31, 19 ___
Your First Name and Middle Initial
Last Name
Your Social Security Number
• •
• •
__ __ __
__ __
__ __ __ __
• •
• •
If a JOINT Return, Spouse’s First Name and Middle Initial
Last Name
Spouse’s Social Security Number
• •
• •
__ __ __
__ __
__ __ __ __
• •
• •
Home Address
Number and Street
PO Box
City, Town or Post Office
State
ZIP Code
Use this form to report purchases of goods or services subject to Connecticut use tax for any calendar year. You may use this form
to report either a single transaction or multiple transactions for the same calendar year. (Instead of using this form, you may use Line 15 on
or Line 7 on
to report your use tax.)
Enter your name and Social Security Number at the top of this form, and if applicable, your spouse’s name and Social Security Number. You
may file either a separate or a joint return regardless of your filing status for income tax purposes.
Enter the last 2 digits of the calendar year for which you are filing this return. You may file more than one form for a given calendar year
but do not combine transactions for different years.
Column 5 -
Multiply the purchase price in Column 4 by 6% (.06)
Column 1 - Enter the month, day and year of the purchases.
or the applicable rate, and enter the result.
Column 2 - Enter a brief description of taxable items or services
Column 6 - Enter the tax, if any, paid to another jurisdiction on
purchased, such as jewelry, a boat, etc.
the taxable item purchased.
Column 3 -
Enter the name of the retailer from which the item
Column 7 - Subtract the amount entered in Column 6 from the
or service was purchased.
amount entered in Column 5 and enter the
Column 4 - Enter the purchase price.
difference in Column 7. Calculate Total Amount Due
(If less than zero, enter 0, and do not file this form).
Column 1
Column 2
Column 3
Column 4
Column 5
Column 6
Column 7
Date of
Description of
Retailer or
Purchase
CT Tax Due
Tax Paid
Balance Due
to Another
(Col. 5 minus Col. 6
*
Purchase
Articles or Services
Service Provider
Price
(.06 X Col. 4)
Jurisdiction
but not less than zero)
If no use tax is due, you are not required to file a use tax return.
See Question 6, on the back of this form for information about tax rates on certain services.
Total Tax
*
PENALTY: FOR FAILURE TO PAY TAX WHEN DUE - 10% (.10) of the tax due.
Penalty
INTEREST: FOR LATE PAYMENT - 1% (.01) of tax due per month, or fraction thereof, from due date.
Interest
Total Amount Due
Check one of the following, whichever applies:
A.
This return represents all purchases subject to use tax made during the calendar year listed above.
B.
This return represents one of the following:
A single taxable purchase made during the calendar year listed above;
Multiple taxable purchases made through a date prior to the end of the calendar year listed above;
A subsequent return for the calendar year listed above for items not previously reported.
Please Note: Do not mail this return with your income tax return. A separate check must accompany this return.
Due Date: This return may be filed at the time of purchase, but not later than April 15 for purchases made during the preceding calendar year.
Do not file this return if use tax was already paid on a motor vehicle, vessel, or aircraft upon registration.
Make check or money order payable to: Commissioner of Revenue Services.
Write your Social Security Number and “19___ Individual Use Tax” on your check or money order.
Mail this return with check or money order to: Department of Revenue Services, PO Box 2973, Hartford CT 06104-2973.
Declaration: I declare under the penalty of false statement that I have examined this return, including any accompanying schedules and statements,
and to the best of my knowledge and belief it is true, complete and correct. Declaration of preparer (other than taxpayer) is based on all information
of which preparer has any knowledge. (The penalty for false statement is imprisonment not to exceed one year or a fine of two thousand dollars, or
both.)
Your Signature
Date
Spouse’s Signature
Date
Paid Preparer’s Signature
Date
Federal Employer ID Number
Keep a copy
for your
Firm Name and Address
records
ADVERTISEMENT
0 votes
Related Articles
Related forms
Related Categories
Parent category: Financial