Form O-Mf3 - Gasohol Tax Return
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1GASOHOL TAX RETURN
STATE OF CONNECTICUT
TAX TYPE
RETURN FOR MONTH ENDED
DEPARTMENT OF REVENUE SERVICES
57
P.O. BOX 5034
HARTFORD CT 06102-5034
CT TAX REGISTRATION NUMBER
DISTRIBUTOR
INSTRUCTIONS
1. Taxpayers must file a return for each calendar month by the 25th day of the following
VERIFIED
OA
FA
month. For example, a Motor Vehicle Fuels Tax Return for January 1st through January
31st should be filed on or before February 25th. A return must be filed even if no tax is due.
2. Make check or money order payable to: COMMISSIONER OF REVENUE SERVICES.
3. Mail to the above address.
I declare under the penalty of false statement that I have
Please correct your name and address if shown incorrectly.
examined this return and to the best of my knowledge
and belief it is true, complete and correct.
SIGNATURE _________________________________________
TITLE ______________________________________________
PHONE NO. _________________ DATE __________, 19_____
Liquid Gallons
(Round off to the nearest gallon)
1
Opening inventory
1
2
Receipts at marketing locations in this state from sources outside this state (Form MF3A, Schedule 2)
2
3
Receipts at marketing locations in this state from sources within this state (Form MF3A, Schedule 3)
3
4
Gasohol produced in Connecticut
4
5
Direct shipments to customers in this state (Form MF3A, Schedule 5)
5
1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 1 2 3 4 5 6 7
1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 1 2 3 4 5 6 7
1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 1 2 3 4 5 6 7
6
6
1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 1 2 3 4 5 6 7
7
Total charges (Add Lines 1 through 5)
7
8
Closing inventory (Include transit items)
8
9
Total gallons to be accounted for (Subtract Line 8 from Line 7)
9
10
Sales and transfers out of state and sales for export (Form MF3B, and Schedules 10 and 10A)
10
11
Nontaxable sales to licensed distributors (Form MF3B, Schedule 11)
11
1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 1 2 3 4 5 6 7
1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 1 2 3 4 5 6 7
1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 1 2 3 4 5 6 7
11A
11A
1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 1 2 3 4 5 6 7
1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 1 2 3 4 5 6 7
12
Sales to U.S. Government, State of Connecticut and municipalities (Form MF3B, Schedule 12)
12
13
Nontaxable use and other distribution
13
14
Gain or loss (Show gain as “G” and deduct)
14
15
Total nontaxable distribution (Add Lines 10 through 14)
15
16
Taxable sales
16
16A
Taxable sales to licensed distributors (Form MF3B, Schedule 16A)
16A
17
Taxable use
17
18
Taxable distribution (Add Lines 16, 16A and 17)
18
19
Total gallons accounted for (Add Line 15 and Line 18; the sum must equal Line 9)
19
AMOUNT
TAX COMPUTATION
Liquid Gallons
20
Total taxable distribution (Multiply Line 18 by 31¢ per gallon)
20
20
$
21
Tax paid purchases (Form MF3A, Schedules 2, 3, 4, and 5)
21
21
$
22
Dealer Sales to United States Goverment (Form MF3B, Schedule 22)
22
22
$
23
Total Deductions (Add Line 21 and Line 22)
23
23
$
24
Tax Due (Subtract Line 23 from Line 20)
24
24
$
24A
Credit ( Attach credit memo)
24A
24A
$
24B
Net amount due (Subtract Line 24A from Line 24)
24B
$
24C
Interest _____________________________ Plus
Penalty _________________________
=
24C
$
24D
Total amount due (Add Line 24B and Line 24C)
24D
$
O-MF3 (Rev. 7/98)
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