Form Op-300 - Tobacco Products Tax Return - Connecticut Department Of Revenue Services

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FORM OP-300
STATE OF CONNECTICUT
DEPARTMENT OF REVENUE SERVICES
RETURN FOR PERIOD ENDED
TOBACCO PRODUCTS TAX RETURN
<
PO BOX 5018
HARTFORD CT 06102-5018
CT TAX REGISTRATION NUMBER
<
Important: Please see instructions on the back of this return.
(Rev. 07/00)
FEDERAL EMPLOYER ID NUMBER
<
PLEASE CHANGE YOUR NAME AND MAILING ADDRESS IF SHOWN INCORRECTLY
Check if applicable:
H
Final Return
(going out of business)
H
Amended Return
Tobacco Products (excluding snuff tobacco products)
<
1.
Purchased, imported, received or acquired in Connecticut (from Schedule A-1 or A-2)
1
Tobacco Products (excluding snuff tobacco products)
<
2.
Manufactured in Connecticut (from Schedule B)
2
<
3. Subtotal (Add Line 1 and Line 2)
3
Tobacco Products (excluding snuff tobacco products)
<
4.
Exported from Connecticut (from Schedule C)
4
Tobacco Products (excluding snuff tobacco products)
<
5.
Sold to the federal government (from Schedule D)
5
<
6. Subtotal (Add Line 4 and Line 5)
6
<
7. Amount subject to tax (Subtract Line 6 from Line 3)
7
<
8. TAX DUE ON TOBACCO PRODUCTS (Multiply Line 7 by 20% (.20))
8
<
9. TAX DUE ON SNUFF TOBACCO PRODUCTS (from Schedule A-3 or A-4)
9
<
10. TOTAL TAX DUE (Add Line 8 and Line 9)
10
<
11. PENALTY: 10% (.10) of total tax due or $50, whichever is greater
11
<
12. INTEREST: 1% (.01) per month or fraction thereof from due date to date of payment
12
<
13. TOTAL AMOUNT DUE (Add Lines 10, 11, and 12)
13
I declare under the penalty of false statement that I have examined this return, FORM OP-300, and, to the best of my knowledge and
belief, it is true, complete, and correct. (The penalty for false statement is imprisonment not to exceed one year or a fine not to exceed
two thousand dollars, or both.)
Signature
Title
Date
Print Name

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