Form Omc-11a - Connecticut Motor Carrier Road Tax Return (Back)
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1Make check or money order payable to: Commissioner of Revenue Services.
PENALTY: Failure to file or pay tax when due: $50 or 10% (.10) of the tax due, whichever is greater.
INTEREST: For late payment: 1% (.01) of the tax due per month, or fraction thereof, from due date.
DUE DATE: One month after end of period indicated.
A return must be filed by each registered carrier, even when no tax is due.
I DECLARE UNDER THE PENALTIES OF FALSE STATEMENT THAT I HAVE
EXAMINED THIS RETURN AND TO THE BEST OF MY KNOWLEDGE AND
IMPORTANT!
BELIEF IT IS TRUE, COMPLETE AND CORRECT.
FAILURE TO COMPLETE LINES 1, 2, 4 AND 6 MAY
RESULT IN A BILLING OR DELAY IN CREDIT TO
TAXPAYER SIGNATURE
YOUR ACCOUNT
DATE
TITLE
CREDITS ARE NOT AUTOMATIC REFUNDS.
SEE GENERAL INFORMATION
SECTION OF INSTRUCTION SHEET.
(Back) (Rev. 7/98)
Make check or money order payable to: Commissioner of Revenue Services.
PENALTY: Failure to file or pay tax when due: $50 or 10% (.10) of the tax due, whichever is greater.
INTEREST: For late payment: 1% (.01) of the tax due per month, or fraction thereof, from due date.
DUE DATE: One month after end of period indicated.
A return must be filed by each registered carrier, even when no tax is due.
I DECLARE UNDER THE PENALTIES OF FALSE STATEMENT THAT I HAVE
EXAMINED THIS RETURN AND TO THE BEST OF MY KNOWLEDGE AND
IMPORTANT!
BELIEF IT IS TRUE, COMPLETE AND CORRECT.
FAILURE TO COMPLETE LINES 1, 2, 4 AND 6 MAY
RESULT IN A BILLING OR DELAY IN CREDIT TO
TAXPAYER SIGNATURE
YOUR ACCOUNT
DATE
TITLE
CREDITS ARE NOT AUTOMATIC REFUNDS.
SEE GENERAL INFORMATION
SECTION OF INSTRUCTION SHEET.
(Back) (Rev. 7/98)
Make check or money order payable to: Commissioner of Revenue Services.
PENALTY: Failure to file or pay tax when due: $50 or 10% (.10) of the tax due, whichever is greater.
INTEREST: For late payment: 1% (.01) of the tax due per month, or fraction thereof, from due date.
DUE DATE: One month after end of period indicated.
A return must be filed by each registered carrier, even when no tax is due.
I DECLARE UNDER THE PENALTIES OF FALSE STATEMENT THAT I HAVE
EXAMINED THIS RETURN AND TO THE BEST OF MY KNOWLEDGE AND
IMPORTANT!
BELIEF IT IS TRUE, COMPLETE AND CORRECT.
FAILURE TO COMPLETE LINES 1, 2, 4 AND 6 MAY
RESULT IN A BILLING OR DELAY IN CREDIT TO
TAXPAYER SIGNATURE
YOUR ACCOUNT
DATE
TITLE
CREDITS ARE NOT AUTOMATIC REFUNDS.
SEE GENERAL INFORMATION
SECTION OF INSTRUCTION SHEET.
(Back) (Rev. 7/98)
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