Form Au-526 - Sales And Use Tax Refund Application For Purchases Made Under The "Buy Connecticut" Provision

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STATE OF CONNECTICUT
Form AU-526
DEPARTMENT OF REVENUE SERVICES
25 Sigourney Street
Sales and Use Tax Refund Application
Hartford, CT 06106-5032
for Purchases Made Under the
Rev. 08/01
“Buy Connecticut” Provision
Name
Connecticut Tax Registration Number
Federal Employer ID Number
Address
Number and Street
PO Box
City or Town
State
ZIP Code
General Instructions
Purpose: Use this form to claim a refund of sales and use
Complete Schedule A on Page 2 of this form. For each item
taxes paid on tangible personal property that is purchased
listed, provide a copy of the purchase invoice or bill of sale
from Connecticut retailers under Conn. Gen. Stat. §12-408c
along with documentation substantiating that the qualifying
(the “Buy Connecticut” provision) and is eventually shipped
tangible personal property has been shipped outside the state
out of Connecticut for exclusive use outside the state. Any
by common or contract carrier. Attach additional sheets if
person carrying on a trade, occupation, business, or profession
necessary. If the tangible personal property has not been
in Connecticut who purchases from a retailer tangible personal
shipped outside Connecticut at the time the refund claim is
property for use or consumption in carrying on a trade,
filed, your signature on this claim attests to the fact that the
occupation, business, or profession can file a refund claim.
property will be shipped outside the state by common or
For more information, see Special Notice 2001(5), The “Buy
contract carrier within three years from the date of purchase
Connecticut” Provision .
for use solely outside Connecticut.
Due Date: All claims for refund of taxes paid on tangible
Complete all other lines on the face of this return. Sign and
personal property purchased under the “Buy Connecticut”
date the form.
provision during a calendar year must be filed by April 1 of the
Mail all refund applications to:
next calendar year. No extensions are allowed by law. A
Department of Revenue Services
refund claim is considered timely if the date shown by the
Refunds, Clearances, and Adjustments Unit
U. S. Post Office cancellation mark is on or before the due
25 Sigourney Street
date. If April 1 is a Saturday, Sunday, or legal holiday, the
Hartford CT 06106
refund claim must be filed by the next succeeding day that is
not a Saturday, Sunday, or legal holiday.
Special Note
Documentation: All applicants must supply substantiating
Connecticut when a refund claim is filed, the taxpayer must
documentation supporting the fact that the tangible personal
still complete this form attesting to that fact that the property
property purchased under the “Buy Connecticut” provision has
will be shipped outside Connecticut within three years of the
been shipped outside the State of Connecticut. If any of the
date the property was purchased.
tangible personal property has not been shipped outside
For Further Information
Call the Department of Revenue Services Refunds, Clearances, and Adjustments Unit at 860-541-3253 during business hours,
Monday through Friday, 8:00 a.m. to 5:00 p.m.,
Declaration: I certify under the penalty of false statement that the tangible personal property described in this refund application
has been, or will be, shipped outside Connecticut by common or contract carrier, to be used or consumed solely outside the
state thereafter, and that no other claim for refund or credit has been filed with the Commissioner of Revenue Services for this
tangible personal property. (The penalty for false statement is imprisonment not to exceed one year or a fine not to exceed two
thousand dollars, or both.)
Print Name of Taxpayer
Date
Sign
Here
Authorized Signature
Title

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