Form Au-736 - Motor Vehicle Fuels Tax Refund Claim Page 2
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1
2Form AU-736
Instructions
General Instructions
Complete this form in blue or black ink only
.
2013 Tax Refund Rates for Motor Buses Only
Your motor vehicle fuels tax refund claim for fuel used during
calendar year 2013 must:
January 1, 2013, through June 30, 2013, purchases
1.
Be fi led with Department of Revenue Services (DRS) on or
Diesel .............................................. 51.2¢ per gallon
before May 31, 2014; and
Motor vehicle fuels ..........................25¢ per gallon
2.
Involve at least 200 gallons of fuel eligible for tax refund.
July 1, 2013, through December 31, 2013, purchases
The appropriate fuel type and claim type box must be marked on
Diesel .............................................. 54.9¢ per gallon
the front of this form to process this claim. You must fi le a separate
Form AU-736, Motor Vehicle Fuels Tax Refund Claim, for each
Motor vehicle fuels ..........................25¢ per gallon
motor vehicle fuel type and claim type.
You must file a separate Form AU-736 for each fuel type
Provide a telephone number where DRS can contact you.
and each claim type in effect between January 1, 2013, and
June 30, 2013. You must also fi le a separate Form AU-736 for
You must indicate your Connecticut Tax Registration Number,
each fuel type and each claim type in effect between July 1, 2013,
Federal Employer Identifi cation Number (FEIN), or Social Security
and December 31, 2013.
Number (SSN) in the space provided.
2013 Motor Vehicle Fuels Tax Refund Rates for
Schedule A Instructions
Taxicabs and Livery Only
For all purchases of fuel listed, you must attach a copy of each
purchases
January 1, 2013 through June 30, 2013,
numbered slip or invoice issued at the time of the purchase. The
slip or invoice may be the original or a photocopy and must show:
Diesel .............................................. 25.6¢ per gallon
1.
Date of purchase;
Motor vehicle fuels ........................ 12.5¢ per gallon
2.
Name and address of the seller, which must be printed or rubber
July 1, 2013, through December 31, 2013, purchases
stamped on the slip or invoice;
Diesel ............................................. 27.45¢ per gallon
3.
Name and address of the purchaser, which must be the name
Motor vehicle fuels ........................ 12.5¢ per gallon
and address of the person or entity fi ling the claim for refund;
You must file a separate Form AU-736 for each fuel type
4.
Number of gallons of fuel purchased;
and each claim type in effect between January 1, 2013, and
5.
Price per gallon;
June 30, 2013. You must also fi le a separate Form AU-736 for
6.
Total amount paid; and
each fuel type and each claim type in effect between July 1, 2013,
7.
If payment is made within a discounted period, provide proof
and December 31, 2013.
of amount paid.
You must keep records to substantiate your refund claim for at least
Additional Information
three years following the fi ling of the claim and make them available
to DRS upon request.
Mail the completed refund application to:
Motor bus companies must attach a copy of their Certifi cate of
Department of Revenue Services
Public Convenience and Necessity issued under Chapter 244 of
State of Connecticut
the Connecticut General Statutes with each claim fi led.
Excise Taxes Unit
25 Sigourney St Ste2
Taxicab operators must attach a copy of their Certifi cate of Public
Hartford CT 06106-5032
Convenience and Necessity issued under Chapter 244a of the
Connecticut General Statutes with each claim fi led.
If you need additional information or assistance, call the DRS
Excise Taxes Unit at 860-541-3224, Monday through Friday,
Livery service operators must attach a copy of their permit issued
8:30 a.m. to 4:30 p.m.
under Chapter 244b of the Connecticut General Statutes with each
claim fi led. Livery service vehicles are refunded at half the motor
F o r m s a n d P u b l i c a t i o n s : Vi s i t t h e D R S w e b s i t e a t
vehicle fuels tax rate.
to download and print Connecticut tax
forms and publications.
Schedule B Instructions
Your refund will be applied against any outstanding DRS tax
liability.
Line 9 only - Rounding off to whole dollars: You must round off
cents to the nearest whole dollar on your return and schedules.
If you do not round, DRS will disregard the cents. Round down
to the next lowest dollar all amounts that include 1 through 49
cents. Round up to the next highest dollar all amounts that include
50 through 99 cents
Line 9 - Gross refund: Use the table to calculate the proper tax
refund rate based on when your purchase was made.
Form AU-736 Back (Rev. 06/13)
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