Fillable Form Au-738 - Motor Vehicle Fuels Tax Refund Claim - Nutrition Program (Page 2 of 2) in pdf

Form AU-738

Instructions

General Instructions

Your motor vehicle fuels tax refund claim for fuel used during

calendar year 2013 must:

2013 Tax Refund Rates for

Nutrition Program Only

Be ﬁ led with Department of Revenue Services (DRS) on or

before May 31, 2014; and

January 1, 2013, through June 30, 2013, purchases

Involve at least 200 gallons of fuel eligible for tax refund.

Diesel ..............................................51.2¢ per gallon

The appropriate fuel type must be marked on the front of this form

Motor vehicle fuels ......................... 25¢ per gallon

to process this claim. You must ﬁ le a separate Form AU-738, Motor

Vehicle Fuels Tax Refund Claim, for each motor vehicle fuel type.

July 1, 2013, through December 31, 2013, purchases

Provide a telephone number where DRS can contact you.

Diesel ..............................................54.9¢ per gallon

You must indicate your Connecticut Tax Registration Number,

Motor vehicle fuels ......................... 25¢ per gallon

Federal Employer Identiﬁ cation Number (FEIN), or Social Security

You must file a separate Form AU-738 for each fuel type

Number (SSN) in the space provided.

and each claim type in effect between January 1, 2013, and

June 30, 2013. You must also ﬁ le a separate Form AU-738 for

Schedule A Instructions

each fuel type and each claim type in effect between July 1,

For all purchases of fuel listed, you must attach a copy of each

2013, and December 31, 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:

Date of purchase;

Additional Information

Name and address of the seller which must be printed or rubber

Mail the completed refund application to:

stamped on the slip or invoice;

Department of Revenue Services

Name and address of the purchaser which must be the name

State of Connecticut

and address of the person or entity ﬁ ling the claim for refund;

Excise Taxes Unit

Number of gallons of fuel purchased;

25 Sigourney St Ste 2

Hartford CT 06106-5032

Price per gallon; and

If you need additional information or assistance, call the DRS

Total amount paid.

Excise Taxes Unit at 860-541-3224, Monday through Friday,

You must retain records to substantiate your refund claim for at

8:30 a.m. to 4:30 p.m.

least three years following the ﬁ ling of the claim and make them

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

available to DRS upon request.

to download and print Connecticut tax

forms and publications.

Schedule B Instructions

Your refund will be applied against any outstanding DRS tax

Line 6 - Gross refund: Use the table to calculate the proper tax

liability.

refund rate based on when your purchase was made.

You must attach a copy of your contract with your local area agency

on aging as evidence of your eligibility to provide Title III-C meals

to senior citizens.

Line 6 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.

Form AU-738 Back (Rev. 06/13)

Form Au-738 - Motor Vehicle Fuels Tax Refund Claim - Nutrition Program Page 2

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