Fillable Form Op-210 - Room Occupancy Tax Return printable pdf download

Form Op-210 - Room Occupancy Tax Return

Download a blank fillable Form Op-210 - Room Occupancy Tax Return in PDF format just by clicking the "DOWNLOAD PDF" button.

Open the file in any PDF-viewing software. Adobe Reader or any alternative for Windows or MacOS are required to access and complete fillable content.

Complete Form Op-210 - Room Occupancy Tax Return with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.

Some fillable PDF-files have the option of saving the completed form that contains your own data for later use or sending it out straight away.

Department of Revenue Services

For Period Ending

State of Connecticut

OP-210



PO Box 5031

Room Occupancy Tax Return

Hartford CT 06102-5031

Connecticut Tax Registration Number



(Rev. 07/11)

Federal Employer Identiﬁ cation Number

Complete this form in blue or black ink only.

For DRS Use Only

If the address

at right is

incorrect,

Did you know you can ﬁ le this form

please make

by Internet?

any changes

necessary.



 



Check here if this is an amended return.

Taxable receipts from room occupancy



Amount of tax due: Multiply Line 1 by 15% (.15).



Add Penalty



.00

and Interest



.00



Total amount due: Add Line 2 and Line 3.

Check all boxes that apply and provide the information requested:



 Permanently out of business: Enter last business date:

________

M M

D D

Y Y Y Y



 New mailing address, trade name, or physical location:

Enter new mailing address: _____________________________________________________________________

___________________________________________________________________________________________

Enter new trade name: ________________________________________________________________________

Enter new physical location: PO Box is not acceptable _______________________________________________

___________________________________________________________________________________________



 First return: Enter business start date:

________

M M

D D

Y Y Y Y



 Change in ownership: Enter date business was sold:

________

M M

D D

Y Y Y Y

New owners must obtain a new Connecticut Tax Registration Number.

Enter name of new owner: ______________________________________________________________________

Enter address of new owner: ____________________________________________________________________

___________________________________________________________________________________________

Declaration: I declare under penalty of law that I have examined this return (including any accompanying schedules and statements) and, to the best of

my knowledge and belief, it is true, complete, and correct. I understand the penalty for willfully delivering a false return or document to the Department of

Revenue Services (DRS) is a ﬁ ne of not more than $5,000, imprisonment for not more than ﬁ ve years, or both. The declaration of a paid preparer other

than the taxpayer is based on all information of which the preparer has any knowledge.

Taxpayer’s Signature

Title

Date

Preparer’s Signature

Preparer’s Address

Date