Form Op-383 - Rental Surcharge Annual Report Page 2
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4Rental Surcharge
Schedule A
Computation of Net Amount of Surcharge Due for Each Private Passenger Motor Vehicle, Rental Truck, or Machinery Rented
During Calendar Year 2012.
Each rental company must complete this schedule to report each private passenger motor vehicle, rental truck, or piece of machinery rented in Connecticut
to a lessee during calendar year 2012. Rental company does not include any person, fi rm, or corporation licensed or required to be licensed under Conn. Gen.
Stat. §14-52 as a new car dealer, repairer, or limited repairer. Rental company also does not include any person, fi rm, or corporation licensed or required
to be licensed under Conn. Gen. Stat. §14-52 as a used car dealer if the person, fi rm, or corporation is not primarily engaged in the business of renting
passenger motor vehicles or rental trucks without drivers in Connecticut to lessees. The rental surcharge is imposed on each private passenger motor vehicle,
rental truck, or piece of machinery rented in Connecticut to a lessee by a rental company for a period of less than 31 days. See the Schedule A Instructions on
Page 3 before completing this schedule. Make additional copies of this schedule as needed.
Mail all copies of this schedule to the Department of Revenue Services (DRS) with Form OP-383, Rental Surcharge Annual Report.
A
B
C
D
E
F
G
Vehicle Identifi cation Number
Town Code for
Amount received
Amount received
Surcharge
Personal
Licensing, titling,
Connecticut town
during 2012 from
property taxes
If the piece of machinery has no vehicle
during 2012
actually
and registration
to which personal
rentals of trucks
identification number, enter a brief
from rentals
actually paid to
fees paid to the
collected
and passenger
p r o p e r t y t a x e s
description of the machinery.
of machinery
during 2012 on
a Connecticut
Connecticut DMV
motor vehicles
were paid during
subject to 1.5%
rentals subject
town during
during 2012 if
subject to 3%
2012
(.015) surcharge
to surcharge
2012
applicable
(.03) surcharge
See Page 4.
1. Total of Column C: Enter on Form OP-383, Line 1.
2. Total of Column D: Enter on Form OP-383, Line 2.
3. Total of Column E: Enter on Form OP-383, Line 3.
4. Total of Column F: Enter on Form OP-383, Line 4.
5. Total of Column G: Enter on Form OP-383, Line 5.
OP-383 (Rev. 12/12)
Page 2 of 4
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