Form O-Mf - Motor Vehicle Fuels Tax Return
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1
2Department of Revenue Services
Form O-MF
PO Box
5031
Hartford CT 06102-5031
Motor Vehicle Fuels Tax Return
(Rev. 11/10)
Return For Period Ended
Connecticut Tax Registration Number
Federal Employer Identification Number (FEIN)
Due on or before
Check if applicable:
Out
of business
Amended return
All Liquid Gallons
(Round off to the nearest gallon)
1
Opening physical inventory: Must equal prior month’s closing inventory.
1
2
Gallons purchased, state excise tax paid within Connecticut: Attach Form MF-R, Schedule 1.
2
3
Gallons purchased, state excise tax unpaid within Connecticut: Attach Form MF-R, Schedule 2.
3
4
Gallons imported direct to customers within Connecticut: Attach Form MF-R, Schedule 3.
4
5
Gallons imported into Connecticut storage: Attach Form MF-R, Schedule 4.
5
6
Gallons available for sale or use: Add Lines 1 through 5.
6
7
Closing physical inventory: Include in-transit items.
7
8
Total gallons to be accounted for: Subtract Line 7 from Line 6.
8
9
Nontaxable sales and transfers to licensed distributors: Attach Form MF-D, Schedule 6.
9
Sales and transfers out of Connecticut and sales in Connecticut for immediate
10
:
10
export from Connecticut: Attach Form MF-D, Schedule 7.
11
Gallons sold to U.S. government tax exempt: Attach Form MF-D, Schedule 8.
11
12
Gallons sold to state and local goverment tax exempt: Attach Form MF-D, Schedule 9.
12
Gallons sold to farmers or other tax exempt entities, sale of aviation gas,
13
13
and nontaxable uses: Attach Form MF-D, Schedule 10.
14
Gain or loss from inventory variation: Show gain as negative and deduct.
14
15
Total nontaxable sales and uses: Add Lines 9 through 14.
15
16
Taxable sales other than to licensed distributors
16
17
Taxable sales to licensed distributors: Attach Form MF-D, Schedule 5.
17
18
Number of gallons for taxable uses
18
19
Total taxable sales and uses: Add Lines 16, 17, and 18.
19
20
Total gallons accounted for: Add Line 19 and Line 15; the sum must equal Line 8.
20
21
Deduct tax paid purchases.
21
22
Deduct dealer sales to governmental entities: Attach Form MF-D, Schedule 13.
22
23
Total deductions: Add Line 21 and Line 22.
23
24
Taxable gallons: Subtract Line 23 from Line 19.
24
25
Tax due: Multiply Line 24 by 25¢ per gallon.
25
.00
26
Penalty: 10% (.10) of total tax due or $50, whichever is greater
26
.00
27
Interest: 1% (.01) per month or fraction of a month from due date to date of payment
27
.00
28
Total amount due: Add Line 25, Line 26, and Line 27.
28
.00
Please sign this return on the reverse side.
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