Form Apl-004 - Deposit In The Nature Of A Cash Bond

ADVERTISEMENT

State of Connecticut
Department of Revenue Services
FORM APL-004
25 Sigourney Street
Deposit in the Nature of a Cash Bond
Hartford CT 06106-5032
(Rev. 09/00)
Conn. Gen. Stat. §12-39m permits any taxpayer objecting to the assessment of any tax due the State of Connecticut to make a
remittance that is designated in writing as a deposit in the nature of a cash bond. This limits the accrual of additional interest on
the tax assessed, without conceding liability for the assessment. Form APL-004 should be used to designate a remittance as a
deposit in the nature of a cash bond. See Informational Publication 2000(18), Deposits in the Nature of a Cash Bond , for further
information.
This form must be signed by:
• A principal officer, if the taxpayer is a corporation
• The general partner, if the taxpayer is a limited partnership or
• A partner, if the taxpayer is a general partnership
a limited liability partnership
• The fiduciary, if the taxpayer is a trust or an estate
• An individual or sole proprietor, if the taxpayer is an
• A principal officer, if the taxpayer is a limited
individual or sole proprietorship
liability company
1. Taxpayer’s Name
4. Social Security Number (If an Individual)
2. Address (Number and Street)
5. Connecticut Tax Registration Number (Business Only)
3. City, State, and ZIP Code
6. Federal Employer Identification Number (Business Only)
7. Taxpayer is:
Limited Liability Company
Limited Liability Partnership
Limited Partnership
General Partnership
Corporation
Sole Proprietorship
Individual
Trust
Estate
Other
8. Revenue Examiner Conducting Audit Examination
9. Tax Periods Involved in the Audit Examination
10. Tax Type Audited
11. Amount of Remittance Designated as a
Deposit in the Nature of a Cash Bond
Date of Deposit (For DRS Use Only)
If you need help in completing this form, please call 860-297-4775, Monday through Friday, 8:00 a.m. to 5:00 p.m.
Signature
Title
Date
Print Your Name
Print Company Name

ADVERTISEMENT

00 votes

Related Articles

Top 20 Happy Easter Cards And Gift Tags To Download For Free
Top Ten Easter Arts And Crafts Activities For Your Kids
Free Easter Coloring Pages And Easter Printables For Your Kids

Related forms

Form Apl-004 - Deposit In The Nature Of A Cash Bond - 2000 Form Apl-004 - Deposit In The Nature Of A Cash Bond - 2000 Financial
Form Apl-004 - Deposit In The Nature Of A Cash Bond - Connecticut Department Of Revenue Services Form Apl-004 - Deposit In The Nature Of A Cash Bond - Connecticut Department Of Revenue Services Financial
Form Apl-004 - Deposit In The Nature Of A Cash Bond - Connecticut Department Of Revenue Form Apl-004 - Deposit In The Nature Of A Cash Bond - Connecticut Department Of Revenue Financial
Instructions For Deposit In The Nature Of A Cash Bond Form Apl-004 Instructions For Deposit In The Nature Of A Cash Bond Form Apl-004 Financial
Form Ao 443 - Warrant For The Arrest Of A Witness Or Material Witness In A Pending Criminal Case Form Ao 443 - Warrant For The Arrest Of A Witness Or Material Witness In A Pending Criminal Case Legal
Form Ao 444 - Warrant For The Arrest Of A Witness In A Grand Jury Proceeding - United States District Court Form Ao 444 - Warrant For The Arrest Of A Witness In A Grand Jury Proceeding - United States District Court Legal
Form Ao 445 - Warrant For The Arrest Of A Witness In A Civil Action Form Ao 445 - Warrant For The Arrest Of A Witness In A Civil Action Legal
A Day In The Life Of A Fool (bar) Chord Chart A Day In The Life Of A Fool (bar) Chord Chart Life
A Day In The Life Of A Fool Chord Chart A Day In The Life Of A Fool Chord Chart Life
Form Rv-f1305401 Application For Exemption From Sales Tax For Interstate Telecommunications Used In The Operation Of A Call Center Form Rv-f1305401 Application For Exemption From Sales Tax For Interstate Telecommunications Used In The Operation Of A Call Center Financial

Related Categories

Parent category: Financial
Download
Go
Page of 2