Form Au-741 - Motor Vehicle Fuels Tax Refund Claim - 2015 Page 2
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2Form AU-741
Instructions
General Instructions
Your motor vehicle fuels tax refund claim for fuel used during
2015 Tax Refund Rates for
calendar year 2015 must:
Commuter Vans Only
1.
Be fi led with DRS on or before May 31, 2016;
January 1, 2015, through June 30, 2015, purchases
2.
Involve at least 200 gallons of fuel eligible for tax refund;
Diesel ........................................ 54.5¢ per gallon
3.
The fuel is used in a high-occupancy commuter vehicle on
roads in this state;
Motor vehicle fuels .................. 25¢ per gallon
4.
The vehicle is owned or leased by a corporation or an
July 1, 2015, through December 31, 2015, purchases
employee of a corporation of the United States, the state of
Connecticut, or a municipality of the state of Connecticut; and
Diesel ........................................ 50.3¢ per gallon
Motor vehicle fuels .................. 25¢ per gallon
5.
The high-occupancy commuter vehicle seats at least ten but
not more than 15 passengers and has a minimum average daily
You must file a separate Form AU-741 for each fuel type
usage of nine persons and is transporting the passengers to
and each claim type in effect between January 1, 2015, and
and from work daily.
June 30, 2015. You must also fi le a separate Form AU-741 for
each fuel type and each claim type in effect between July 1,
The appropriate fuel type box must be marked on the front of this
form to process this claim. You must fi le a separate Form AU-741,
2015, and December 31, 2015.
Motor Vehicles Fuels Tax Refund, for each motor vehicle fuel type.
Provide a telephone number where DRS can contact you.
Additional Information
You must indicate your Connecticut Tax Registration Number,
Federal Employer Identifi cation Number (FEIN), or Social Security
Mail the completed refund application to:
Number (SSN) in the space provided.
Department of Revenue Services
State of Connecticut
Schedule A Instructions
Excise Taxes Unit
For all purchases of fuel listed, you must attach a copy of each
25 Sigourney St Ste 2
numbered slip or invoice issued at the time of the purchase. The slip
Hartford CT 06106-5032
or invoice may be the original or a photocopy and must show the:
If you need additional information or assistance, call the DRS
1.
Date of purchase;
Excise Taxes Unit at 860-541-3224, Monday through Friday,
2.
Name and address of the seller, which must be printed or rubber
8:30 a.m. to 4:30 p.m.
stamped on the slip or invoice;
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
3.
Name and address of the purchaser, which must be the name
to download and print Connecticut tax
and address of the person or entity fi ling the claim for refund;
forms and publications.
4.
Number of gallons of fuel purchased;
Your refund will be applied against any outstanding DRS tax
5.
Price per gallon; and
liability.
6.
Total amount paid.
You must keep records to substantiate your refund claim for at least
three years following the fi ling of the claim and make them available
to DRS upon request.
Schedule B Instructions
Line 6 - Gross refund: Use the table to calculate the proper tax
refund rate based on when your purchase was made.
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-741 Back (Rev. 07/15)
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