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Get Form Au 724

The appropriate fuel type box at right. Complete this refund claim in blue or black ink only. m m / / through d d m m d Connecticut Tax Registration Number d Print name of claimant Federal Employer Identification Number (FEIN) Telephone number ( ) Social Security Number (SSN) Number and street Fuel type: Diesel/propane Motor vehicle fuels (gasoline-gasohol) City or town State Type of business Cl.

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  • CRRA
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  • FEIN
  • nontaxable
  • 2011
  • Sigourney
  • gasohol
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