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Department of Revenue Services Form OP-216
PO Box 5031
Hartford CT 06102‑5031 Special Fuel Tax Return
(Rev. 06/22)
OP216 0622W 01 9999
Form OP‑216can be filed and paid electronicallyusingmyconneCT at portal.ct.gov/DRS-myconneCT.

Return for period ended
 Due on or before Connecticut Tax Registration Number
M M ‑ D D ‑ Y Y Y Y M M ‑ D D ‑ Y Y Y Y 
Name
Federal Employer Identification Number

Street address
Out of business 
City/town State Zip Code
Amended return 

Complete the return in blue or black ink.
Section 1 - Special Fuels Gallons Accountability
1. Opening physical inventory: Must agree with 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. 
10. Sales and transfers out of Connecticut and sales in Connecticut for immediate export from
Connecticut: Attach Form MF‑D, Schedule 7. 10. 

11. Gallons sold to U.S. government tax exempt: Attach Form MF‑D, Schedule 8. 11. 

12. Gallons sold to state and local government tax exempt: Attach Form MF‑D, Schedule 9. 12. 
13. Sales to farmers or other tax exempt entities, nontaxable uses, sales of jet fuel, sales
of #2 heating oil and kerosene for heating purposes, and sales of dyed diesel fuel for
marine purposes: Attach Form MF‑D, Schedule 10. 13. 

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: Attach Form MF‑D, Schedule 11. 16. 

17. Taxable sales to licensed distributors: Attach Form MF‑D, Schedule 5. 17. 

18. 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. 

Complete Sections 2 and 3 on the reverse side.
Visit us at portal.ct.gov/DRS for more information.

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Form OP‑216 Connecticut Tax
Page 2 of 2 Registration Number
(Rev. 06/22)
OP216 0622W 02 9999

Section 2 - Special Fuels Tax Calculation
Column A - Diesel Column B - Alternative Fuel

21. Taxable gallons. 21.  

22. Deduct tax paid purchases. 22.  

23. Deduct dealer sales to governmental
entities: Attach Form MF‑D, Schedule 13. 23.  

24. Total taxable gallons: Subtract Line 22 and
Line 23 from Line 21 for each column. 24.  

25. Tax due: Multiply Line 24 by the rate
(Column A by 49.2¢; Column B by 26¢) 25.  .00  .00

26. Total tax due: Add Line 25, Column A and Column B. 26.  .00

27. Penalty: 10% (.10) of total tax due or $50, whichever is greater. 27.  .00

28. Interest: 1% (.01) per month or fraction of a month from due date to date of payment. 28.  .00

29. Total amount due: Add Lines 26, 27, and 28. 29.  .00

Section 3 - Declaration and Signature
Declaration: I declare under penalty of law that I have examined this return (including any accompanying schedules and statements) and, to the best of
my knowledge and belief, it is true, complete, and correct. I understand the penalty for willfully delivering a false return or document to the Department of
Revenue Services (DRS) is a fine of not more than $5,000, or imprisonment for not more than five years, or both. The declaration of a paid preparer other
than the taxpayer is based on all information of which the preparer has any knowledge.

Taxpayer signature Title Date (MMDDYYYY)
Sign Here

Keep a Print taxpayer name Telephone number Taxpayer SSN
copy of
this return
for your
Paid preparer signature Preparer address Preparer’s SSN or PTIN
records.

Taxpayer’s email address


Visit us at portal.ct.gov/DRS for more information.

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Form OP-216 - Instructions
General Instructions Line Instructions
Form OP-216 must be filed for each calendar month by the Visit the DRS website at portal.ct.gov/DRS/myconneCT/
twenty-fifth day of the following month. If the due date falls on Excise-File-Uploads for instructions on Form MF‑R
a Saturday, Sunday, or legal holiday, the next business day and Form MF-D, Motor Vehicle Fuels Tax Schedule of
is the due date. A return must be filed even if no tax is due. Disbursements.
Line 2
Filing and Paying Electronically
Report Connecticut state excise tax paid purchases of
Form OP-216 can be filed and paid electronically using diesel fuel, #2 heating oil, kerosene, jet fuel, and biodiesel
myconneCT. DRS myconneCT and purchases of propane and natural gas sold as a motor
allows taxpayers to electronically vehicle fuel. For each product code, you must complete a
file, pay, and manage state tax separate Form MF-R, Motor Vehicle Fuels Tax Schedule
responsibilities. of Receipts, Schedule Type 1, indicating gallons purchased
from each supplier.
Filing and Paying by Mail
If you file by mail, complete the return in blue or black ink Line 3
only. Do not use staples. Report Connecticut state excise tax unpaid purchases of
Mail this return and schedules with a check to: diesel fuel, #2 heating oil, kerosene, jet fuel, and biodiesel
and purchases of propane and natural gas sold as a motor
Department of Revenue Services vehicle fuel. For each product code, you must complete a
State of Connecticut separate Form MF‑R, Schedule Type 2, indicating gallons
PO Box 5031 purchased from each supplier.
Hartford CT 06102‑5031
Line 4
If you pay by mail, make check payable to Commissioner
of Revenue Services. To ensure payment is applied to your Report gallons imported from another state direct to customers
account, write “Form OP-216” and your Connecticut Tax within Connecticut. For each product code, you must complete
a separate Form MF‑R, Schedule Type 3, indicating gallons
Registration Number, optional, on the front of your check.
purchased from each supplier.
Be sure to sign your check and paper clip it to the front of
your return. Do not use staples. Do not send cash. DRS may Line 5
submit your check to your bank electronically. Report gallons imported from another state into Connecticut
Rounding gallons: On your return, you must round off storage. For each product code, you must complete a
fractions of a gallon to the nearest whole gallon. Round down separate Form MF‑R, Schedule Type 4, indicating gallons
to the next lowest whole gallon all fractions of a gallon less purchased from each supplier.
than a half gallon. Round up to the next highest whole gallon Line 9
all fractions of a half gallon or more. Report Connecticut state excise tax‑exempt sales and
You must round off cents to the nearest whole dollar on transfers of diesel fuel, #2 heating oil, kerosene, jet fuel,
your return and schedules. If you do not round, DRS will biodiesel, propane, and natural gas to licensed diesel fuel
disregard the cents. Round down to the next lowest dollar distributors. For each product code, you must complete a
all amounts that include 1 through 49 cents. Round up to separate Form MF‑D, Schedule Type 6, indicating gallons
the next highest dollar all amounts that include 50 through sold to each customer. To view the current list of licensed
99 cents. However, if you need to add two or more amounts distributors, visit portal.ct.gov/DRS/myconneCT/Excise-
to compute the amount to enter on a line, include cents and Distributor-Dealer-Supplier-Lists.
round off only the total. Line 10
Report sales and transfers out of Connecticut and sales in
Special Instructions for Sellers of Certain
Connecticut to licensed motor vehicle fuels exporters. For
Alternative Fuel
each product code, you must complete a separate Form MF‑D,
Effective for sales made on or after July 1, 2008, sales
Schedule Type 7, indicating gallons sold to each customer.
of compressed natural gas, liquefied petroleum gas, and
liquefied natural gas (alternative fuels) are subject to motor Line 11
vehicle fuels tax at 26¢ per gallon. When selling such fuels Report tax‑exempt sales to the U.S. government. For each
in a gaseous form, seeSpecial Notice 2022(2),Conversion product code, you must complete a separate Form MF‑D,
Factors for Motor Vehicle Fuels Occurring in Gaseous Form Schedule Type 8, indicating gallons sold to each branch of
Beginning July 1, 2022. the U.S. government.
Line 12
Report tax‑exempt sales to the State of Connecticut and
municipalities of this state. For each product code, you must
complete a separate Form MF‑D, Schedule Type 9, indicating
gallons sold to each state agency and each municipality.
Form OP‑216 Instructions (Rev. 06/22) Page 1 of 2

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Line 13 Column B
Report tax‑exempt sales to farmers and other tax‑exempt Report all alternative fuel credit card sales to governmental
purchasers. Report tax‑exempt sales of jet fuel to licensed entities made at retail outlets. For each product code, you must
aviation fuel dealers or sold directly to an aircraft owner or complete a separate Form MF‑D, Schedule Type 13, indicating
operator documented by Form AU-477, Aircraft Owner or alternative fuel gallons sold to each governmental entity.
Operator Declaration Motor Vehicle Fuels Tax Exemption. Line 24
Report tax‑exempt sales to any vessel having a displacement Total taxable gallons: Subtract Line 22 and Line 23 from
exceeding four thousand (4,000) dead weight tons or primarily Line 21 for Column A (diesel) and Column B (alternative fuel).
engaged in interstate commerce. Report tax‑exempt sales
of dyed diesel fuel to a licensed marine fuel dock owner or Line 25 - Tax Due
operator documented by Form AU-478. Column A.
Multiply Line 24, Column A by 49.2¢
For each product code, you must complete a separate
Form MF‑D, Schedule Type 10, indicating to whom the gallons Column B
were sold. Include nontaxable use and tax‑exempt sales of Multiply Line 24, Column B by 26¢.
#2 heating oil and kerosene for heating purposes, but do not
complete Form MF‑D for such sales. Line 26
Total tax due: Add Line 25, Column A and Line 25, Column B.
Line 16
Report all taxable sales other than to licensed distributors. Line 27
Do not complete Form MF‑D. Late Payment Penalty: The penalty for late payment is 10%
of tax due or $50, whichever is greater.
Line 17 : The Commissioner of Revenue Services
Late Filing Penalty
Report taxable sales to licensed diesel fuel distributors. may impose a $50 penalty for failure to file any return required
For each product code, you must complete a separate by law to be filed.
Form MF‑D, Schedule Type 5, indicating gallons sold to each
licensed diesel fuel distributor. Line 28
Interest: The interest charge for late payment is 1% per month
Line 18 or fraction of a month from the due date.
Report all taxable use.
Line 29
Line 21 Remit the amount due with this return.
Column A
Report the diesel gallons included in Line 19. For Additional Information on the Special Fuels Tax
Column B Call the Business Tax Subdivision/Excise Tax Field Unit at
Report the alternative fuel gallons included in Line 19. 860-541-3224, Monday through Friday 8:30 a.m. to 4:30 p.m.

Line 22 For the Latest News
Column A Visit the DRS website at portal.ct.gov/DRS.
Of the taxable gallons on Line 21, Column A, report those diesel
gallons that were purchased as state excise tax‑paid, as reported E-Services Update
on Form MF‑R, Schedule Type 1. Use myconneCT to file taxes, make payments, view filing
history, and communicate with the agency simply and more
Column B
efficiently on virtually any mobile device, including laptops,
Of the taxable gallons on Line 21, Column B, report those
tablets, and smartphones, 24 hours a day, 7 days a week.
alternative fuel gallons that were purchased as state excise
For updated information, please visit the DRS website at
tax‑paid, as reported on Form MF‑R, Schedule Type 1.
portal.ct.gov/DRS-myconneCT.
Line 23
Column A
Report all diesel credit card sales to governmental entities
made at retail outlets. For each product code, you must
complete a separate Form MF‑D, Schedule Type 13,
indicating diesel gallons sold to each governmental entity.

Form OP‑216 Instructions (Rev.06/22) Page 2 of 2

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