Form REG-15 "Alcoholic Beverages Tax - Application for Small Winery Certifi Cate" - Connecticut

What Is Form REG-15?

This is a legal form that was released by the Connecticut Department of Revenue Services - a government authority operating within Connecticut. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on December 1, 2013;
  • The latest edition provided by the Connecticut Department of Revenue Services;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a printable version of Form REG-15 by clicking the link below or browse more documents and templates provided by the Connecticut Department of Revenue Services.

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Download Form REG-15 "Alcoholic Beverages Tax - Application for Small Winery Certifi Cate" - Connecticut

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Department of Revenue Services
REG-15
State of Connecticut
Alcoholic Beverages Tax
PO Box 2937
Application For
Hartford CT 06104-2937
Small Winery Certifi cate
Rev. 12/13
Please complete this application and return it to the Department of Revenue Services (DRS) at the address shown above.
Federal Employer Identifi cation Number
(if applicable)
Please
correct
name and
Connecticut Tax Registration Number
address
(if applicable)
if
incorrect.
Type of Organization:


Corporation
S Corporation
Name(s) of owner(s), partner(s), corporate name, or LLC
Business telephone number
(
)


Sole proprietorship
Partnership

Limited liability company
Trade/registered name (if different from above)

Other
Physical location of this business (PO box is not acceptable.)
Business mail address (if different from physical location of business)
Are you licensed with the Connecticut Department of Consumer Protection (DCP), Division of Liquor Control, to distribute alcoholic beverages in Connecticut?

  
No
Yes
If yes, list your Permit No.___________________
Purpose: Form REG-15 is an application for a small winery certifi cate. Any winery that produced not more than 55,000 wine gallons of wine during the
preceding calendar year is eligible to apply for a small winery certifi cate. Additionally, this application may be completed on behalf of a foreign small
winery by a licensed shipper of alcohol. A Licensed Shipper of alcohol is a shipper of alcohol, who holds either a CT wholesaler’s permit with DCP or a
.
CT out-of-state shipper’s permit with DCP
If DRS grants your application, we will issue you a Form OR-267, Small Winery Certifi cate. A copy of the Small
Winery Certifi cate can be given to the licensed alcoholic beverage distributor selling your wine.
A licensed distributor of alcoholic beverages is subject to the Connecticut alcoholic beverages tax at the rate of 18¢ per wine gallon (rather than the regular
rate of 72¢ per wine gallon) if:
The licensed distributor is selling still wine that contains not more than 21% of absolute alcohol by volume; and
The still wine is produced by a winery with a Form OR-267.
Still wine contains not more than 0.392 of a gram of carbon dioxide per hundred milliliters of wine. Alcoholic cider is a still wine if it contains not more than
0.392 of a gram of carbon dioxide per hundred milliliters of wine.
Form REG-15 expires annually on June 30 and will be renewed upon completion and submission of the REG-15 renewal form issued by DRS.
If you have any questions, call the Excise/Public Services Taxes Subdivision at 860-541-3224, Monday through Friday, 8:30 a.m. to 4:30 p.m.
Declaration of Small Winery: I declare, under the penalty of false statement, that I have examined this application, REG-15, and to the best of my knowledge
and belief it is true, complete, and correct. The applicant named above produced not more than 55,000 wine gallons of wine during the preceding year. I
understand that the penalty for willfully delivering a false application to DRS is a fi ne of not more than $5,000, imprisonment for not more than fi ve years, or both.
Name of winery:
By:
Name of owner or authorized agent (Print or type.)
Title (Print or type.)
Signature of owner or authorized agent
Date
Declaration of Licensed Shipper on Behalf of Foreign Winery (if applicable): I declare, under the penalty of false statement, that I have examined this
application, REG-15, and to the best of my knowledge and belief it is true, complete, and correct. The applicant named above produced not more than
55,000 wine gallons of wine during the preceding year. I understand that the penalty for willfully delivering a false application to DRS is a fi ne of not more
than $5,000, imprisonment for not more than fi ve years, or both.
DCP permit number:
By:
Name of licensed shipper (Print or type.)
Title (Print or type.)
Signature of licensed shipper
Date
Department of Revenue Services
REG-15
State of Connecticut
Alcoholic Beverages Tax
PO Box 2937
Application For
Hartford CT 06104-2937
Small Winery Certifi cate
Rev. 12/13
Please complete this application and return it to the Department of Revenue Services (DRS) at the address shown above.
Federal Employer Identifi cation Number
(if applicable)
Please
correct
name and
Connecticut Tax Registration Number
address
(if applicable)
if
incorrect.
Type of Organization:


Corporation
S Corporation
Name(s) of owner(s), partner(s), corporate name, or LLC
Business telephone number
(
)


Sole proprietorship
Partnership

Limited liability company
Trade/registered name (if different from above)

Other
Physical location of this business (PO box is not acceptable.)
Business mail address (if different from physical location of business)
Are you licensed with the Connecticut Department of Consumer Protection (DCP), Division of Liquor Control, to distribute alcoholic beverages in Connecticut?

  
No
Yes
If yes, list your Permit No.___________________
Purpose: Form REG-15 is an application for a small winery certifi cate. Any winery that produced not more than 55,000 wine gallons of wine during the
preceding calendar year is eligible to apply for a small winery certifi cate. Additionally, this application may be completed on behalf of a foreign small
winery by a licensed shipper of alcohol. A Licensed Shipper of alcohol is a shipper of alcohol, who holds either a CT wholesaler’s permit with DCP or a
.
CT out-of-state shipper’s permit with DCP
If DRS grants your application, we will issue you a Form OR-267, Small Winery Certifi cate. A copy of the Small
Winery Certifi cate can be given to the licensed alcoholic beverage distributor selling your wine.
A licensed distributor of alcoholic beverages is subject to the Connecticut alcoholic beverages tax at the rate of 18¢ per wine gallon (rather than the regular
rate of 72¢ per wine gallon) if:
The licensed distributor is selling still wine that contains not more than 21% of absolute alcohol by volume; and
The still wine is produced by a winery with a Form OR-267.
Still wine contains not more than 0.392 of a gram of carbon dioxide per hundred milliliters of wine. Alcoholic cider is a still wine if it contains not more than
0.392 of a gram of carbon dioxide per hundred milliliters of wine.
Form REG-15 expires annually on June 30 and will be renewed upon completion and submission of the REG-15 renewal form issued by DRS.
If you have any questions, call the Excise/Public Services Taxes Subdivision at 860-541-3224, Monday through Friday, 8:30 a.m. to 4:30 p.m.
Declaration of Small Winery: I declare, under the penalty of false statement, that I have examined this application, REG-15, and to the best of my knowledge
and belief it is true, complete, and correct. The applicant named above produced not more than 55,000 wine gallons of wine during the preceding year. I
understand that the penalty for willfully delivering a false application to DRS is a fi ne of not more than $5,000, imprisonment for not more than fi ve years, or both.
Name of winery:
By:
Name of owner or authorized agent (Print or type.)
Title (Print or type.)
Signature of owner or authorized agent
Date
Declaration of Licensed Shipper on Behalf of Foreign Winery (if applicable): I declare, under the penalty of false statement, that I have examined this
application, REG-15, and to the best of my knowledge and belief it is true, complete, and correct. The applicant named above produced not more than
55,000 wine gallons of wine during the preceding year. I understand that the penalty for willfully delivering a false application to DRS is a fi ne of not more
than $5,000, imprisonment for not more than fi ve years, or both.
DCP permit number:
By:
Name of licensed shipper (Print or type.)
Title (Print or type.)
Signature of licensed shipper
Date