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Get and Sign UCT 212 Flat, Municipal Gas Utilities, Gas Suppliers, and CT Gov 2012 Form
Black ink only.
Name of Company
Taxpayer
(Type
or
Print)
Connecticut Tax Registration Number
Address
Number and street
PO Box
For Calendar quarter ending
City, town, or post office
State
ZIP code
Federal Employer ID Number (FEIN)
Amended return
Change of address
Date received (DRS use only)
To be completed by local gas distribution companies (LDCs) and municipal gas utilities only
1. Income classified as operating revenues by Department of...
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