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Connecticut Free Printable CT-3911 Approved 20160711.indd for 2020 Connecticut Taxpayer Statement Regarding State of Connecticut Tax Refund

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Taxpayer Statement Regarding State of Connecticut Tax Refund
CT-3911 Approved 20160711.indd

Department of Revenue Services State of Connecticut (Rev. 07/16) Form CT-3911 Taxpayer Statement Regarding State of Connecticut Tax Refund Use Form CT-3911 to report a missing or stolen Connecticut tax refund that was a direct deposit or issued as a check. Do not use this form to report a missing debit card. Contact Chase Customer Service at 866-586-1705 to report lost, stolen, not received, or damaged debit cards and to request a new card(s). General Instructions Complete this form in blue or black ink only. Attach copies of any correspondence received from DRS concerning this refund to Form CT-3911. The Department of Revenue Services (DRS) will provide information in writing concerning your refund. If DRS determines that your refund check was cashed, a copy of the cashed check will be mailed to you. If DRS determines that your refund check was not cashed, a stop payment will be placed on the original check and a replacement check will be mailed to you. Part I If you do not receive any information from DRS within six weeks after filing Form CT-3911, contact DRS at 800-382-9463 (Connecticut calls outside the Greater Hartford calling area only) or 860-297-5962 (from anywhere). Where to File Mail to: Department of Revenue Services Revenue Accounting Unit PO Box 5035 Hartford CT 06102-5035 Fax to: 860-297-5703 Refund Information Prior to completing Part I, verify with your bank that the refund has not been deposited. 1. Type of return filed:  Individual  Business  Other ___________________________________ Form: ____________________ Tax period: _________________ Date filed: _____________________________ 2. Type of refund requested:  Direct Deposit  Check If Direct Deposit, enter your bank information: Bank name: __________________________________________ If Check, identify if the refund check was: Part II  Account #: ____________________________ Never received; or  Lost, stolen or destroyed. Taxpayer Information Print your name, Taxpayer Identification Number (TIN), and mailing address. For individuals, the TIN is your Social Security Number (SSN); for businesses, the TIN is your Connecticut Tax Registration Number or Federal Employer Identification Number (FEIN). Check the box to indicate which TIN you are listing. If you filed a joint return, you must complete Lines 1, 2, and 3. 1. Your name (or business name) Enter your TIN and check the appropriate box. 2. Spouse’s name (if joint return) Spouse’s SSN  SSN  CT Reg. No.  FEIN •• •• ___ ___ ___ •• ___ ___ •• ___ ___ ___ ___ 3. Address (number and street) Apt. no. PO Box City State ZIP Code Home/cell telephone number ( Part III ) Signature Sign below exactly as you signed the original return. For a joint return, both you and your spouse must sign. For business returns, the signature must be of the person authorized to sign the check. Declaration: I declare under penalty of law that I have examined this document 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 DRS is a fine of not more than $5,000, or imprisonment for not more than five years, or both. Your signature Please sign here. Spouse’s signature (if joint return) Title (if business return) Date Date
Extracted from PDF file 2019-connecticut-form-ct-3911.pdf, last modified July 2016

More about the Connecticut Form CT-3911 Individual Income Tax TY 2019

Use this form to report a lost, stolen or missing refund check.

We last updated the Taxpayer Statement Regarding State of Connecticut Tax Refund in March 2020, so this is the latest version of Form CT-3911, fully updated for tax year 2019. You can download or print current or past-year PDFs of Form CT-3911 directly from TaxFormFinder. You can print other Connecticut tax forms here.

Other Connecticut Individual Income Tax Forms:

TaxFormFinder has an additional 85 Connecticut income tax forms that you may need, plus all federal income tax forms.

Form Code Form Name
Tax Instruction Booklet Form CT-1040 Instruction Booklet
CT-1040NR/PY Instructions Tax Instruction Booklet: CT-1040 for Nonresidents/Part-Year Residents
Form CT-1040 Connecticut Resident Income Tax Return
Form CT-1040NR-PY Nonresident/Part-Year Resident Tax Return
CT-1040ES (Current Year) Estimated Connecticut Income Tax Payment Coupon for Individuals

Download all CT tax forms View all 86 Connecticut Income Tax Forms


Form Sources:

Connecticut usually releases forms for the current tax year between January and April. We last updated Connecticut Form CT-3911 from the Department of Revenue Services in March 2020.

Show Sources >

About the Individual Income Tax

The IRS and most states collect a personal income tax, which is paid throughout the year via tax withholding or estimated income tax payments.

Most taxpayers are required to file a yearly income tax return in April to both the Internal Revenue Service and their state's revenue department, which will result in either a tax refund of excess withheld income or a tax payment if the withholding does not cover the taxpayer's entire liability. Every taxpayer's situation is different - please consult a CPA or licensed tax preparer to ensure that you are filing the correct tax forms!

Historical Past-Year Versions of Connecticut Form CT-3911

We have a total of nine past-year versions of Form CT-3911 in the TaxFormFinder archives, including for the previous tax year. Download past year versions of this tax form as PDFs here:


2019 Form CT-3911

CT-3911 Approved 20160711.indd

2018 Form CT-3911

CT-3911 Approved 20160711.indd

2017 Form CT-3911

CT-3911 Approved 20160711.indd

2016 Form CT-3911

CT-3911 Approved 20160711.indd

2015 Taxpayer Statement Regarding State of Connecticut Tax Refund 2015 Form CT-3911

CT-3911, 2015 Taxpayer Statement Regarding State of Connecticut Tax Refund

Taxpayer Statement Regarding State of Connecticut Tax Refund 2014 Form CT-3911

CT-3911, Taxpayer Statement Regarding State of Connecticut Tax Refund

Taxpayer Statement Regarding State of Connecticut Tax Refund 2013 Form CT-3911

CT-3911, Taxpayer Statement Regarding State of Connecticut Tax Refund

Taxpayer Statement Regarding State of Connecticut Tax Refund 2012 Form CT-3911

Form CT-3911, Taxpayer Statement Regarding State of Connecticut Tax Refund

Taxpayer Statement Regarding State of Connecticut Tax Refund 2011 Form CT-3911

Form CT-3911, Taxpayer Statement Regarding State of Connecticut Tax Refund


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Source: http://www.taxformfinder.org/connecticut/form-ct-3911