Form Preview Example

Form CT-1040

Connecticut Resident Income Tax Return

Complete return in blue or black ink only.

For DRS		2009
	2 0	2009

Use Only		CT-1040

Taxpayers must sign declaration on reverse side.

For the year January 1 - December 31, 2009, or other taxable year beginning: _________________ , 2009 and ending: __________________, ______ .

1Filing Status

Single

Filing jointly for federal and Connecticut

Filing jointly for		Filing separately for	Filing separately for
		Filing separately for	Filing separately for
		federal and Connecticut	Connecticut only


Connecticut
Connecticut	
only	

Enter spouse’s name here and SSN below.

Head of household

Qualifying widow(er) with dependent child


name,	SSN here.
Print your	address,and


Your Social Security Number

Spouse Social Security Number

Check if

deceased

Your ﬁrst name

Last name (If two last names, insert a space between names.)

Sufﬁx (Jr./Sr.)

If joint return, spouse’s ﬁrst name

Last name (If two last names, insert a space between names.)

Sufﬁx (Jr./Sr.)

Mailing address (number and street, apartment number, suite number, PO Box)

City, town, or post ofﬁce (If town is two words, leave a space between the words.) State

ZIP code

Check here if you do not want forms sent to you next year. This does not relieve you of your responsibility to ﬁle.

Check here if you ﬁled Form CT-2210 and checked any boxes on Part 1.

	Form CT-8379	Check here if you are ﬁling the
		following and attach the form to the

	Form CT-1040CRC front of the return.

21. Federal adjusted gross income from federal Form 1040, Line 37;

			Form 1040A, Line 21; or Form 1040EZ, Line 4	1.
		2.	Additions to federal adjusted gross income from Schedule 1, Line 39	2.
		3.	Add Line 1 and Line 2.	3.
		4.	Subtractions from federal adjusted gross income from Schedule 1, Line 50	4.

staple.notDo	forms.1099or	5.	Connecticut adjusted gross income: Subtract Line 4 from Line 3.	5.
staple.notDo	forms.1099or	6.	Income tax from tax tables or Tax Calculation Schedule: See instructions, Page 15.	6.
		6.		6.
		7.	Credit for income taxes paid to qualifying jurisdictions from Schedule 2, Line 59	7.
		8.	Subtract Line 7 from Line 6. If Line 7 is greater than Line 6, enter “0.”	8.
here.checkClip	sendnotDoW-2	9.	Connecticut alternative minimum tax from Form CT-6251	9.
here.checkClip	sendnotDoW-2	10.	Add Line 8 and Line 9.	10.
		10.	Add Line 8 and Line 9.	10.
		11.	Credit for property taxes paid on your primary residence, motor vehicle, or both:
			Complete and attach Schedule 3 on Page 4 or your credit will be disallowed.	11.
		12.	Subtract Line 11 from Line 10. If less than zero, enter “0.”	12.

		13.	Adjusted net Connecticut minimum tax credit from Form CT-8801	13.
		14.	Connecticut income tax: Subtract Line 13 from Line 12. If less than zero, enter “0.”	14.
		14.		14.
		15.	Individual use tax from Schedule 4, Line 69: If no tax is due, enter “0.”	15.
		16.	Add Line 14 and Line 15.	16.

Whole Dollars Only

,	,
,	,
,	,
,	,
,	,
,	,
,	,
,	,
,	,
,	,

,	,
,	,
,	,
,	,
,	,

.00

. 00

Due date: April 15, 2010 - Attach a copy of all applicable schedules and forms to this return.

For a faster refund, see Page 2 of the booklet for electronic ﬁling options.

Form CT-1040 - Page 2 of 4	Your Social	
	Security Number

17. Enter amount from Line 16.

17.

.00

					Column A		Column B					Column C
3					Column A		Column B					Column C
3		Employer’s federal ID No. from Box b of W-2,					Connecticut wages, tips, etc.			Connecticut income tax withheld
			or payer’s federal ID No. from Form 1099				. 00
				–		
W-2 and 1099	18a.			–				18a.			,			,	.	00
W-2 and 1099	18a.							18a.			,			,	.
Information				–			. 00	18b.
Information	18b.										,			,	.	00
Only enter	18b.															00
Only enter
information				–			. 00	18c.
information	18c.														.	00
from your W-2	18c.										,			,		00
from your W-2											,			,
and 1099 forms				–			. 00
and 1099 forms	18d.							18d.							.	00
if Connecticut											,			,		00
if Connecticut											,			,
income tax				–			. 00	18e.
income tax	18e.														.	00
was withheld.	18e.										,			,		00
							. 00				,

	18f.			–					18f.		,			,	.	00
							. 00				,

	18g.			–				18g.			,			,	.	00
	18g.							18g.


	18h. Enter amount from Supplemental Schedule CT-1040WH, Line 3.							18h.			,		,		.	00

18.Total Connecticut income tax withheld: Add amounts in Column C and enter here.

		You must complete Columns A, B, and C or your withholding will be disallowed.			18.	,		,		.		00

19.		All 2009 estimated tax payments and any overpayments applied from a prior year			19.		,		,		.	00

20.		Payments made with Form CT-1040 EXT (Request for extension of time to ﬁle)			20.		,		,		.	00

21.		Total payments: Add Lines 18, 19, and 20.			21.		,		,		.	00



4	22.	Overpayment: If Line 21 is more than Line 17, subtract Line 17 from Line 21.			22.		,		,		.	00
23.		Amount of Line 22 you want applied to your 2010 estimated tax									.
23.					23.		,		,		.	00
24.		Total contributions of refund to designated charities from Schedule 5, Line 70			24.		,		,		.	00
25.		Refund: Subtract Lines 23 and 24 from Line 22.					,		,		.
25.		Refund: Subtract Lines 23 and 24 from Line 22.
		For faster refund, use Direct Deposit by completing Lines 25a, 25b, and 25c.			25.							00

	25a.	Checking	25b. Routing	25c. Account
		Savings	number	number
	25d.Will this refund go to a bank account outside the U.S.?			Yes

526. Tax due: If Line 17 is more than Line 21, subtract Line 21 from Line 17.

27.If late: Enter penalty. Multiply Line 26 by 10% (.10).

28.If late: Enter interest. Multiply Line 26 by number of months or fraction of a month late, then by 1% (.01).

29. Interest on underpayment of estimated tax from Form CT-2210: See instructions, Page 17.

30. Total amount due: Add Lines 26 through 29.

26.

27.

28.

29.

30.

.00

6Declaration: 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 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.

Keep a copy for your records.

Sign Here

Your signature

Date

Daytime telephone number



(

)

Spouse’s signature (if joint return)

Date

Daytime telephone number



(

)

Paid preparer’s signature

Date

Telephone number

Preparer’s SSN or PTIN



(

)

Firm’s name, address, and ZIP code

FEIN



Third Party Designee - Complete the following to authorize DRS to contact another person about this return.

Designee’s name

Telephone number

Personal identiﬁcation number (PIN)



Complete applicable schedules on Pages 3 and 4 and send all four pages of the return to DRS.

Form CT-1040 - Page 3 of 4	Your Social	
	Security Number	

Schedule 1 - Modiﬁ cations to Federal Adjusted Gross Income			Enter all items as positive numbers.
See instructions, Page 18.
See instructions, Page 18.				,	,	.	00
31. Interest on state and local government obligations other than Connecticut		31.		,	,	.	00
32. Mutual fund exempt-interest dividends from non-Connecticut state or municipal
				,	,	.	00
government obligations		32.		,	,	.	00
						.
33. Cancellation of debt income: See instructions.		33.		,	,	.	00
33. Cancellation of debt income: See instructions.		33.					00
34. Taxable amount of lump-sum distributions from qualiﬁ ed plans not included in federal

				,	,	.	00
adjusted gross income		34.		,	,	.	00

35. Beneﬁ ciary’s share of Connecticut ﬁ duciary adjustment: Enter only if greater than zero.		35.		,	,	.	00

36. Loss on sale of Connecticut state and local government bonds		36.		,	,	.	00
		36.		,	,	.

37. Domestic production activity deduction from federal Form 1040, Line 35		37.		,	,	.	00

38. Other - specify ________________________________________________________		38.		,	,	.	00

39. Total additions: Add Lines 31 through 38. Enter here and on Line 2.		39.		,	,	.	00

40. Interest on U.S. government obligations		40.		,	,	.	00

41. Exempt dividends from certain qualifying mutual funds derived from U.S. government obligations		41.		,	,	.	00

42. Social Security beneﬁt adjustment: See Social Security Beneﬁt Adjustment Worksheet, Page 20.		42.		,	,	.	00

43. Refunds of state and local income taxes		43.		,	,	.	00

44. Tier 1 and Tier 2 railroad retirement beneﬁ ts and supplemental annuities		44.		,	,	.	00

45. 50% of military retirement pay		45.		,	,	.	00
45. 50% of military retirement pay		45.		,	,	.

46. Beneﬁ ciary’s share of Connecticut ﬁ duciary adjustment: Enter only if less than zero.		46.		,	,	.	00

47. Gain on sale of Connecticut state and local government bonds		47.		,	,	.	00

48. Connecticut Higher Education Trust (CHET) contributions		48.		,	,	.	00
Enter CHET account number:	–
Enter CHET account number:	–
(can be up to 14 digits)
49. Other - specify: Do not include out of state income. ___________________________		49.		,	,	.	00

50. Total subtractions: Add Lines 40 through 49.	Enter here and on Line 4.	50.		,	,	.	00

Schedule 2 - Credit for Income Taxes Paid to Qualifying Jurisdictions

You must attach a copy of your return ﬁ led with the qualifying jurisdiction(s) or your credit will be disallowed.

51.Modiﬁ ed Connecticut adjusted gross income See instructions, Page 24.

52.Enter qualifying jurisdiction’s name and two-letter

code: See instructions, Page 24.

52.

53.Non-Connecticut income included on Line 51 and reported on a qualifying jurisdiction’s income tax return: Complete Schedule 2 Worksheet, Page 24. 53.

54.Divide Line 53 by Line 51. May not exceed 1.0000 54.

55.Income tax liability: Subtract Line 11 from Line 6. 55.

56. Multiply Line 54 by Line 55.	56.
57. Income tax paid to a qualifying jurisdiction
See instructions, Page 25.	57.
58. Enter the lesser of Line 56 or Line 57.	58.

Column A

Name

,	,
.
,	,
,	,
,	,
,	,

51.

Code

.00

.	00

.	00

Column B

Name

,	,
.
,	,
,	,
,	,
,	,

. 00

Code

. 00

59. Total credit: Add Line 58, all columns. Enter here and on Line 7.

59.

.00

Complete applicable schedules on Page 4 and send all four pages of the return to DRS.

Form CT-1040 - Page 4 of 4	Your Social	
	Security Number	

Schedule 3 - Property Tax Credit See instructions,

Page 25.

Auto 2

Qualifying Property

Primary Residence

Auto 1

(joint returns or qualifying widow(er) only)

Name of Connecticut Tax



Town or District

Description of Property

If primary residence, enter

street address.

If motor vehicle, enter year,



make, and model.

Date(s) Paid



_ _ /_ _ / 2009



_ _ /_ _ / 2009



_ _ /_ _ / 2009



_ _ /_ _ / 2009



_ _ /_ _ / 2009



_ _ /_ _ / 2009

Amount Paid 60.

61.

62.

63. Total property tax paid: Add Lines 60, 61, and 62.

63.

64. Maximum property tax credit allowed

64.



500 .

65. Enter the lesser of Line 63 or Line 64.

65.



66. Enter the decimal amount for your ﬁ ling status and Connecticut AGI from the Property Tax



Credit Table exactly as it appears on Page 27. If zero, enter the amount from Line 65 on Line 68.

66.

67. Multiply Line 65 by Line 66.

67.



68. Subtract Line 67 from Line 65. Enter here and on Line 11.

Attach Schedule 3 to your return or your credit will be disallowed.

68.

Schedule 4 - Individual Use Tax - Do you owe use tax? See instructions, Page 28.

Complete this worksheet to calculate your Connecticut individual use tax liability and attach Page 4 to your return.

Column A

Column B

Column C

Column D

Column E

Column F

Column G

Tax, if any,

Balance due

Date of

Description of

Retailer or

Purchase

CT tax due

paid to

(Column E minus

purchase

goods or services

service provider

price

(.06 X Column D)

another

Column F but not

jurisdiction

less than zero)



Total of individual purchases under $300 not listed above

69. Individual use tax: Add all amounts for Column G. Enter here and on Line 15.	 69.					,

Schedule 5 - Contributions to Designated Charities

.00

70a. AIDS Research		70a.
70b. Organ Transplant		70b.
70c. Endangered Species/Wildlife		70c.
70d. Breast Cancer Research		70d.
70e. Safety Net Services		70e.
70f. Military Family Relief Fund		70f.
70f. Military Family Relief Fund		70f.

.00

70. Total Contributions: Add Lines 70a through 70f. Enter amount here and on Line 24.	70.			,
Use envelope provided, with correct mailing label, or mail to:

.00

For refunds and all other tax forms without payment: Department of Revenue Services

PO Box 2976

Hartford CT 06104-2976

For all tax forms with payment: Department of Revenue Services PO Box 2977

Hartford CT 06104-2977

Make your check payable to: Commissioner of Revenue Services

To ensure proper posting, write your SSN(s) (optional) and “2009 Form CT-1040” on your check.

Question	Answer
Form Name	Form Ct 1040 Connecticut
Form Length	4 pages
Fillable?	No
Fillable fields	0
Avg. time to fill out	1 min
Other names	ct 1040 fillable form, preparer, 70e, 18d

Form Ct 1040 Connecticut – Fill Out and Use This PDF

Form Ct 1040 Connecticut PDF Details

Form Preview Example

Form Ct 1040 Connecticut isn’t the one you’re looking for?

Form Ct 1040 Connecticut – Fill Out and Use This PDF

Form Ct 1040 Connecticut PDF Details

Form Preview Example

Form Ct 1040 Connecticut isn’t the one you’re looking for?

Related Documents