Form Ct 1040 Connecticut PDF Details

Individuals who reside in Connecticut and are required to file a federal tax return must also file a Connecticut income tax return. The Form CT 1040 is the form used to file the Connecticut state income tax return. There are a number of different filing statuses and exemptions that can be claimed on the Form CT 1040, so it is important to understand the requirements in order to comply with state law and avoid penalties. This guide will provide an overview of how to complete the Form CT 1040, including information on which credits and deductions are available.

QuestionAnswer
Form NameForm Ct 1040 Connecticut
Form Length4 pages
Fillable?No
Fillable fields0
Avg. time to fill out1 min
Other namesct 1040 fillable form, preparer, 70e, 18d

Form Preview Example

Form CT-1040

Connecticut Resident Income Tax Return

Complete return in blue or black ink only.

For DRS

 

 

2009

2 0

 

 

 

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

 

 

 

federal and Connecticut

 

Connecticut only

 

 

 

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

 

 

 

 

 

-

 

 

-

 

 

 

 

 

 

 

 

 

 

 

 

 

Check if

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

deceased

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

deceased

 

 

 

 

Your first name

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

MI

 

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

Suffix (Jr./Sr.)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

If joint return, spouse’s first name

 

 

 

 

 

 

 

 

 

 

MI

 

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.

6.

Income tax from tax tables or Tax Calculation Schedule: See instructions, Page 15.

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.

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.

 

 

 

 

 

 

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

.00

.00

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.00

.00

.00

.00

.00

.00

. 00

. 00

. 00

. 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

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Information

 

 

 

 

 

 

 

 

 

 

 

 

 

. 00

18b.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

18b.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

,

 

 

 

 

,

 

 

 

 

 

.

00

Only enter

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

information

 

 

 

 

 

 

 

 

 

 

 

 

 

. 00

18c.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

18c.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

.

00

from your W-2

 

 

 

 

 

 

 

 

 

 

 

 

 

,

 

 

 

 

,

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

and 1099 forms

 

 

 

 

 

 

 

 

 

 

 

 

. 00

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

18d.

 

 

 

 

 

 

 

 

 

 

 

18d.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

.

00

if Connecticut

 

 

 

 

 

 

 

 

 

 

 

 

 

,

 

 

 

 

,

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

income tax

 

 

 

 

 

 

 

 

 

 

 

 

. 00

18e.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

18e.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

.

00

was withheld.

 

 

 

 

 

 

 

 

 

 

 

 

 

,

 

 

 

 

,

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

. 00

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

18f.

 

 

 

 

 

 

 

 

 

 

 

 

18f.

 

 

,

 

 

 

 

,

 

 

 

 

 

.

00

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

. 00

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

18g.

 

 

 

 

 

 

 

 

 

 

 

18g.

 

 

,

 

 

 

 

,

 

 

 

 

 

.

00

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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.

 

 

 

 

,

 

 

 

 

 

 

,

 

 

 

 

 

 

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.

 

 

 

 

 

 

 

 

 

 

 

,

 

 

 

 

 

 

,

 

 

 

 

 

.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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

.00

.00

.00

.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.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

,

 

 

 

,

 

 

 

 

 

.

00

31. Interest on state and local government obligations other than Connecticut

31.

 

 

 

 

 

 

 

 

 

 

 

32. Mutual fund exempt-interest dividends from non-Connecticut state or municipal

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

,

 

 

 

,

 

 

 

 

 

.

00

government obligations

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

32.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

.

 

 

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.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(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

.

00

 

 

.

00

,

,

Column B

Name

,

,

.

 

,

,

,

,

,

,

,

,

. 00

Code

. 00

. 00

. 00

. 00

. 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.

 

 

 

 

,

 

 

 

.

00

 

 

61.

 

 

 

 

 

,

 

 

 

 

 

.

00

 

62.

 

 

 

 

 

,

 

 

 

 

 

 

00

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

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

63.

 

 

 

 

 

,

 

 

 

 

 

.

 

00

64. Maximum property tax credit allowed

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

64.

 

 

 

500 .

 

00

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

65.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

.

 

00

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.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

.

 

00

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

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

00

 

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.

 

,

,

,

,

,

,

,

,

,

,

,

,

.00

.00

.00

.00

.00

.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.