Form Ct-1040 - Connecticut Resident Income Tax Return 1999
ADVERTISEMENT
1
2STATE OF CONNECTICUT
DEPARTMENT OF REVENUE SERVICES
For the year January 1 - December 31, 1999, or other taxable year
beginning ______________ , 1999,
ending _______________ , _______ .
Your First Name and Middle Initial
Last Name
Your Social Security Number
Label
L
A
Use the
B
DRS label
If a JOINT Return, Spouse’s First Name and Middle Initial
Last Name
Spouse’s Social Security Number
E
located on
L
the inside
DEPARTMENT USE ONLY
of this
Home Address
Number and Street
Apt. No.
H
booklet.
E
Otherwise,
R
City, Town or Post Office
State
ZIP Code
Your Telephone Number
please print
E
(
)
or type.
( See
Check here if you do not want forms sent to you next year. Checking this box does not relieve you of your responsibility to file ..........................
instructions,
If you are required to file Form CT-2210 and checked any boxes on Part 1, check here ...............................................................................................
page 12)
NOTE: Your filing status must be the same as your federal income tax filing status for this year ( See instructions, page 12 ).
Filing
Single
A.
Status
Married filing joint return or Qualifying widow(er) with dependent child
B.
Check only
Married filing SEPARATE return
C.
one box.
Spouse’s full name
Spouse’s Social Security Number
D.
Head of household (with qualifying person)
1. Federal Adjusted Gross Income (from federal Form 1040, Line 33; Form 1040A, Line 18;
Form 1040EZ, Line 4; or Telefile Tax Record, Line
I
)
1
2. Additions, if any (from Schedule 1 , Line 37 on reverse)
2
3. Add Line 1 and Line 2
3
4. Subtractions, if any (from Schedule 1 , Line 47 on reverse)
4
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 12 )
6
7. Credit for income taxes paid to other jurisdictions (from Schedule 2 , Line 56 on reverse)
7
Income
8. Subtract Line 7 from Line 6. (If Line 7 is greater than Line 6, enter 0.)
8
and
9. Connecticut Alternative Minimum Tax (from Form CT-6251)
9
Tax
10. Add Line 8 and Line 9
10
11. Credit for property taxes paid on your primary residence and/or motor vehicle (You must complete
Schedule 3 , on reverse.) Enter the amount from Line 64 here. (See instructions, page 13)
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 (Complete the Individual Use Tax Worksheet.) You must enter 0 on
this line if no use tax is due. ( See instructions, page 13 )
15
16. Total Tax (Add Line 14 and Line 15)
16
17. Connecticut tax withheld (Attach all W-2s and certain 1099s; see instructions, page 13 )
17
18. All 1999 estimated tax payments and any overpayments applied from a prior year
18
Payments
19. Payments made with extension request (Form CT-1040 EXT)
19
20. Total payments (Add Lines 17, 18, and 19)
20
21. If Line 20 is greater than Line 16, enter amount overpaid. (Subtract Line 16 from Line 20)
21
22. Amount of Line 21 you want applied to your 2000 estimated tax
22
23. Amount of Line 21 you want to contribute to: ( See instructions, page 13)
Refund,
AIDS Research
___ $2
___ $5
___ $15
other ______ .00
Amount
Organ Transplant
___ $2
___ $5
___ $15
other ______ .00
You Owe,
Endangered Species/Wildlife
___ $2
___ $5
___ $15
other ______ .00
or
Breast Cancer Research
___ $2
___ $5
___ $15
other ______ .00
Contribution
Safety Net Services
___ $2
___ $5
___ $15
other ______ .00
00
TOTAL CONTRIBUTIONS
23
24. Amount of Line 21 you want refunded to you (Subtract Line 22 and Line 23 from Line 21)
REFUND
24
25. If Line 16 is greater than Line 20, enter the amount of tax you owe. (Subtract Line 20 from Line 16)
25
26. If Late: Enter Penalty (Multiply Line 25 by 10% (.10))
26
27. If Late: Enter Interest (Multiply Line 25 by number of months late or fraction thereof, then by 1% (.01))
27
28. Interest on underpayment of estimated tax (from Form CT-2210; see instructions, page 14 )
28
AMOUNT YOU OWE
29. Amount you owe with this return (Add Lines 25 through 28)
29
For refund request or no tax due, mail to:
For payment, mail to:
Make your check or money order payable to:
Department of Revenue Services
Department of Revenue Services
COMMISSIONER OF REVENUE SERVICES
PO Box 2976
PO Box 2977
Write your Social Security Number(s) and
Hartford CT 06104-2976
Hartford CT 06104-2977
“1999 Form CT-1040" on your check or
Mail in the envelope provided with the correct label affixed.
money order.
Taxpayers must sign declaration on reverse — Due date: April 18, 2000 — Attach a copy of all applicable schedules and forms to this return.
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