Form Ct-1040 - Connecticut Resident Income Tax Return 1999 Page 2

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SCHEDULE 1 - MODIFICATIONS TO FEDERAL ADJUSTED GROSS INCOME (See instructions, page 15)
Additions To Federal Adjusted Gross Income - Enter All Amounts as Positive Numbers
30. Interest on state and local government obligations other than Connecticut
30
31. Exempt-interest dividends from a mutual fund derived from state or municipal
government obligations other than Connecticut
31
32. Shareholder’s pro rata share of S corporation nonseparately computed loss
32
33. Taxable amount of lump sum distributions from qualified plans not included in federal adjusted gross income
33
34. Beneficiary’s share of Connecticut fiduciary adjustment (Enter only if greater than zero)
34
35. Loss on sale of Connecticut state and local government bonds
35
36. Other - specify
36
37. Total additions (Add Lines 30 through 36) Enter here and on Line 2 on the front of this form.
37
Subtractions From Federal Adjusted Gross Income - Enter All Amounts as Positive Numbers
38. Interest on United States government obligations
38
39. Exempt dividends from certain qualifying mutual funds derived from United States government obligations
39
40. Social Security benefit adjustment ( See Social Security Benefit Adjustment Worksheet, page 17)
40
41. Refunds of state and local income taxes
41
42. Tier 1 and Tier 2 railroad retirement benefits and supplemental annuities
42
43. Shareholder’s pro rata share of S corporation nonseparately computed income
43
44. Beneficiary’s share of Connecticut fiduciary adjustment (Enter only if less than zero)
44
45. Gain on sale of Connecticut state and local government bonds
45
46. Other - specify (Do not include out-of-state income) ____________________________________________________
46
47. Total subtractions (Add Lines 38 through 46) Enter here and on Line 4 on the front of this form.
47
SCHEDULE 2 - CREDIT FOR INCOME TAXES PAID TO OTHER JURISDICTIONS
Important: You must attach a copy of your return filed with the other jurisdiction(s) or the credit will be disallowed.
48. MODIFIED CONNECTICUT ADJUSTED GROSS INCOME ( See instructions, page 19)
48
COLUMN A
COLUMN B
FOR EACH COLUMN, ENTER THE FOLLOWING:
Name
Code
Name
Code
49. Enter other jurisdiction’s name and two-letter code ( See instructions, page 19)
49
50. Non-Connecticut income included on Line 48 and reported on another
jurisdiction’s income tax return (Complete Schedule 2 Worksheet, page 20)
50
51. Divide Line 50 by Line 48 (may not exceed 1.0000)
51
52. Income tax liability (Subtract Line 11 from Line 6; see instructions, page 19)
52
53. Multiply Line 51 by Line 52
53
54. Income tax paid to another jurisdiction
54
55. Enter the lesser of Line 53 or Line 54
55
56. TOTAL CREDIT (Add Line 55, all columns)
Enter this amount here and on Line 7 on the front of this form.
56
SCHEDULE 3 - CREDIT FOR PROPERTY TAXES PAID ON YOUR PRIMARY RESIDENCE AND/OR MOTOR VEHICLE
Failure to complete this schedule could result in the disallowance of this credit.
COLUMN A
COLUMN B
COLUMN C
COLUMN D
COLUMN E
QUALIFYING
NAME OF
DESCRIPTION OF PROPERTY
LIST OR BILL
DATE PAID
AMOUNT PAID
PROPERTY
CONNECTICUT TAX
NUMBER
(See instructions,
If primary residence, enter street address
TOWN OR DISTRICT
(If available)
page 21)
If motor vehicle, enter year, make, and model
PRIMARY
57
RESIDENCE
58
AUTO 1
MARRIED FILING
59
JOINT ONLY - AUTO 2
60. TOTAL PROPERTY TAX PAID (Add all amounts for Column E)
60
425 00
61. MAXIMUM PROPERTY TAX CREDIT ALLOWED
61
62. Enter the Lesser of Line 60 or Line 61. (If $100 or less, enter this amount on Line 64. If greater than $100, go to Line 63.)
62
63. Limitation - Enter the result from the Property Tax Credit Limitation Worksheet ( See instructions, page 21 )
63
64. Subtract Line 63 from Line 62. Enter here and on Line 11 on the front of this form.
64
DECLARATION: I declare under the penalties of false statement 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. The penalty for false statement
is imprisonment not to exceed one year or a fine not to exceed two thousand dollars, or both. Declaration of preparer (other than
taxpayer) is based on all information of which preparer has any knowledge.
Your Signature
Date
Spouse’s Signature (if joint return)
Date
Sign
Paid Preparer’s Signature
Date
Your
Return
Firm Name
Preparer’s EIN, SSN or PTIN
CT-1040 Back (Rev. 12/99)

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