Form Ct-1040ez - Connecticut Resident Ez Income Tax Return - 2002

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2002
State of Connecticut
Form CT-1040EZ
Department of Revenue Services
EZ
EZ
EZ
EZ
EZ
Connecticut Resident EZ Income Tax Return
For the year January 1 - December 31, 2002, or other taxable year
beginning _____________, 2002,
ending _____________, ______.
Label
Your First Name and Middle Initial
Last Name
Your Social Security Number
L
__ __ __
__ __
__ __ __ __
• •
• •
A
• •
• •
Use the
B
DRS label
Spouse’s Social Security Number
If a JOINT Return, Spouse’s First Name and Middle Initial
Last Name
E
__ __ __
__ __
__ __ __ __
located on
• •
• •
L
• •
• •
cover.
IMPORTANT!
Home Address (number and street), Apartment Number, PO Box
Otherwise,
H
You MUST enter your SSN(s) above.
print or type.
E
(See
R
City, Town, or Post Office
State
ZIP Code
DRS USE ONLY
instructions,
E
– 20
Page 7)
WEBFILING OR
WEBFILING OR
WEBFILING OR ELECTRONIC FILING
ELECTRONIC FILING
ELECTRONIC FILING
ELECTRONIC FILING
WEBFILING OR
WEBFILING OR
ELECTRONIC FILING
WEBFILE
WEBFILE
WEBFILE OR
E-FILE
E-FILE
E-FILE Y Y Y Y Y OU
WEBFILE
WEBFILE
OR
OR
OR E-FILE
OR
E-FILE
OU
OU
OU
OUR R R R R RETUR
RETUR
RETUR
RETUR
RETURN N N N N FO
FO
FO
FO
FOR R R R R F F F F F ASTE
ASTE
ASTE
ASTE
ASTER R R R R REFUND
REFUND
REFUND
REFUND
REFUND, , , , , see
see
see
see
see P P P P P a a a a a g g g g g e e e e e 3 3 3 3 3 . . . . .
MA
MAY SPEED Y
MA
Y SPEED Y
Y SPEED Y
Y SPEED YOUR REFUND
OUR REFUND
OUR REFUND
OUR REFUND, see P
, see P
, see Pa a a a a g g g g g e X.
, see P
e X.
e X.
e X.
MA
MA
Y SPEED Y
OUR REFUND
, see P
e X.
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 .........................................................................................................................................................................
You may file Form CT-1040EZ if you meet ALL of the following conditions: (See instructions, Page 6)
A.
You were a resident of Connecticut for the entire taxable year; and
Who May
B.
You did not report federally taxable Social Security benefits for the 2002 taxable year; and
File Form
C.
You had no modifications to federal adjusted gross income or your only modification is a federally taxable refund of state
CT-1040EZ
and local income tax; and
D.
You are not claiming credit for income taxes paid to a qualifying jurisdiction; and
E.
You do not have a federal alternative minimum tax liability and are not claiming an adjusted net Connecticut minimum tax credit.
NOTE: Generally, your filing status must be the same as your federal income tax filing status for this year (See instructions, Page 8) .
Filing
Married filing SEPARATELY. Enter spouse’s SSN above and full
A.
Single
C.
Status
name here: _____________________________________________
Check only
B.
Married filing jointly or Qualifying
D.
Head of household (with qualifying person)
one box.
widow(er) with dependent child
1. Federal Adjusted Gross Income (From federal Form 1040, Line 35; Form 1040A, Line 21;
1
Form 1040EZ, Line 4; or federal TeleFile Tax Record, Line
I
)
Income
2. Refunds of state and local income taxes (From federal Form 1040, Line 10. See instructions, Page 8. )
2
3. Connecticut Adjusted Gross Income (Subtract Line 2 from Line 1)
3
4. Income Tax: From Tax Tables or Tax Calculation Schedule (See instructions, Page 8)
4
5. Credit for property taxes paid on your primary residence and/or motor vehicle. (You must complete
Schedule 1 EZ, on reverse. Enter the amount from Line 25. See instructions, Page 8. )
5
Tax
6. Connecticut Income Tax (Subtract Line 5 from Line 4. If less than zero, enter “0.”)
6
7. Individual Use Tax (From Schedule 2 EZ, Line 26)
7
8. Total Tax (Add Line 6 and Line 7)
8
Payments
9. Connecticut tax withheld (Attach all W-2s and certain 1099s. See instructions, Page 9. )
9
Failure to
10. All 2002 estimated tax payments and any overpayments applied from a prior year
10
attach W-2s
11. Payments made with Form CT-1040 EXT (Request for extension of time to file)
will result in the
11
disallowance of
12. Total Payments (Add Lines 9, 10, and 11)
withholding.
12
13. If Line 12 is greater than Line 8, enter amount overpaid. (Subtract Line 8 from Line 12)
13
Refund
14. Amount of Line 13 you want applied to your 2003 estimated tax
14
00
15. Amount of Line 13 you want to contribute to charity (From Schedule 3 EZ, Line 27) Total Contributions
15
REFUND
16. Amount of Line 13 you want refunded to you. (Subtract Lines 14 and 15 from Line 13)
16
For faster refund, choose direct deposit and complete Lines 16a, 16b, and 16c.
16a.
Type of Account:
Checking
Savings
16b.
16c.
Routing Number
Account Number
Amount
17. If Line 8 is greater than Line 12, enter the amount of tax you owe. (Subtract Line 12 from Line 8)
You Owe
17
Check if paying by credit card
(See instructions, Page 9)
AMOUNT YOU OWE
Make your check or money order payable to:
Use envelope provided, with correct mailing label, or mail to:
“Commissioner of Revenue Services”
For refunds and all other tax forms without payment:
For all tax forms with payment:
To ensure proper posting, write your
Department of Revenue Services
Department of Revenue Services
SSN(s) and “2002 Form CT-1040EZ” on
PO Box 150420
PO Box 150440
your check or money order.
Hartford CT 06115-0420
Hartford CT 06115-0440
Taxpayers must sign declaration on reverse — Due date: April 15, 2003 — Attach a copy of all applicable schedules and forms to this return.

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