Form Ct-1041 - Connecticut Income Tax Return For Trusts And Estates - 2006 Page 2

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Schedule A - Connecticut Fiduciary Adjustments See instructions.
Additions
00
1. Interest on state and local government obligations other than Connecticut
1
2. Mutual fund exempt-interest dividends from state or municipal government obligations other than
00
Connecticut
2
3. Loss on sale of Connecticut state and local government bonds: Enter as a positive number.
3
00
4. Connecticut income tax payments deducted in determining federal taxable income prior to deductions
relating to distributions to beneficiaries
4
00
5. Other (Specify) _________________________________________________________________
5
00
6. Total additions: Add Lines 1 through 5.
6
00
Subtractions
00
7. Interest on U.S. government obligations
7
00
8. Exempt dividends from certain qualifying mutual funds derived from U.S. government obligations
8
00
9. Gain on sale of Connecticut state and local government bonds
9
00
10. Refunds of Connecticut income tax
10
00
11. Other (Specify) _________________________________________________________________
11
00
12. Total subtractions: Add Lines 7 through 11.
12
13. Connecticut fiduciary adjustment - Subtract Line 12 from Line 6. (This amount may be positive or
00
negative.) Enter on Schedule CT-1041B, Part 1, Line f, Column 5.
13
Resident estates or full year resident trusts (except for those that meet the Quick-File
Requirements) must attach Schedule CT-1041C and if applicable, Schedule CT-1041FA.
Questions
A.
If the trust is an inter vivos trust, enter name, address, and Social Security Number of grantor:
________________________________________________________________________________
B.
If you checked “Part-year resident trust” on the front of this return, enter the date on which the trust
became irrevocable: ______________________________________________
C. Does the trust or estate have an interest in real property or tangible personal property located in
Connecticut?
Yes
No
Completed CT-1041 schedules must be attached to the back of Form CT-1041 in the following order unless the trust or estate meets the
Quick-File Requirements. Also attach Form CT-8801, if applicable, and a copy of all income tax returns filed with qualifying jurisdictions,
if applicable, or the credit will be disallowed.
1.
Schedule CT-1041B
2.
Schedule CT-1041C
3.
Schedule CT-1041FA
4.
Schedule I
5.
Form CT-8801
6.
Credit for income taxes paid to qualifying jurisdictions - Attach a copy of all income tax returns filed with qualifying
jurisdictions or the credit will be disallowed.
Declaration: 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 the Department of Revenue Services (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.
Signature of Fiduciary or Officer Representing Fiduciary
Date
Telephone Number
Sign
(
)
Here
Paid Preparer’s Signature
Preparer’s PTIN or SSN
Keep a
copy of
this return
Firm’s Name and Address
FEIN
for your
records
Telephone Number
(
)
Check this box if you used a paid preparer and do not want forms sent to you next year.
This does not relieve you of your responsibility to file.
Form CT-1041 Back (Rev. 12/06)

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