Form Ct-990t - Connecticut Unrelated Business Income Tax Return - 2009
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1
2Form CT-990T
Department of Revenue Services
2009
State of Connecticut
Connecticut Unrelated Business
PO Box 5014
Income Tax Return
Hartford CT 06102-5014
(Rev. 12/09)
Complete this return in blue or black ink only.
_____________________________
Enter Income Year Beginning
__________________________ , 2009, and Ending
DRS
CT Tax Registration Number
Organization name
(please type or print)
Use Only
Audited by
DRS use only
Address
number and street
PO Box
–
– 20
F
City or town
State
ZIP code
Federal Employer ID Number (FEIN)
O
Init._______
Check and Complete All Applicable Boxes
If the organization is annualizing its income check here
Change of:
Mailing address
Closing month (Attach explanation.) Return status:
Amended return
Initial return
Final return
If fi nal return:
Dissolved
Withdrawn
Merged/reorganized: Enter survivor’s CT Tax Reg. Number. ___________________________________
Type of organization:
Corporation
Domestic trust
Foreign trust
Other: Explain _____________________________________
1. Date unrelated trade or business began in Connecticut: _______________________________________________
2. Nature of unrelated trade or business income activity: ______________________________________________________________________________
3. Corporation only: Enter state of incorporation: _________________________________ Date of organization: ________________________________
Date qualifi ed in Connecticut if not incorporated in Connecticut: __________________________________________________________________________
– Attach a Complete Copy of Form 990-T Including all Schedules as Filed With the Internal Revenue Service –
Computation of Income
1. Federal unrelated business taxable income from 2009 federal Form 990-T, Part II, Line 34 .........................
1
00
2. Federal net operating loss deduction from 2009 federal Form 990-T, Part II, Line 31 ...................................
2
00
3. Federal deduction for Connecticut tax on unrelated business taxable income ..............................................
3
00
4. Total: Add Lines 1, 2, and 3. ..........................................................................................................................
4
00
5. Refund or credit for overpayment of Connecticut tax included in federal unrelated business taxable income
5
00
6. Unrelated business taxable income: Subtract Line 5 from Line 4. .................................................................
6
00
Computation of Tax
00
1. Unrelated business taxable income from Line 6 above. If 100% Connecticut, enter also on Line 3. ........
1
2. Apportionment fraction from Form CT-990T, Schedule A, Line 5. Carry to six places. .................................
2
0.
00
3. Connecticut unrelated business taxable income: Line 1 or Line 1 multiplied by Line 2. ................................
3
00
4. Operating loss carryover from Form CT-990T, Schedule B, Line 10 .............................................................
4
00
5. Income subject to tax: Subtract Line 4 from Line 3. .......................................................................................
5
6. Tax: Multiply Line 5 by 7.5% (.075). ...............................................................................................................
00
6
Computation of Amount Payable
00
1. Tax: Include surtax if applicable (See instructions) ........................................................................................
1
2. Reserved for future use. .................................................................................................................................
2
00
3. Total Tax: Enter the amount from Line 1. ........................................................................................................
3
00
4. Tax credits from Form CT-1120K, Part III, Line 9. Do not exceed amount on Line 1. ................................
4
00
5. Balance of tax payable: Subtract Line 4 from Line 3. If zero or less, enter “0.” ..............................................
5
00
Paid with application for extension from Form CT-990T EXT
6a.
............................................................................
6a
00
Paid with estimates from Forms CT-990T ESA, ESB, ESC, & ESD
6b.
.................................................................
6b
00
Overpayment from prior year
6c.
.................................................................................................................................
6c
00
6. Tax Payments: Enter the total of Lines 6a, 6b, and 6c. .................................................................................
6
00
7. Balance of tax due (overpaid): Subtract Line 6 from Line 5. ..........................................................................
7
.
00
.
00
.
00
00
8. Add Penalty
(8a) ___________ Interest
(8b) ___________ CT-1120I Interest
(8c) ___________
8
.00
.
00
00
9. Amount to be credited to 2010 estimated tax
(9a) _____________ Refunded
(9b) _______________
9
00
10. Balance due with this return: Add Line 7 and Line 8. ................................................................................
10
Pay by mail: Make check payable to Commissioner of Revenue Services.
Visit the DRS website at
Mail this return to: Department of Revenue Services, State of Connecticut,
to pay this return electronically.
PO Box 5014, Hartford CT 06102-5014
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 fi ne of not more than $5,000, or imprisonment for not more than fi ve 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 offi cer or fi duciary
Date
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shown below about this return?
Sign Here
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)
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of this
return for
Paid preparer’s signature
Date
Preparer’s SSN or PTIN
your
records.
Firm’s name and address
FEIN
Telephone number
(
)
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