Form Tc-40 - Income Tax Supplemental Schedule - 2013

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TC-40A
Clear form
Income Tax Supplemental Schedule
40304
Rev. 12/13
Your last name
Your social security number
Part 1 - Additions to Income (write the code and amount of each addition to income, see insructions)
Code
Amount
Code
Code
51 Lump sum distribution
56 Child's income excluded from parent's return
.00
*
53 Medical Savings Account (MSA) addback
57 Municipal bond interest
.00
*
54 Utah Educational Savings Plan (UESP) addback
60 Untaxed income of a resident trust
*
61 Untaxed income of a nonresident trust
55 Reimbursed adoption expenses
.00
*
69 Equitable adjustments - attach explanation
To the extent previously deducted
.00
or credited on Utah return
.00
Total additions to income (add all additions to income and enter total here and on TC-40, line 5)
.00
Part 2 - Subtractions from Income (write the code and amount of each subtraction from income, see instructions)
Code
Code
Code
Amount
71 Interest from U. S. Government Obligations
78 Railroad retirement income
.00
77 Native American income
79 Equitable adjustments - attach explanation
Tribe
82 Nonresident active duty military pay
Your enrollment number
Code
.00
85 State tax refund distributed to beneficiary
.00
88 Nonresident military spouse income
Spouse's enrollment number
Code
.00
.00
Total subtractions from income (add all subtractions and enter total here and on TC-40, line 8)
.00
Part 3 - Apportionable Nonrefundable Credits (write the code and amount of each nonrefundable credit, see instructions)
Code
Code
Amount
Code
04 Capital gain transactions credit
22 Medical Care Savings Account (MSA) credit
.00
23 Health benefit plan credit
18 Retirement tax credit (attach TC-40C)
20 Utah Educational Savings Plan (
24 Qualifying solar project credit
UESP)
credit
.00
26 Gold and silver coin sale credit
.00
.00
.00
Total apportionable nonrefundable credits (add all credits and enter total here and on TC-40, line 24)
.00
Part 4 - Nonapportionable Nonrefundable Credits (write the code and amount of each nonrefundable credit, see instructions)
Code
Code
Amount
Code
12 Research activities credit
01 At-home parent credit
.00
02 Qualified sheltered workshop credit
13 Carryover of mach./equip. research credit
17 Tax paid to another state (attach TC-40S)
Name
.00
19 Live organ donation expenses credit
05 Clean fuel vehicle credit
.00
21 Renewable residential energy systems credit
06 Historic preservation credit
25 Combat related death credit
.00
07 Enterprise zone credit
27 Veteran employment tax credit
08 Low-income housing credit
.00
10 Recycling market dev. zone credit
Total nonapportionable nonrefundable credits (add all Part 4 credits and enter total here and on TC-40, line 26)
.00
Submit this page ONLY if data entered
Attach completed schedule to your 2013 Utah Income Tax return

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