STATE OF CONNECTICUT
DEPARTMENT OF REVENUE SERVICES
Your First Name and Middle Initial
Last Name (as shown on your income tax return)
Your Social Security Number
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If a JOINT Return, Spouse’s First Name and Middle Initial
Last Name
Spouse’s Social Security Number
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Please read instructions before completing this form
1. Federal alternative minimum taxable income (see instructions)
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2. Additions to federal alternative minimum taxable income (see instructions)
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3. Add Line 1 and Line 2
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4. Subtractions from federal alternative minimum taxable income (see instructions)
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5. Adjusted federal alternative minimum taxable income. Subtract Line 4 from Line 3 (If married filing
separately and Line 5 is more than $165,000, see instructions )
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6. If this form is for a child under age 14, see instructions. Otherwise, enter $33,750 ($45,000 if
married filing jointly or qualifying widow(er), $22,500 if married filing separately)
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7. Enter $112,500 ($150,000 if married filing jointly or qualifying widow(er), $75,000 if married
filing separately)
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8. Subtract Line 7 from Line 5. If zero or less, enter zero here and on Line 9
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9. Multiply Line 8 by 25% (.25)
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10. Exemption (Subtract Line 9 from Line 6. If zero or less, enter zero)
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11. Subtract Line 10 from Line 5. If zero or less, enter zero here and on Line 24 and skip
Lines 12 through 23
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IMPORTANT: Complete only one of Line 12, 13 or 14. Enter the result on Line 15.
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12. If you completed Part IV of the federal Form 6251, complete Part II of this form and
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enter the amount from Line 49 here and on Line 15. Skip Line 13 and Line 14
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13. If Line 11 is $175,000 or less ($87,500 or less if married filing separately),
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multiply Line 11 by 26% (.26). Enter the result here and on Line 15
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14. If Line 11 is more than $175,000 (more than $87,500 if married filing
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separately), multiply Line 11 by 28% (.28) and subtract $3,500 ($1,750 if
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married filing separately) from the result. Enter the result here and on Line 15
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15. Enter the amount from Line 12, Line 13, or Line 14
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16. Alternative minimum tax foreign tax credit (from federal Form 6251, Line 25)
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17. Adjusted federal tentative minimum tax (Subtract Line 16 from Line 15)
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18. Multiply Line 17 by 19% (.19)
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19. Multiply Line 5 by 5% (.05)
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20. Connecticut minimum tax (Enter the lesser of Line 18 or Line 19)
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21. Apportionment factor (Connecticut residents, enter 1.0000;
Nonresidents/part-year residents, see instructions )
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22. Apportioned Connecticut minimum tax (Multiply Line 20 by Line 21)
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23. Connecticut income tax (from Form CT-1040, Line 6 or Form CT-1040NR/PY, Line 10)
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24. Net Connecticut minimum tax (Subtract Line 23 from Line 22. If zero or less, enter -0-)
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25. Credit for minimum tax paid to qualifying jurisdictions. Residents and part-year residents only
(from Schedule A, Line 60)
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26. Subtract Line 25 from Line 24
Enter the amount here and on Form CT-1040, Line 9 or Form CT-1040NR/PY, Line 13
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