Form Tc-41 - Utah Fiduciary Income Tax Return - 2004

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2004
Utah State Tax Commission
210 N 1950 W, Salt Lake City, Utah 84134
(801) 297-2200 or 1-800-662-4335
TC-41
Utah Fiduciary Income Tax Return
Rev. 12/04
For calendar year January 1, 2004 through December 31, 2004 or other taxable
period beginning date ________________, and ending date _______________.
Check if
FOR AMENDED RETURN - ENTER CODE (1 - 5) from page 2 of instructions
Final Return
Full name of the estate or trust
Employer identification number
Name of fiduciary
Federal identification or social security
Please type
number of fiduciary
or print in
Fiduciary's address
black ink.
City, town or post office
State and ZIP code (foreign country)
2. Status of estate or trust
1. Type of return (check one)
3. Check if this estate or trust has
G
Grantor trust
(check one)
any
nonresident beneficiaries?
F
E
Qualified funeral trust (QFT)
H
Decedent estate
Charitable trust
Resident
S
A
D
Qualif. disability trust
Bankruptcy estate Ch 7
Simple trust
Nonresident Beneficiaries
C
B
Nonresident
Complex trust
Bankruptcy estate Ch 11
T
ESBT
1041 line 22 or 1041-QFT line 12 or Schedule A, line 10
00
4. Federal taxable income from federal form
(
)
4
5. Additions to income (
page 4 for instructions and
codes
- dd lines 5a through 5f
a
)
CODE
CODE
CODE
5a
00
5c
5e
00
00
5b
5f
00
5
00
5d
00
00
00
6
6. Total adjusted income (add lines 4 and 5)
00
7. One-half of federal tax liability on federal return (see page 5)
7
8. Other deductions (
page 5 for instructions and
codes
- dd lines 8a through 8f
a
)
CODE
CODE
CODE
8a
8e
00
8c
00
00
8b
8f
00
00
00
8
8d
00
00
9. Total deductions (add lines 7 and 8)
9
00
10. Utah taxable income (subtract line 9 from line 6)
10
00
11. Utah tax (compute from rate schedule on back using the amount on line 10)
11
12. Credit for tax paid to another state (from Schedule B, line 7 - page 6)
12
00
13. Nonrefundable credits (
pages 6 through 8 for instructions and
codes
- dd lines 13a through 13f
a
)
CODE
CODE
CODE
13e
13a
13c
00
00
00
13b
00
13f
13
00
00
00
13d
If claiming the Qualified Sheltered Workshop cash contribution credit (
code 02
), write the
Qualified Sheltered Workshop name here:
___________________________________________________
14. Total tax paid to another state and nonrefundable credits (add lines 12 and 13)
14
00
15. Subtract line 14 from line 11 (if line 14 is greater than or equal to line 11, enter zero)
15
00
16
00
16. AMENDED RETURNS ONLY (previous refund received on original return)
17
00
17. Utah use tax (see pages 8 and 9)
00
18
18. Total tax, additions and use tax (add lines 15, 16 and 17)
00
19
19. Utah tax withheld (see page 9)
00
20
20. Credit for Utah income taxes prepaid (from form TC-548)
00
21
21. AMENDED RETURNS ONLY (taxes paid on original return)
22. Refundable credits (
pages 9 and 10 for instructions and
codes
- dd lines 22a through 22f
a
)
CODE
CODE
CODE
22a
22e
00
22c
00
00
22b
22f
22
00
00
00
00
22d
If claiming the nonresident shareholder's tax credit
(
code 43
), enter the S corporation federal ID number
00
23
23. Total withholdings and credits (add lines 19 through 22)
00
24. Tax Due - if line 18 is greater than line 23, subtract line 23 from line 18. This is the amount you owe.
TAX DUE
24
00
25
25. Refund - if line 23 is greater than line 18, subtract line 18 from line 23. This is the amount you overpaid.
REFUND
This return must be signed on the back.

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