Form Tc40 - Utah Individual Income Tax Return - 2004 Page 2
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Utah Income Tax Return TC-40 (2004) Page 2
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18. Enter tax (
full-year Utah resident, enter tax from line 16b - non or part-year resident, enter tax from line 17
)
18
19. Credit for income tax paid to another state (page 10). Attach form TC-40A. Nonresidents do not qualify.
.
00
19
20. Nonrefundable credits (pages 10 through 12 - add lines 20a through 20f and enter total nonrefundable credits on line 20)
AMOUNT
CODE
AMOUNT
CODE
.
.
00
20a
00
20b
.
.
00
00
20c
20d
.
.
.
20e
00
20f
00
00
20
If claiming Qualified Sheltered Workshop (
code 02
), write the Workshop name here:
__________________________________
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00
21. Subtotal (add lines 19 and 20)
21
.
00
22. Subtract line 21 from line 18 (Note: if line 21 is greater than or equal to line 18, enter zero)
22
23.
Contributions
(pages 12 through 13 - add lines 23a through 23f and enter total contributions on line 23)
NOTE: SCH/TECH CODE used only for Nonprofit School District Foundation and Utah College of Applied Technology.
SCH/TECH
SCH/TECH
CODE
CODE
AMOUNT
CODE
AMOUNT
CODE
23a
23b
23d
23c
.
23f
23e
00
23
.
24. AMENDED RETURNS ONLY - previous refunds (page 13)
00
24
.
00
25. Tax from recapture of credits (page 13)
25
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00
26. Utah use tax (page 13)
26
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00
27. Total tax, use tax and additions to tax (add lines 22 through 26)
27
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00
28.
UTAH TAX WITHHELD
(must attach Utah W-2 and/or 1099 forms) (page 14)
UTAH TAX WITHHELD
28
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00
29. Credit for Utah income taxes prepaid (page 14)
29
.
00
30. AMENDED RETURNS ONLY - previous payments (page 14)
30
31. Refundable credits (pages 14 through 15 - add lines 31a through 31f and enter total refundable credits on line 31)
CODE
AMOUNT
AMOUNT
CODE
.
.
00
31a
00
31b
.
.
31c
00
00
31d
.
.
.
00
31e
00
31f
00
31
If claiming the nonresident shareholder's tax credit
(
code 43
), enter S corporation’s federal ID number
.
00
32
32. Total (add lines 28 through 31)
33. Tax due
- If line
27
is greater than line
32
, subtract line
32
from line
27 This is the amount you owe.
.
.
00
You will be billed for any penalty and interest owed. See page 15 about payment options.
33
TAX DUE
Use enclosed envelope or mail to Utah State Tax Commission, 210 N 1950 W, SLC, UT 84134-0266
34. Refund
- If line
32
is greater than line
27
, subtract line
27
from line
32 This is your refund.
.
(page 15)
.
00
REFUND
34
Use enclosed envelope or mail to Utah State Tax Commission, 210 N 1950 W, SLC, UT 84134-0260
35.
Enter the amount of refund you want applied to your 2005 taxes. Your refund will be reduced
Amount to be
.
00
by this amount.
If AMENDING, you cannot apply refund to 2005 tax liability.
(page 15)
35
applied to 2005
36. DIRECT DEPOSIT YOUR REFUND. Complete information below. (page 15)
Routing number
What type of account is it?
Account number
Checking
Savings
account
account
Under penalties of perjury, I declare to the best of my knowledge and belief, this return and accompanying schedules reflect my true tax status.
Your signature
Date signed
Date signed
Spouse' s signature (if filing jointly, both MUST sign even if only one had income)
SIGN
HERE
Designee' s telephone number
Designee' s personal ID number (PIN)
Name of designee (if any) you authorize to discuss this return with the Tax Commission (page 15)
Preparer' s signature (page 16)
Preparer' s Social Security no. or PTIN
Preparer' s telephone number
Firm' s name and address
Preparer' s EIN
40042
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