Form Ct-1041 - Connecticut Income Tax Return For Trusts And Estates - 2002 Page 2
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2SCHEDULE A - CONNECTICUT FIDUCIARY ADJUSTMENTS - (See instructions)
Additions
1. Interest on state and local government obligations other than Connecticut
1
2. Mutual fund exempt-interest dividends from state or municipal government obligations other than
Connecticut
2
3. Loss on sale of Connecticut state and local government bonds (Enter as a positive number)
3
4. Connecticut income tax payments deducted in determining federal taxable income prior to deductions
relating to distributions to beneficiaries
4
5. Other (Specify) _________________________________________________________________
5
6. Total additions (Add Lines 1 through 5)
6
Subtractions
7. Interest on U.S. government obligations
7
8. Exempt dividends from certain qualifying mutual funds derived from U.S. government obligations
8
9. Gain on sale of Connecticut state and local government bonds
9
10. Refunds of Connecticut income tax
10
11. Other (Specify) _________________________________________________________________
11
12. Total subtractions (Add Lines 7 through 11)
12
13. Connecticut fiduciary adjustment - (Subtract Line 12 from Line 6. This amount may be positive or
negative.) Enter on Form CT-1041, Schedule B , Part 1, Line f, Column 5.
13
Resident estates or full year resident trusts (except for those that meet the Quick-File
Requirements) must attach Form CT-1041, Schedule C and if applicable, Schedule CT-1041FA
Questions
A.
If the trust is an inter vivos trust, enter name, address, and Social Security Number of grantor:
________________________________________________________________________________
B.
If you checked “Part-year resident trust” on the front of this return, enter the date on which the trust
became irrevocable: ______________________________________________
C. Does the trust or estate have an interest in real property or tangible personal property located in
Connecticut?
Yes
No
Completed CT-1041 Schedules, must be attached to the back of Form CT-1041 in the following order, unless the trust or estate
meets the Quick-File Requirements . Also attach Form CT-8801, if applicable, and a copy of all income tax returns filed with
qualifying jurisdictions, if applicable, or the credit will be disallowed.
1.
Schedule B
2.
Schedule C
3.
Schedule CT-1041FA
4.
Schedule I
5.
Form CT-8801
6.
Credit for income taxes paid to qualifying jurisdictions - Attach a copy of all income tax returns filed with qualifying
jurisdictions or the credit will be disallowed.
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 that the penalty for willfully delivering a false return to DRS is a fine of not more than $5,000, or imprisonment for
not more than five 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 Fiduciary or Officer Representing Fiduciary
Date
Telephone Number
Sign
(
)
Here
Paid Preparer’s Signature
Preparer’s PTIN or SSN
Keep a
copy of
this return
Firm’s Name and Address
Federal Employer ID Number
for your
records
Telephone Number
(
)
Check this box if you used a paid preparer and do not want forms sent to you next year.
Checking this box does not relieve you of your responsibility to file.
Form CT-1041 Back (Rev. 12/02)
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