Form Ct-990t - Unrelated Business Income Tax Return

Form CT-990T

CT-990T

Department of Revenue Services

2003

State of Connecticut

Connecticut Unrelated Business Income Tax Return

(Rev. 12/03)

ENTER INCOME YEAR

BEGINNING _______________________, 2003, AND

ENDING ________________________, _______

Organization Name

(Please type or print)

CT TAX REGISTRATION NUMBER

DRS

USE ONLY

Audited By

Address

Number and Street

PO Box

DRS USE ONLY

–

– 20

City or Town

State

ZIP Code

FEDERAL EMPLOYER ID NUMBER

Init. _________

CHECK AND COMPLETE ALL APPLICABLE BOXES

IF THE ORGANIZATION IS ANNUALIZING ITS INCOME CHECK HERE

CHANGE OF:

Mailing Address

Closing Month (Attach explanation) RETURN STATUS:

Amended Return

Initial Return

Final Return

TYPE OF ORGANIZATION:

Corporation

Domestic Trust

Foreign Trust

Other (Explain) ________________________

1. Date unrelated trade or business began in Connecticut: _________________________________________

2. Nature of unrelated trade or business income activity: ________________________________________________________________________________

3. CORPORATIONS ONLY: Enter state of incorporation: _________________________ Date of organization: __________________________________

Date qualified in Connecticut if not incorporated in Connecticut: ________________________________________________________________________

IF FINAL RETURN:

DISSOLVED

WITHDRAWN

MERGED/REORGANIZED (Enter survivor’s CT Tax Registration Number) ________________________

– ATTACH A COMPLETE COPY OF FORM 990-T INCLUDING ALL SCHEDULES AS FILED WITH THE INTERNAL REVENUE SERVICE –

COMPUTATION OF INCOME

1. Federal unrelated business taxable income (2003 federal Form 990-T, Part II, Line 34) ...............................

2. Federal net operating loss deduction (2003 federal Form 990-T, Part II, Line 31) ..........................................

3. Federal deduction for Connecticut tax on unrelated business taxable income ..............................................

4. TOTAL (Add Lines 1, 2, and 3) .....................................................................................................................

5. Refund or credit for overpayment of Connecticut tax included in federal unrelated business taxable income

6. Unrelated business taxable income (Subtract Line 5 from Line 4) ..................................................................

COMPUTATION OF TAX

1. Unrelated business taxable income (Line 6 above) (If 100% Connecticut, enter also on Line 3.) ............

2. Apportionment fraction (Form CT-990T, Schedule A , Line 5. Carry to six places.) ....................................

3. Connecticut unrelated business taxable income (Line 1 or Line 1 multiplied by Line 2) ................................

4. Operating loss carryover (Form CT-990T, Schedule B , Line 6) ...................................................................

5. Income subject to tax (Subtract Line 4 from Line 3) ........................................................................................

6. TAX: Multiply Line 5 by 7.5% (.075) .................................................................................................................

COMPUTATION OF AMOUNT PAYABLE

1. Tax (From Computation of Tax , Line 6) ...........................................................................................................

2. Surtax (Line 1 multiplied by 20% (.20)) ............................................................................................................

3. Total Tax (Enter the total of Line 1 and Line 2) ................................................................................................

4. Electronic Data Processing Equipment Property Tax Credit (Attach Form CT-1120 EDPC) .........................

5. Balance of tax payable (Subtract Line 4 from Line 3. If zero or less, enter -0-) ...........................................

1 2 3 4 5 6

ENTER TOTAL OF

1 2 3 4 5 6

6a. Paid with application for extension, Form CT-990T EXT ........

1 2 3 4 5 6

6. TAX

1 2 3 4 5 6

LINES 6a, 6b, & 6c

1 2 3 4 5 6

6b. Paid with estimates (Forms CT-990T ESA, ESB, ESC, & ESD) ..

1 2 3 4 5 6

PAYMENTS

6c. Overpayment from prior year ......................................................

6 c

7. Balance of tax due (overpaid) (Subtract Line 6 from Line 5) ..........................................................................

1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8

Tax overpaid: 8a. Amount on Line 7 to be credited to 2004 estimated tax ..

1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8

8b. Amount to be refunded ...................................................

1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8

8. Total tax overpaid (Add Line 8a and Line 8b) ....................................................................................................... 8

9a. Penalty for late payment or late filing (See instructions) .................................................................................

9b. Interest for late payment or late filing (See instructions) .................................................................................

9c. Interest on underpayment of estimated tax (Attach Form CT-1120I) ...........................................................

9. Balance due with this return (Add Lines 7, 9a, 9b, and 9c) .................................................................

Make check or money order payable to: COMMISSIONER OF REVENUE SERVICES (Attach check or money order to return with paper clip. Do not staple.)

Mail to: Department of Revenue Services, PO Box 5014, Hartford CT 06102-5014

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 Officer or Fiduciary

Date

May DRS contact the preparer

SIGN HERE

shown below about this return?

Title

Telephone Number

Yes

Keep a

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C:\Working Directory\Forms\2003\CT\990T\CT-990T 20031202.p65