Form Ct-1041 - Connecticut Income Tax Return For Trusts And Estates

Schedule A - Connecticut Fiduciary Adjustments: See instructions.

Additions

1. Interest on state and local government obligations other than Connecticut

2. Mutual fund exempt-interest dividends from state or municipal government obligations other than

Connecticut

3. Loss on sale of Connecticut state and local government bonds: Enter as a positive number.

4. Connecticut income tax payments deducted in determining federal taxable income prior to deductions

relating to distributions to beneﬁ ciaries

5. Other (Specify) __________________________________________________________________

6. Total additions: Add Lines 1 through 5.

Subtractions

7. Interest on U.S. government obligations

8. Exempt dividends from certain qualifying mutual funds derived from U.S. government obligations

9. Gain on sale of Connecticut state and local government bonds

10. Refunds of Connecticut income tax

11. Other (Specify) __________________________________________________________________

12. Total subtractions: Add Lines 7 through 11.

13. Connecticut ﬁ duciary adjustment: Subtract Line 12 from Line 6. This amount may be positive or

negative. Enter on Schedule CT-1041B, Part 1, Line f, Column 5.

Resident estates or full year resident trusts, except for those that meet the Quick-File

Requirements, must attach Schedule CT-1041C and, if applicable, Schedule CT-1041FA.

Questions

If the trust is an inter vivos trust, enter name, address, and Social Security Number of grantor:

____________________________________________________________________________________________________

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

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.

Schedule CT-1041B

Schedule CT-1041C

Schedule CT-1041FA

Form CT-1041 Schedule I

Also attach the following, if applicable:

Form CT-8801;

Forms W-2, W-2G, 1099, and Schedule CT K-1 if Connecticut income tax was withheld or the tax withheld will be disallowed; and

Copies of all income tax returns ﬁ led with qualifying jurisdictions or the credit for income taxes paid to a qualifying jurisdiction will be

disallowed.

Amended return: Attach a statement explaining the reason for ﬁ ling an amended return.

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 the penalty for willfully delivering a false return or document to DRS is a ﬁ ne of not more than $5,000, or

imprisonment for not more than ﬁ ve 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 ﬁ duciary or ofﬁ cer representing ﬁ duciary

Date

Telephone number

Sign

(

)

Here

Paid preparer’s signature

Preparer’s Tax Identiﬁ cation Number (PTIN) or SSN

Keep a

copy of