Schedule Ct-1040aw Draft - Part-Year Resident Income Allocation

2012

Department of Revenue Services

Schedule CT-1040AW

State of Connecticut

Part-Year Resident Income Allocation

(Rev. 12/12)

Part-year residents must complete this schedule before completing Schedule CT-SI and attach it to Form CT-1040NR/PY. Complete in blue

or black ink only.

Your Social Security Number

Your ﬁ rst name and middle initial

Last name

• •

__ __ __ __ __ __ __ __ __

•

Spouse’s Social Security Number

If joint return, spouse’s ﬁ rst name and middle initial

Last name

• •

__ __ __ __ __ __ __ __ __

• •

Part 1 – Adjusted Gross Income

Federal Income

Connecticut

as Modiﬁ ed

Nonresident Period

Resident Period

See instructions.

Column C

Column D

Column A

Column B

Income from

Income from Column A

Income from Column C

Income from Column A

for this period

from Connecticut sources

federal return

for this period

1. Wages, salaries, tips, etc. .......................................... 1

2. Taxable interest .......................................................... 2

3. Ordinary dividends ..................................................... 3

4. Alimony received ....................................................... 4

5. Business income or (loss) .......................................... 5

6. Capital gain or (loss) .................................................. 6

7. Other gains or (losses) .............................................. 7

8. Taxable amount of IRA distributions .......................... 8

9. Taxable amount of pensions and annuities ................ 9

10. Rental real estate, royalties, partnerships,

DRAFT

S corporations, trusts, etc. ......................................... 10

11. Farm income or (loss) ................................................ 11

12. Unemployment compensation ................................... 12

13. Taxable amount of social security beneﬁ ts ................ 13

14. Other income: See instructions. ................................ 14





15. Add Lines 1 through 14. . ......................................

Part 2 – Adjustments to Income

9/24/2012

16. Educator expenses .................................................... 16

17. Certain business expenses of reservists,

artists, and fee-basis government ofﬁ cials ................. 17

18. Health savings account deduction ............................. 18

19. Moving expenses ....................................................... 19

20. Deductible part of self-employment tax ..................... 20

21. Self-employed SEP, SIMPLE, and qualiﬁ ed plans ..... 21

22. Self-employed health insurance deduction ................ 22

23. Penalty on early withdrawal of savings ...................... 23

24. Alimony paid .............................................................. 24

25. IRA deduction ............................................................ 25

26. Student loan interest deduction ................................. 26

27. Tuition and fees ......................................................... 27

28. Reserved for future use ............................................. 28

29. Total adjustments: Add Lines 16 through 28. . ........... 29



30. Subtract Line 29 from Line 15. . ............................

This reﬂ ects the information on the federal 1040 as of the print date. Check the DRS website at for an updated Schedule CT-1040AW.

Line 30, Column A, must equal the amount on Form CT-1040NR/PY, Line 5.

Add Columns B and D for each line and enter the totals on Lines 1 through 30 on Schedule CT-SI.

Part 3 – Part-Year Resident Information

Moved Into Connecticut

1. Date you moved into Connecticut

and state of prior residence:

2. Date your spouse moved into Connecticut

and state of prior residence:

Moved Out of Connecticut

1. Date you moved out of Connecticut

and state of new residence

2. Date your spouse moved out of Connecticut

and state of new residence

Income From Connecticut Sources During Nonresident Period





1. Did you receive income from Connecticut sources during your nonresident period? ....................................................

Yes



2. Did your spouse receive income from Connecticut sources during his or her nonresident period? .............................

Yes

P:\Special\AFP\PROD\FORMS\12\SCHEDULE\Schedule CT-1040AW\CT-1040AW 20120731.indd

20120731

10:40 AM

Schedule Ct-1040aw Draft - Part-Year Resident Income Allocation - 2012

Related Articles

Related forms

Related Categories