Form Ct-1040ez - Connecticut Resident Ez Income Tax Return - 2007 Page 2
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2
3Form CT-1040EZ - Page 2 of 3
Your Social
-
-
Security Number
00
.
9. Enter amount from Line 8.
9.
,
Column A
Column B
Column C
3
Employer’s federal ID No. from Box b of W-2
Connecticut Wages, Tips, etc.
or Payer’s federal ID No. from Form 1099
Connecticut Income Tax Withheld
.
–
00
00
.
10a.
10a.
,
W-2 and 1099
Information
.
–
00
00
.
10b.
10b.
,
Only enter
information
.
–
00
00
.
10c.
10c.
from your W-2
,
and 1099 forms
.
–
00
00
.
10d.
if Connecticut
10d.
,
income tax
.
–
00
.
00
was withheld.
10e.
10e.
,
.
–
00
00
.
10f.
10f.
,
.
–
00
00
.
10g.
10g.
,
00
.
,
10h.
Enter amount from Supplemental Schedule CT-1040WH, Line 3.
10h.
.
00
,
10. Total Connecticut Income Tax Withheld: Add amounts in Column C and enter here.
10.
You must complete Columns A, B, and C or your withholding will be disallowed.
00
.
,
11. All 2007 estimated tax payments and any overpayments applied from a prior year
11.
00
.
,
12. Payments made with Form CT-1040 EXT (Request for extension of time to file)
12.
00
.
,
13. Total Payments: Add Lines 10, 11, and 12.
13.
00
.
,
4
14. Overpayment: If Line 13 is more than Line 9, subtract Line 9 from Line 13.
14.
00
.
,
15. Amount of Line 14 you want applied to your 2008 estimated tax
15.
00
.
,
16. Total Contributions of Refund to Designated Charities from Schedule 3EZ, Line 29
16.
17. Refund: Subtract Lines 15 and 16 from Line 14.
00
.
,
For faster refund, use Direct Deposit by completing Lines 17a, 17b, and 17c.
17.
17a.Type:
17b. Routing
17c. Account
checking
Number
Number
savings
00
.
5
,
18. Total Amount Due: If Line 9 is more than Line 13, subtract Line 13 from Line 9.
18.
Declaration: I declare under penalty of law that I have examined this return (including any accompanying
6
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 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.
Your Signature
Date
Daytime Telephone Number
(
)
Spouse’s Signature (if joint return)
Date
Daytime Telephone Number
(
)
Paid Preparer’s Signature
Date
Telephone Number
Preparer’s SSN or PTIN
(
)
Firm’s Name, Address, and ZIP Code
FEIN
Third Party Designee - Complete the following to authorize DRS to contact another person about this return.
Designee’s Name
Telephone Number
Personal Identification Number (PIN)
Complete applicable schedules on Form CT-1040EZ, Page 3, and send all three pages of the return to DRS.
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