Form Ct-1040 - Connecticut Resident Income Tax Return - 2004

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2004
Form CT-1040
2 0
FOR DRS
1040
USE ONLY
Connecticut Resident Income Tax Return
2004
For the year January 1 - December 31, 2004, or other taxable year beginning: _________________ ,
and ending: ________________ , ______ .
Your Social Security Number
Filing Status
Single
Married filing jointly
Married filing SEPARATELY.
Head of
or Qualified
Enter spouse’s SSN at left
household
Spouse's Social Security Number
widow(er) with
and full name here:
(with qualifying
dependent child
person)
Your First Name
Last Name
Suffix
MI
Spouse's First Name
MI
Last Name
Suffix
Home Address (number and street)
Apartment Number, PO Box, Suite Number
City, Town, or Post Office
State
ZIP Code
Check here if you do not want forms sent to you next year.
Check here if you are required to file Form CT-2210 and checked
Checking this box does not relieve you of your responsibility to file.
any boxes on Part 1 of that form.
Whole Dollar
Whole Dollar
Whole Dollars Only
Whole Dollar
Whole Dollar
s Only
s Only
s Only
s Only
1. Federal adjusted gross income (from federal Form 1040, Line 36; Form 1040A,
.
00
,
,
Line 21; Form 1040EZ, Line 4; or federal Telefile, Line
I
)
1.
00
.
,
,
2. Additions to federal adjusted gross income (from Schedule 1, Line 39)
2.
00
.
,
,
3. Add Line 1 and Line 2.
3.
.
00
,
,
4. Subtractions from federal adjusted gross income (from Schedule 1, Line 50)
4.
00
.
,
,
5. Connecticut Adjusted Gross Income (Subtract Line 4 from Line 3.)
5.
00
.
,
,
6. Income Tax (from Tax Tables or Tax Calculation Schedule, see instructions, Page 15) 6.
.
00
,
,
7. Credit for income taxes paid to qualifying jurisdictions (from Schedule 2, Line 59)
7.
00
.
,
,
8. Subtract Line 7 from Line 6 (If Line 7 is greater than Line 6, enter "0.")
8.
.
00
,
,
9. Connecticut Alternative Minimum Tax (from Form CT-6251)
9.
.
00
,
,
10. Add Line 8 and Line 9.
10.
11. Credit for property taxes paid on your primary residence and/or motor vehicle
00
.
(from Schedule 3, Line 68)
11.
.
00
,
,
12. Subtract Line 11 from Line 10 (If less than zero, enter “0.”)
12.
.
00
,
,
13. Adjusted Net Connecticut Minimum Tax Credit (from Form CT-8801)
13.
00
.
,
,
14. Connecticut Income Tax (Subtract Line 13 from Line 12.) If less than zero, enter “0.” 14.
.
00
,
,
15. Individual Use Tax (from Schedule 4, Line 69) If no tax is due, enter “0.”
15.
.
00
,
,
16. Total Tax (Add Line 14 and Line 15.)
16.
Taxpayers must sign declaration on reverse side.
Due date: April 15, 2005 - Attach a copy of all applicable schedules and forms to this return.
WEBFILE OR E-FILE YOUR RETURN FOR FASTER REFUND, see Page 4 of booklet.

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