Form Ct-1040nr/py - Connecticut Nonresident And Part-Year Resident Income Tax Return - 2007 Page 2

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Form CT-1040NR/PY - Page 2 of 4
Your Social
-
-
Security Number
00
.
19. Enter amount from Line 18.
19.
,
,
Column C
Column A
Column B
3
Employer’s federal ID No. from Box b of W-2, or
Connecticut Wages,
Connecticut Income Tax Withheld
Schedule
Check box at left if from Schedule CT K-1.
Payer’s federal ID No. from Schedule CT K-1 or 1099
Tips, etc.
CT K-1
.
00
00
.
20a.
20a.
,
,
W-2
and 1099
.
00
00
.
20b.
20b.
,
,
Information
Only enter
.
00
00
.
20c.
20c.
information
,
,
from your W-2,
.
00
00
Schedule
.
20d.
20d.
,
,
CT K-1, and
.
1099 forms if
00
00
.
20e.
20e.
,
,
Connecticut
.
income tax
00
00
.
20f.
20f.
,
,
was withheld.
.
00
00
.
20g.
,
,
20g.
00
.
20h.
Enter amount from Supplemental Schedule CT-1040WH, Line 3.
20h.
,
,
00
.
,
,
20. Total Connecticut Income Tax Withheld: Add amounts in Column C and enter here. 20.
You must complete Columns A, B, and C or your withholding will be disallowed.
00
.
,
,
21. All 2007 estimated tax payments and any overpayments applied from a prior year
21.
00
.
,
,
22. Payments made with Form CT-1040 EXT (Request for extension of time to file)
22.
00
.
,
,
23. Total Payments: Add Lines 20, 21, and 22.
23.
00
.
,
,
4
24. Overpayment: If Line 23 is more than Line 19, subtract Line 19 from Line 23.
24.
00
.
,
,
25. Amount of Line 24 you want applied to your 2008 estimated tax
25.
00
.
,
,
26. Total Contributions of Refund to Designated Charities from Schedule 4, Line 63
26.
27. Refund: Subtract Lines 25 and 26 from Line 24.
00
.
,
,
For faster refund, use Direct Deposit by completing Lines 27a, 27b, and 27c.
27.
27a. Type:
27b. Routing
27c. Account
checking
Number
Number
savings
00
.
5
,
,
28. Tax Due: If Line 19 is more than Line 23, subtract Line 23 from Line 19.
28.
00
.
,
,
29. If Late: Enter Penalty. Multiply Line 28 by 10% (.10).
29.
30. If Late: Enter Interest. Multiply Line 28 by number of months or fraction of a month
00
.
,
,
late, then by 1% (.01).
30.
.
00
,
,
31. Interest on underpayment of estimated tax: See instructions, Page 18.
31.
00
.
,
,
32. Total Amount Due: Add Lines 28 through 31.
32.
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 Pages 3 and 4.

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