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2005

Form CT-1040NR/PY

FOR DRS

2 0

Connecticut Nonresident and Part-Year

USE ONLY

CT-1040NR/PY

Resident Income Tax Return

Complete return in

Taxpayers must sign

declaration on reverse side.

blue or black ink only.

2005

For the year January 1 - December 31, 2005, or other taxable year beginning: _______________ ,

and ending: ________________ , ______ .

Filing Status

Head of

Single

Married filing jointly or qualified

Married filing

widow(er) with dependent child

household

separately

(Enter spouse SSN below and full name here.)

Check if

Your Social Security Number

Spouse Social Security Number

deceased

Your First Name

Last Name (If two last names, insert a space between names.)

Suffix (Jr./Sr.)

Spouse's First Name

Last Name (If two last names, insert a space between names.)

Suffix (Jr./Sr.)

Mailing Address (number and street, apartment number, suite number, PO Box)

2005 resident status

Nonresident

Part-Year Resident

City, Town, or Post Office

State

ZIP Code

(If town is two words, leave a space between the words.)

Check here if you do not want forms

Check here if you filed

Check here if you are filing the

CT-8379

sent to you next year. (This does not

Form CT-2210 and checked

following and attach the form

Schedule CT-1040CRC

relieve you of your responsibility to file.)

any boxes on Part 1.

to the front of the return.

Whole Dollars Only

1. Federal adjusted gross income (From federal Form 1040, Line 37;

Form 1040A, Line 21; or Form 1040EZ, Line 4)

2. Additions to federal adjusted gross income (From Schedule 1, Line 41)

3. Add Line 1 and Line 2.

4. Subtractions from federal adjusted gross income (From Schedule 1, Line 52) 4.

5. Connecticut Adjusted Gross Income (Subtract Line 4 from Line 3.)

6. Income from Connecticut sources (From Schedule CT-SI, Line 30)

7. Enter the greater of Line 5 or Line 6. (If zero or less, go to Line 12 and enter “0.”) 7.

8. Income Tax (From Tax Tables or Tax Calculation Schedule. See instructions, Page 15.) 8.

9. Divide Line 6 by Line 5. (If Line 6 is equal to or greater than Line 5, enter 1.0000.) 9.

10. Multiply Line 9 by Line 8.

10.

11. Credit for income taxes paid to qualifying jurisdictions during resident portion

of taxable year — Part-Year Residents Only (From Schedule 2, Line 61)

11.

12. Subtract Line 11 from Line 10. (If Line 11 is greater than Line 10, enter "0.") 12.

13. Connecticut Alternative Minimum Tax (From Form CT-6251)

13.

14. Add Line 12 and Line 13.

14.

15. Adjusted Net Connecticut Minimum Tax Credit (From Form CT-8801)

15.

16. Connecticut Income Tax (Subtract Line 15 from Line 14. If less than zero, enter “0.”)16.

17. Individual Use Tax (From Schedule 3, Line 62. If no tax is due, enter “0.”)

17.

18. Add Line 16 and Line 17.

18.

Due date: April 15, 2006 - Attach a copy of all applicable schedules and forms to this return.

E-FILE Your Return For Faster Refund, see Page 4 of booklet.

Form Ct-1040nr/py - Connecticut Nonresident And Part-Year Resident Income Tax Return - 2005

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