Connecticut Telefile Tax Return Form - 2002
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1
2
3Connecticut Telefile Tax Return
2002
Keep this copy of your 2002
Connecticut income tax
Use your telephone to file. Do not mail.
Telefile
return for your records.
Your Name(s)
1A.
Your Social
-
-
Quick Start Checklist!
Security Number
1B.
•
Complete Federal Return.
Spouse’s Social
-
-
Security Number
•
Fill in Items 1 through 10.
(If married filing a joint return)
2.
Personal Identification Number (PIN)
•
Call 860-692-9787.
(Printed on the label on the back cover. If you do not know your PIN,
see Page T6.)
3.
NOTE:
Your filing status must be the same as your federal income tax filing status for the 2002 taxable year.
Filing
A.
Status
Single
Married filing SEPARATELY
C.
Check only
Married filing jointly or Qualifying
B.
D.
Head of household (with qualifying person)
one box.
widow(er) with dependent child
4.
5 5 5 5 5 .
Federal Adjusted Gross Income (AGI) from your federal Form 1040EZ, Line 4;
4 4 4 4 4 .
.00
I
Form 1040A, Line 21; Form 1040, Line 35; or TeleFile Tax Record, Line
.
5.
CHECK THE BOX INDICATING THE FORM USED TO FILE YOUR 2002 FEDERAL RETURN
1040EZ
1040A
TeleFile
1040
Refunds of State and Local Income Taxes: Enter “0” in item 5 if your 2002 federal return is a
5. 5. 5. 5. 5.
.00
Form 1040EZ, Form 1040A, or you TeleFiled your federal return. If you filed federal Form 1040,
enter the amount reported on federal Form 1040, Line 10.
6.
Enter the total number of W-2 forms and any 1099 forms showing Connecticut
6 6 6 6 6 .
income tax withholding.
(Maximum of seven)
7.
Enter the Employer Identification Number and Connecticut income tax withheld for each W-2 form or
1099 form included in Item 6. (See instructions on Page T6)
Column C
Column A
Column B
Employer Identification Number from your W-2 or 1099 Forms
Connecticut Income Tax Withheld
W-2 or 1099
1st
.00
2nd
.00
3rd
.00
4th
.00
5th
.00
.00
6th
7th
.00
8.
Auto 1
Auto 2
Primary Residence
Enter the amount of Property
(If married filing a joint return)
Taxes paid to your town on:
8A
8B
8C
.00
.00
.00
(See instructions on Page T6)
9.
Enter the individual use tax due if you purchased taxable
Individual Use Tax
9 9 9 9 9 .
goods or services and did not pay Connecticut sales tax on
.00
(See instructions on Page T7)
the purchase. If none enter “0.”
10.
1 – Checking
Want your refund
10A. Account Type
2 – Savings
directly deposited,
10B. Routing Number
or your tax due
automatically
10C. Account Number
withdrawn? Fill in
Complete Item 10D only if you want your tax due withdrawn at a future date. (See instructions on Page T7)
Items 10A, 10B, and
10D. Enter the date you want your tax due withdrawn
10C (and 10D, for
2 0 0 3
from your account (no later than April 15, 2003).
direct payment only).
M M D D
DO NOT MAIL
2002 Connecticut Telefile - Page T4
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