Form Ct-1065/ct-1120si - Connecticut Composite Income Tax Return

Part VI – Connecticut-Sourced Portion of Items From Federal Schedule K-1 of Form 1065 or Form 1120S.

Include member’s share of Connecticut modiﬁ cations from Part V.

Attach supplemental attachment(s), if needed.

Member

Totals for All

# ___________

Members

1. Ordinary business income (loss) ............................. 1.

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2. Net rental real estate income (loss) ......................... 2.

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3. Other net rental income (loss) ................................. 3.

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4. Guaranteed payments ............................................. 4.

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5. Interest income ........................................................ 5.

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6a. Ordinary dividends .................................................. 6a.

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6b. Qualiﬁ ed dividends .................................................. 6b.

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7. Royalties .................................................................. 7.

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8. Net short-term capital gain (loss) ............................ 8.

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9a. Net long-term capital gain (loss) .............................. 9a.

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9b. Collectibles (28%) gain (loss) .................................. 9b.

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9c. Unrecaptured section 1250 gain ............................. 9c.

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10. Net section 1231 gain (loss) .................................... 10.

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11. Other income (loss): Attach statement. ................... 11.

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12. Section 179 deduction ............................................. 12.

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13. Other deductions: Attach

statement.

....................... 13.

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Part VII

–

Connecticut Income Tax Credit Summary

Attach supplemental attachment(s), if needed.

Totals for

Member

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# ___________

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All Members

1. Qualiﬁ ed small business tax credit .......................... 1.

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2. Vocational rehabilitation job creation tax credit ...... 2.

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3. Angel investor tax credit ......................................... 3.

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4. Insurance reinvestment fund tax credit .................. 4.

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5. Total credits: Add Lines 1 through 4. ...................... 5.

The PE must furnish Schedule CT K-1 to all members.

Copies of all Schedule CT K-1s issued by a PE must be ﬁ led with the Department of Revenue Services (DRS).

Do not attach Schedule CT K-1s to the composite income tax return. See Form CT K-1T instructions.

Visit the DRS website at to use the Taxpayer Service Center (TSC) to ﬁ le and pay this return electronically. To pay

by mail, make check payable to Commissioner of Revenue Services. Mail return with payment to: Department of Revenue Services,

State of Connecticut, PO Box 5019, Hartford CT 06102-5019. Mail return without payment to: Department of Revenue Services, State of

Connecticut, PO Box 2967, Hartford CT 06104-2967.

Declaration: I declare under penalty of law that I have examined this return (including any accompanying 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 ﬁ ne of not

more than $5,000, imprisonment for not more than ﬁ ve 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.

Signature of general partner or corporate ofﬁ cer

Date

May DRS contact the preparer

shown below about this return?

Sign Here

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Yes

Title

Telephone number

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