Form Ct-1040es - Estimated Connecticut Income Tax Payment - 2015 Page 3

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Social Security Benefi t Adjustment Worksheet
Enter the amount you expect to enter on Form CT-1040 or Form CT-1040NR/PY, Line 1.
00
If your fi ling status is single or married fi ling separately, is the amount on Line 1 $50,000 or more?

Yes: Complete this worksheet.

No: Do not complete this worksheet. *
If your fi ling status is married fi ling jointly, qualifying widow(er) with dependent child, or head of household, is the
amount on Line 1 $60,000 or more?

Yes: Complete this worksheet.

No: Do not complete this worksheet. *
* If you answered No to either question, enter the amount of federally taxable Social Security benefi ts you expect to report on federal
Form 1040, Line 20b, or federal Form 1040A, Line 14b, on the 2015 Estimated Connecticut Income Tax Worksheet, Line 2.
A. Enter the amount you reported on federal Publication 505 **, Tax Withholding and Estimated
Tax, Worksheet 2-2, Line 1. If Line A is zero or less, stop here. Otherwise, go to Line B.
A.
B. Enter the amount you reported on federal Publication 505 **, Tax Withholding and Estimated
Tax, Worksheet 2-2, Line 10. If Line B is zero or less, stop here. Otherwise, go to Line C. B.
C. Enter the lesser of Line A or Line B.
C.
D. Multiply Line C by 25% (.25).
D.
E. Expected taxable amount of Social Security benefi ts you reported on federal
Publication 505 **, Tax Withholding and Estimated Tax, Worksheet 2-2, Line 19.
E.
F. Social Security benefi t adjustment: Subtract Line D from Line E. Enter the amount here
and as a subtraction on the 2015 Estimated Connecticut Income Tax Worksheet, Line 2. If
Line D is greater than or equal to Line E, enter “0.”
F.
**
To obtain federal Publication 505, visit the IRS website at or call the IRS at 800-829-3676.
Table A - Personal Exemptions for 2015 Taxable Year
Enter the exemption amount on the Tax Calculation Schedule, Line 2.
Use the fi ling status you expect to report on your 2015 tax return and your Connecticut AGI *** (from Tax Calculation Schedule,
Line 1) to determine your exemption.
Married Filing Jointly or
Single
Married Filing Separately
Head of Household
Qualifi ed Widow(er)
***
***
***
***
Connecticut AGI
Exemption Connecticut AGI
Exemption Connecticut AGI
Exemption Connecticut AGI
Exemption
More Than Less Than
More Than Less Than
More Than Less Than
More Than Less Than
or Equal To
or Equal To
or Equal To
or Equal To
$
0
$30,000
$15,000
$
0
$48,000
$24,000
$
0
$24,000
$12,000
$
0
$38,000
$19,000
$30,000
$31,000
$14,000
$48,000
$49,000
$23,000
$24,000
$25,000
$11,000
$38,000
$39,000
$18,000
$31,000
$32,000
$13,000
$49,000
$50,000
$22,000
$25,000
$26,000
$10,000
$39,000
$40,000
$17,000
$32,000
$33,000
$12,000
$50,000
$51,000
$21,000
$26,000
$27,000
$ 9,000
$40,000
$41,000
$16,000
$33,000
$34,000
$11,000
$51,000
$52,000
$20,000
$27,000
$28,000
$ 8,000
$41,000
$42,000
$15,000
$34,000
$35,000
$10,000
$52,000
$53,000
$19,000
$28,000
$29,000
$ 7,000
$42,000
$43,000
$14,000
$35,000
$36,000
$ 9,000
$53,000
$54,000
$18,000
$29,000
$30,000
$ 6,000
$43,000
$44,000
$13,000
$36,000
$37,000
$ 8,000
$54,000
$55,000
$17,000
$30,000
$31,000
$ 5,000
$44,000
$45,000
$12,000
$37,000
$38,000
$ 7,000
$55,000
$56,000
$16,000
$31,000
$32,000
$ 4,000
$45,000
$46,000
$11,000
$38,000
$39,000
$ 6,000
$56,000
$57,000
$15,000
$32,000
$33,000
$ 3,000
$46,000
$47,000
$10,000
$39,000
$40,000
$ 5,000
$57,000
$58,000
$14,000
$33,000
$34,000
$ 2,000
$47,000
$48,000
$ 9,000
$40,000
$41,000
$ 4,000
$58,000
$59,000
$13,000
$34,000
$35,000
$ 1,000
$48,000
$49,000
$ 8,000
$41,000
$42,000
$ 3,000
$59,000
$60,000
$12,000
$35,000
and up
$
0
$49,000
$50,000
$ 7,000
$42,000
$43,000
$ 2,000
$60,000
$61,000
$11,000
$50,000
$51,000
$ 6,000
$43,000
$44,000
$ 1,000
$61,000
$62,000
$10,000
$51,000
$52,000
$ 5,000
$44,000
and up
$
0
$62,000
$63,000
$ 9,000
$52,000
$53,000
$ 4,000
$63,000
$64,000
$ 8,000
$53,000
$54,000
$ 3,000
$64,000
$65,000
$ 7,000
$54,000
$55,000
$ 2,000
$65,000
$66,000
$ 6,000
$55,000
$56,000
$ 1,000
$66,000
$67,000
$ 5,000
$56,000
and up
$
0
$67,000
$68,000
$ 4,000
$68,000
$69,000
$ 3,000
$69,000
$70,000
$ 2,000
$70,000
$71,000
$ 1,000
$71,000
and up
$
0
*** Form CT-1040NR/PY fi lers must use income from Connecticut sources if it exceeds Connecticut adjusted gross income.
Form CT-1040ES (Rev. 01/15)
Page 3 of 6

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