Form Ct K-1t - Transmittal Of Schedule Ct K-1, Member'S Share Of Certain Connecticut Items - 2013
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1
2Department of Revenue Services
2013
Form CT K-1T
State of Connecticut
PO Box 150420
Transmittal of Schedule CT K-1,
Hartford CT 06115-0420
Member’s Share of Certain Connecticut Items
For DRS use only
(Rev. 12/13)
-
-
20
Complete this form in blue or black ink only.
Pass-Through Entity Information
Federal Employer ID Number (FEIN)
CT Tax Registration Number
Pass-through entity name
Number and street address
PO Box
City or town
State
ZIP code
Part I - Schedule CT K-1s Submitted
1. Total number of Schedule CT K-1s submitted with this Form CT K-1T ............................................
1.
Part II - Number of Members
Column A
Column B
Number of Members
Ownership Percentage by
Member Type
.
1. Resident (RI, RT, RE) .........................................................................
.
2. Nonresident (NI, NT, NE, PE) .............................................................
.
3. Corporate (CM) .................................................................................
Part III - Summary of Schedule CT K-1 Information
1. Total Connecticut-sourced income (NI, NT, NE) ...............................................................................
1.
00
2. Total Connecticut-sourced income (PE) ...........................................................................................
2.
00
3. Connecticut-sourced income: Amount from Form CT-1065/CT-1120SI, Part I, Schedule A, Line 1. ...
3.
00
4. Connecticut tax liability: Amount from Form CT-1065/CT-1120SI, Part I, Schedule A, Line 4. .........
4.
00
Part IV - Summary of Income Tax Credits
Total Credit Allocated to
Members
1. Qualifi ed small business tax credit ...................................................................................................
1.
00
2. Job expansion tax credit ...................................................................................................................
2.
00
3. Angel investor tax credit ..................................................................................................................
3.
00
4. Insurance reinvestment fund tax credit ............................................................................................
4.
00
5. Total credits earned in 2013: Add Lines 1 through 4. .......................................................................
5.
00
A penalty of $5 per schedule (up to a total of
Do not attach Form CT K-1T or copies of
Attach Schedule CT K-1s to Form CT K-1T
$2,000 per calendar year) will be imposed for
Schedule CT K-1, Member’s Share of Certain
and mail to:
failure to provide a copy of Schedule CT K-1
Connecticut Items to Form CT-1065/CT-1120SI,
Department of Revenue Services
to DRS unless the failure is due to reasonable
Connecticut Composite Income Tax Return.
State of Connecticut
cause and not to willful neglect.
Form CT K-1T and copies of Schedule CT K-1
PO Box 150420
must be mailed separately.
Hartford CT 06115 - 0420
Declaration: I declare under the 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 the Department
of Revenue Services (DRS) is a fi ne of not more than $5,000, imprisonment for not more than fi ve years, or both.
Signature
Date
Sign Here
Keep a copy
of this
Title
Telephone number
return for
your
(
)
records.
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