Form Ct-1040x - Amended Connecticut Income Tax Return For Individuals - 2015 Page 3
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12Form CT-1040X
Your Social Security Number
Page 3 of 5
(Rev. 12/15)
1040X 00 15W 03 9999
Withholding schedule: Only enter information from your Schedule CT K-1, W-2, and 1099 forms if Connecticut income tax was withheld.
Column A: Employer Federal ID Number
Column B: CT Wages, Tips, etc.
Check if from
Column C: CT Income Tax Withheld
Schedule CT K-1
Do not include dashes.
.00
.00
70a.
.00
.00
70b.
.00
.00
70c.
.00
.00
70d.
.00
.00
70e.
.00
70f. Enter additional Connecticut withholding from Supplemental Schedule CT-1040WH, Line 3.
.00
70. Total Connecticut income tax withheld: Enter here and on Line 21, Column C.
A.
B.
C.
Original amount or as
Net change increase
Correct amount
Payments
previously adjusted
or (decrease)
21. Connecticut tax withheld: Enter amount
.00
from Line 70. .................................................... 21.
22. All 2015 estimated Connecticut income tax
payments (including any overpayments
applied from a prior year) and extension
.00
payments ......................................................... 22.
22a. Connecticut earned income tax credit:
From Schedule CT-EITC, Line 16. Schedule
.00
must be attached. Residents only ................ 22a.
22b. Claim of right credit:
From Form CT-1040CRC, Line 6. Attach
.00
Form CT-1040CRC to the back of this return. .. 22b.
23. Amounts paid with original return, plus
additional tax paid after it was fi led:
.00
Do not include penalty and interest. ................ 23.
24. Total payments:
.00
Add Lines 21, 22, 22a, 22b and 23. ................. 24.
.00
25. Overpayment, if any, as shown on original return or as previously adjusted. ........................................25.
.00
26. Subtract Line 25 from Line 24. ...............................................................................................................26.
Refund
.00
27. If Line 26 is greater than Line 20, Column C, enter the amount overpaid. ...........................................27.
Amount You Owe
.00
28. If Line 20, Column C, is greater than Line 26 enter the amount of tax due. ..........................................28.
.00
29. Interest: Multiply Line 28 by number of months or fraction of a month, then by 1% (.01). .....................29.
.00
30. Amount you owe with this return: Add Line 28 and Line 29. ...................................Amount you owe 30.
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