Form Ct-1040nr/py - Connecticut Nonresident And Part-Year Resident Income Tax Return - 2015

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Department of Revenue Services
Form CT-1040NR/PY
2015
State of Connecticut
Connecticut Nonresident and Part-Year
CT-1040NR/PY
(Rev. 12/15)
Resident Income Tax Return
NRPY 00 15W 01 9999
For DRS Use Only
(MMDDYYYY)
Taxpayers must sign declaration on reverse side. Complete return in blue or black ink only.
For January 1 - December 31, 2015,
(MMDDYYYY) and Ending
(MMDDYYYY).
or other taxable year Year Beginning
1
Filing Status - Check only one box.
Single
Married fi ling separately
Head of household
Married fi ling jointly
Qualifying widow(er) with dependent child
Enter spouse’s name here and SSN below.
Your Social Security Number
Spouse’s Social Security Number
Check if
Check if
deceased
deceased
Your fi rst name
MI
Last name (If two last names, insert a space between names.)
Suffi x (Jr./Sr.)
If joint return, spouse’s fi rst name
MI
Last name (If two last names, insert a space between names.)
Suffi x (Jr./Sr.)
Mailing address (number and street, apartment number, suite number, PO Box)
2015 Resident Status
City, town, or post offi ce
State
ZIP code
(If town is two words, leave a space between the words.)
Nonresident
Enter city or town of residence if different from above.
ZIP code
Part-Year Resident
Check here if you are fi ling Form CT-8379:
Check here if you are fi ling Form CT-1040CRC:
Check if you fi led Form CT-2210
Attach to the front of the return.
Attach to the back of the return.
and checked any boxes on Part 1.
Whole Dollars Only
2
1. Federal adjusted gross income from federal Form 1040, Line 37;
00
Form 1040A, Line 21; or Form 1040EZ, Line 4
1.
.
00
2. Additions to federal adjusted gross income from Schedule 1, Line 40
2.
.
00
3. Add Line 1 and Line 2.
3.
.
00
4. Subtractions from federal adjusted gross income from Schedule 1, Line 52
4.
.
00
5. Connecticut adjusted gross income: Subtract Line 4 from Line 3.
5.
.
00
6. Income from Connecticut sources from Schedule CT-SI, Line 30
6.
.
00
7. Enter the greater of Line 5 or Line 6. If zero or less, go to Line 12 and enter “0.”
7.
.
8. Income tax on the amount on Line 7 from tax tables or Tax Calculation Schedule:
00
See instructions, Page 16.
8.
.
.
9. Divide Line 6 by Line 5. If Line 6 is equal to or greater than Line 5, enter 1.0000.
9.
00
10. Multiply Line 9 by Line 8.
10.
.
11. Credit for income taxes paid to qualifying jurisdictions during resident portion
00
of taxable year — part-year residents only (from Schedule 2, Line 61)
11.
.
00
12. Subtract Line 11 from Line 10. If Line 11 is greater than Line 10, enter “0.”
12.
.
00
13. Connecticut alternative minimum tax from Form CT-6251
13.
.
00
14. Add Line 12 and Line 13.
14.
.
00
15. Total allowable credits from Schedule CT-IT Credit, Part I, Line 11
15.
.
00
16. Connecticut income tax: Subtract Line 15 from Line 14. If less than zero, enter “0.” 16.
.
00
17. Individual use tax from Schedule 3, Line 62: If no tax is due, enter “0.”
17.
.
00
18. Add Line 16 and Line 17.
18.
.
Due date: April 15, 2016 - Attach a copy of all applicable schedules and forms to this return.
For a faster refund, fi le your return electronically at and choose direct deposit.

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