Form Ct-1040nr/py - Connecticut Nonresident And Part-Year Resident Income Tax Return - 2015 Page 2

ADVERTISEMENT

Form CT-1040NR/PY
Your Social Security Number
Page 2 of 4
(Rev. 12/15)
NRPY 00 15W 02 9999
.00
19. Enter amount from Line 18.
19.
Column A - Employer’s federal ID No. from Box b of W-2,
Column B - Connecticut
Schedule.
Column C - Connecticut income tax withheld
3
or payer’s federal ID No. from Schedule CT K-1 or 1099
wages, tips, etc.
CT K-1
Check box at left if from Schedule CT K-1.
W-2 and 1099
.00 
.00
20a.
20a.
Information
Only enter
.00 
.00
20b.
20b.
information
from your
.00 
.00
W-2, Schedule
20c.
20c.
CT K-1, and
.00 
1099 forms if
.00
20d.
20d.
Connecticut
income tax
.00 
.00
20e.
20e.
was withheld.
.00
20f. Additional CT withholding from Supplemental Schedule CT-1040WH
20f.
20. Total Connecticut income tax withheld: Add amounts in Column C and enter here.
.00
You must complete Columns A, B, and C or your withholding will be disallowed.
20.
.00
21. All 2015 estimated tax payments and any overpayments applied from a prior year
21.
.00
22. Payments made with Form CT-1040 EXT (Request for extension of time to fi le)
22.
22a. Claim of right credit: From Form CT-1040CRC, Line 6. Attach Form
.00
CT-1040CRC to the back of this return.
22a.
.00
23. Total payments: Add Lines 20, 21, 22, and 22a.
23.
4
.00
24. Overpayment: If Line 23 is more than Line 19, subtract Line 19 from Line 23.
24.
.00
25. Amount of Line 24 overpayment you want applied to your 2016 estimated tax
25.
26. CHET contribution from Schedule CT-CHET, Line 4. Attach Schedule CT-CHET
.00
to the back of this return.
26.
.00
26a. Total contributions of refund to designated charities from Schedule 4, Line 63
26a.
27. Refund: Subtract Lines 25, 26, and 26a from Line 24. For direct deposit,
.00
complete Lines 27a, 27b, and 27c. Direct deposit is not available to fi rst-time fi lers.
27.
27a. Checking
Savings
27c. Account number
27b. Routing number
27d. Will this refund go to a bank account outside the U.S.?
Yes
If you do not elect direct deposit, a refund check will be issued and processing may be delayed.
5
.00
28. Tax due: If Line 19 is more than Line 23, subtract Line 23 from Line 19.
28.
.00
29. If late: Enter penalty. Multiply Line 28 by 10% (.10).
29.
30. If late: Enter interest. Multiply Line 28 by number of months or fraction of a month
.00
late, then by 1% (.01).
30.
.00
31. Interest on underpayment of estimated tax from Form CT-2210:
31.
See instructions, Page 18.
.00
32. Total amount due: Add Lines 28 through 31.
32.
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
6
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, or 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.
Your signature
Date (MMDDYYYY)
Home/cell telephone number
Sign
Here
Your email address
Keep a
copy of
Spouse’s signature (if joint return)
Date (MMDDYYYY)
Daytime telephone number
this return
for your
records.
Paid preparer’s signature
Date (MMDDYYYY)
Telephone number
Preparer’s SSN or PTIN
Firm’s Federal Employer Identifi cation Number (FEIN)
Firm’s name, address, and ZIP code
Third Party Designee - Complete the following to authorize DRS to contact another person about this return.
(PIN)
Designee’s name
Telephone number
Personal identifi cation number
Complete applicable schedules on Pages 3 and 4 and send all four pages of the return to DRS.

ADVERTISEMENT

00 votes

Related Articles

Top 20 Happy Easter Cards And Gift Tags To Download For Free
Top Ten Easter Arts And Crafts Activities For Your Kids
Free Easter Coloring Pages And Easter Printables For Your Kids

Related forms

Form Ct-1040nr/py - Connecticut Nonresident And Part-year Resident Income Tax Return - 2014 Form Ct-1040nr/py - Connecticut Nonresident And Part-year Resident Income Tax Return - 2014 Financial
Form Ct-1040nr/py - Connecticut Nonresident And Part-year Resident Income Tax Return - 2006 Form Ct-1040nr/py - Connecticut Nonresident And Part-year Resident Income Tax Return - 2006 Financial
Form Ct-1040nr/py - Connecticut Nonresident And Part-year Resident Income Tax Return - 2007 Form Ct-1040nr/py - Connecticut Nonresident And Part-year Resident Income Tax Return - 2007 Financial
Form Ct-1040nr/py - Connecticut Nonresident And Part-year Resident Income Tax Return - 2005 Form Ct-1040nr/py - Connecticut Nonresident And Part-year Resident Income Tax Return - 2005 Financial
Form Ct-1040nr/py - Connecticut Nonresident And Part-year Resident Income Tax Return - 2009 Form Ct-1040nr/py - Connecticut Nonresident And Part-year Resident Income Tax Return - 2009 Financial
Form Ct-1040nr/py - Connecticut Nonresident And Part-year Resident Income Tax Return - 2008 Form Ct-1040nr/py - Connecticut Nonresident And Part-year Resident Income Tax Return - 2008 Financial
Form Ct-1040nr/py - Connecticut Nonresident And Part-year Resident Income Tax Return - 2013 Form Ct-1040nr/py - Connecticut Nonresident And Part-year Resident Income Tax Return - 2013 Financial
Form Ct-1040nr/py - Connecticut Nonresident And Part-year Resident Income Tax Return - 2011 Form Ct-1040nr/py - Connecticut Nonresident And Part-year Resident Income Tax Return - 2011 Financial
Form Ct-1040nr/py - Connecticut Nonresident And Part-year Resident Income Tax Return - 2014 Form Ct-1040nr/py - Connecticut Nonresident And Part-year Resident Income Tax Return - 2014 Financial
Form Ct-1040nr/py - Connecticut Nonresident And Part-year Resident Income Tax Return - 2013 Form Ct-1040nr/py - Connecticut Nonresident And Part-year Resident Income Tax Return - 2013 Financial

Related Categories

Parent category: Financial
Download
Go
Page of 4