Tc-40 Forms And Instructions - Individual Income Tax (Page 14 of 31) in pdf

____ TC-40, Page 3 ____

Each contribution is explained below.

Codes for Contributions

Submit TC-40, page 3 ONLY if you have entered information

01 Utah Nongame Wildlife Account

on the form. If the form is blank, do not submit it with your

02 Pamela Atkinson Homeless Account

Utah return.

03 Kurt Oscarson Children's Organ Transplant Account

05 School District and Nonproﬁ t School District Foundation

Part 1 - Deceased Taxpayer Information

09 Cat and Dog Community Spay and Neuter Program

A return must be ﬁ led for a deceased individual who would

10 Methamphetamine Housing Reconstruct. & Rehab. Fund

have been required to ﬁ le an income tax return. The personal

11 Canine Body Armor Account

representative, executor, administrator, legal representative,

(01) Utah Nongame Wildlife Account

or surviving spouse must sign and ﬁ le the ﬁ nal return and any

(UC §59-10-1305)

other returns still due.

Contributions help fund preservation, protection, perpetuation,

If you are ﬁ ling the deceased taxpayer’s return as single, mar-

and enhancement of nongame wildlife species that are

ried separate, head of household, or qualifying widow(er) and

protected, endangered or threatened with extinction.

they died in 2012 or 2013, enter the taxpayer’s date of death

For more information, contact:

(mm/dd/yy) on the ﬁ rst line of TC-40, page 3, Part 1.

Utah Division of Wildlife Resources

If you are the surviving spouse ﬁ ling a joint return with the

1594 W North Temple, Suite 2110

taxpayer who died in 2012 or 2013, enter the deceased tax-

Salt Lake City, UT 84116

payer’s date of death (mm/dd/yy) on the TC-40, page 3, Part 1:

801-538-4853

• Line 1 if the deceased individual was the primary taxpayer

(02) Pamela Atkinson Homeless Account

shown on TC-40, page 1, or

(UC §59-10-1306)

• Line 2 if the deceased individual was the spouse shown

Contributions help fund services and programs to help Utahns

on TC-40, page 1.

become self-sufﬁ cient.

Write “DECEASED” in the signature block on TC-40, page

For more information, contact:

2 for the deceased taxpayer. If you are the surviving spouse

Housing and Community Development Division

ﬁ ling a joint return, you must also sign the return in the space

Department of Workforce Services

indicated on page 2.

130 E 300 S

If you are not a surviving spouse and are claiming a refund

Salt Lake City, UT 84111

for the deceased taxpayer, you must complete form TC-131,

801-526-9329

Statement of Person Claiming Refund Due a Deceased

(03) Kurt Oscarson Children’s Organ Transplant Account

Taxpayer. Check the third box on TC-40, page 3, Part 1 and

(UC §59-10-1308)

attach TC-131 to the tax return.

Contributions provide ﬁ nancial help to families of children

Part 2 - Fiscal Year End Date

needing an organ transplant.

If you ﬁ le your return on a ﬁ scal year basis (a 12-month period

For more information, contact:

ending on the last day of any month except December), enter

Representative for the Department of Health

your ﬁ scal year-end date. Enter the two-digit month and the

7247 S Santa Maria Circle

two-digit year, e.g., 06/13 for June 2013.

West Jordan, UT 84084

801-717-6241 or 801-566-5356

You must use the tax forms for the year in which your ﬁ scal

year begins. For example, if your ﬁ scal year is July 1, 2011

(05) School District and Nonproﬁ t School District

through June 30, 2012, you must use the 2011 Utah return

Foundation (UC §59-10-1307)

to ﬁ le for that ﬁ scal year.

Contributions help fund private, nonproﬁ t school district

foundations established to promote partnership activities

See speciﬁ c ﬁ scal year instructions at incometax.utah.gov/

between schools and communities; charitable giving activities

topics/ﬁ scal-year-ﬁ ling.

to speciﬁ c educational programs; and opportunities for

If you are a calendar year ﬁ ler (your tax year ends on December

scientiﬁ c, educational, literary, and improvement objectives.

31st, like most taxpayers), leave this ﬁ eld blank.

The contribution goes to the school district if there is no

nonproﬁ t foundation. Enter a code for the school district/

Part 3 - Federal Form 8886

foundation (from the list below) in the SCHOOL DIST. CODE

If you ﬁ led federal form 8886, Reportable Transaction Disclosure

box to the right of the amount.

Statement, with the IRS, enter an "X" in Part 3.

School District Codes for "SCHOOL DIST. CODE" box

Part 4 - Voluntary Contributions

Code

01 Alpine

11 Grand

22 N. Sanpete 33 S. Summit

You may contribute to any of the following approved causes.

02 Beaver

12 Granite

23 N. Summit

34 Tintic

Contributions will add to your tax due or reduce your refund.

03 Box Elder

13 Iron

24 Ogden

35 Tooele

04 Cache

14 Jordan

25 Park City

36 Uintah

Once made, you cannot change a contribution on an amended

42 Canyons

15 Juab

26 Piute

41 Utah Assistive

return.

05 Carbon

16 Kane

27 Provo

Technology

06 Daggett

17 Logan

28 Rich

37 Wasatch

Leave the entire Part 4 blank if you are not contributing to one

07 Davis

18 Millard

29 Salt Lake

38 Washington

or more of the accounts.

08 Duchesne 19 Morgan

30 San Juan

39 Wayne

09 Emery

20 Murray

31 Sevier

40 Weber

Write the code and amount of each contribution on the Part

10 Garﬁ eld

21 Nebo

32 S. Sanpete

4 lines. Total your contributions and enter the sum on line 28 of

TC-40, page 2.

Tc-40 Forms And Instructions - Individual Income Tax Page 14

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