Form Ct-W4p - Withholding Certifi Cate For Pension Or Annuity Payments - 2013 Page 5
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6Table C - 3% Tax Rate Phase-Out Add-Back
Use the fi ling status you expect to report on your 2013 tax return and your Connecticut AGI * (Tax Calculation Schedule, Line 1)
to determine your phase-out amount.
Filing Jointly or
Single
Filing Separately
Head of Household
Qualifi ed Widow(er)
Connecticut AGI*
Connecticut AGI*
Connecticut AGI*
Connecticut AGI*
3%
3%
3%
3%
More Than Less Than Phase-Out More Than Less Than Phase-Out More Than Less Than Phase-Out More Than Less Than Phase-Out
or Equal To Add-Back
or Equal To Add-Back
or Equal To Add-Back
or Equal To Add-Back
$
0
$ 56,500
$
0
$
0
$100,500
$
0
$
0
$50,250
$
0
$
0
$ 78,500
$
0
$ 56,500
$ 61,500
$ 20
$100,500
$105,500
$ 40
$50,250
$52,750
$ 20
$ 78,500
$ 82,500
$ 32
$ 61,500
$ 66,500
$ 40
$105,500
$110,500
$ 80
$52,750
$55,250
$ 40
$ 82,500
$ 86,500
$ 64
$ 66,500
$ 71,500
$ 60
$110,500
$115,500
$120
$55,250
$57,750
$ 60
$ 86,500
$ 90,500
$ 96
$ 71,500
$ 76,500
$ 80
$115,500
$120,500
$160
$57,750
$60,250
$ 80
$ 90,500
$ 94,500
$128
$ 76,500
$ 81,500
$100
$120,500
$125,500
$200
$60,250
$62,750
$100
$ 94,500
$ 98,500
$160
$ 81,500
$ 86,500
$120
$125,500
$130,500
$240
$62,750
$65,250
$120
$ 98,500
$102,500
$192
$ 86,500
$ 91,500
$140
$130,500
$135,500
$280
$65,250
$67,750
$140
$102,500
$106,500
$224
$ 91,500
$ 96,500
$160
$135,500
$140,500
$320
$67,750
$70,250
$160
$106,500
$110,500
$256
$ 96,500
$101,500
$180
$140,500
$145,500
$360
$70,250
$72,750
$180
$110,500
$114,500
$288
$101,500
and up
$200
$145,500
and up
$400
$72,750
and up
$200
$114,500
and up
$320
* Form CT-1040NR/PY fi lers must use income from Connecticut sources if it exceeds Connecticut adjusted gross income.
Table D - Tax Recapture
Use the fi ling status you expect to report on your 2013 tax return and your Connecticut AGI * (Tax Calculation Schedule,
Line 1) to determine your recapture amount.
Filing Jointly or
Single or Filing Separately
Head of Household
Qualifi ed Widow(er)
Connecticut AGI*
Connecticut AGI*
Connecticut AGI*
Recapture
Recapture
Recapture
More Than
Less Than
Amount
More Than
Less Than
Amount
More Than
Less Than
Amount
or Equal To
or Equal To
or Equal To
$
0
$200,000
$
0
$ 0
$400,000
$
0
$ 0
$320,000
$
0
$200,000
$205,000
$
75
$400,000
$410,000
$ 150
$320,000
$328,000
$ 120
$205,000
$210,000
$ 150
$410,000
$420,000
$ 300
$328,000
$336,000
$ 240
$210,000
$215,000
$ 225
$420,000
$430,000
$ 450
$336,000
$344,000
$ 360
$215,000
$220,000
$ 300
$430,000
$440,000
$ 600
$344,000
$352,000
$ 480
$220,000
$225,000
$ 375
$440,000
$450,000
$ 750
$352,000
$360,000
$ 600
$225,000
$230,000
$ 450
$450,000
$460,000
$ 900
$360,000
$368,000
$ 720
$230,000
$235,000
$ 525
$460,000
$470,000
$1,050
$368,000
$376,000
$ 840
$235,000
$240,000
$ 600
$470,000
$480,000
$1,200
$376,000
$384,000
$ 960
$240,000
$245,000
$ 675
$480,000
$490,000
$1,350
$384,000
$392,000
$1,080
$245,000
$250,000
$ 750
$490,000
$500,000
$1,500
$392,000
$400,000
$1,200
$250,000
$255,000
$ 825
$500,000
$510,000
$1,650
$400,000
$408,000
$1,320
$255,000
$260,000
$ 900
$510,000
$520,000
$1,800
$408,000
$416,000
$1,440
$260,000
$265,000
$ 975
$520,000
$530,000
$1,950
$416,000
$424,000
$1,560
$265,000
$270,000
$1,050
$530,000
$540,000
$2,100
$424,000
$432,000
$1,680
$270,000
$275,000
$1,125
$540,000
$550,000
$2,250
$432,000
$440,000
$1,800
$275,000
$280,000
$1,200
$550,000
$560,000
$2,400
$440,000
$448,000
$1,920
$280,000
$285,000
$1,275
$560,000
$570,000
$2,550
$448,000
$456,000
$2,040
$285,000
$290,000
$1,350
$570,000
$580,000
$2,700
$456,000
$464,000
$2,160
$290,000
$295,000
$1,425
$580,000
$590,000
$2,850
$464,000
$472,000
$2,280
$295,000
$300,000
$1,500
$590,000
$600,000
$3,000
$472,000
$480,000
$2,400
$300,000
$305,000
$1,575
$600,000
$610,000
$3,150
$480,000
$488,000
$2,520
$305,000
$310,000
$1,650
$610,000
$620,000
$3,300
$488,000
$496,000
$2,640
$310,000
$315,000
$1,725
$620,000
$630,000
$3,450
$496,000
$504,000
$2,760
$315,000
$320,000
$1,800
$630,000
$640,000
$3,600
$504,000
$512,000
$2,880
$320,000
$325,000
$1,875
$640,000
$650,000
$3,750
$512,000
$520,000
$3,000
$325,000
$330,000
$1,950
$650,000
$660,000
$3,900
$520,000
$528,000
$3,120
$330,000
$335,000
$2,025
$660,000
$670,000
$4,050
$528,000
$536,000
$3,240
$335,000
$340,000
$2,100
$670,000
$680,000
$4,200
$536,000
$544,000
$3,360
$340,000
$345,000
$2,175
$680,000
$690,000
$4,350
$544,000
$552,000
$3,480
$345,000
and up
$2,250
$690,000
and up
$4,500
$552,000
and up
$3,600
2013 Form CT-W4P (Rev. 12/12)
Page 5 of 6
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