Form Tc-41 - Utah Fiduciary Income Tax Return - 2012 Page 7
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12Bankruptcy Estate Schedule for
TC-41C
Non or Part-Year Resident - Page 2
Rev. 12/12
41207
Name of bankruptcy estate
EIN of bankruptcy estate
Residency status:
/
/
/
/
Nonresident. Home state abbreviation:
Part-year Utah resident from
______________
to
______________
mm
dd
yy
mm
dd
yy
INCOME
COLUMN A - UTAH
COLUMN B - TOTAL
21. Wages, salaries, tips, etc. (1040 line 7)
.00
.00
22
. Taxable interest income
(1040 line 8a)
.00
.00
23
. Ordinary dividends
(1040 line 9a)
.00
.00
24. Taxable refunds, credits, or offsets of state and local income taxes (1040 line 10)
.00
.00
25
. Alimony received
(1040 line 11)
.00
.00
26
. Business income or (loss)
(1040 line 12)
.00
.00
27
. Capital gain or (loss)
(1040 line 13)
.00
.00
28
. Other gains or (losses)
(1040 line 14)
.00
.00
29
. IRA distributions - taxable amount
(1040 line 15b)
.00
.00
30
. Pensions and annuities - taxable amount
(1040 line 16b)
.00
.00
31
. Rental real estate, royalties, part., S corp., trusts, etc.
(1040 line 17)
.00
.00
32
. Farm income or (loss)
(1040 line 18)
.00
.00
33
. Unemployment compensation
(1040 line 19)
.00
.00
34
. Social Security benefits - taxable amount
(1040 line 20b)
.00
.00
35
. Other income
(1040 line 21)
.00
.00
36 Additions to income from TC-40A, Part 1 (Utah portion only in Utah column)
.
.00
.00
37. Total income (loss) (add lines 21 through 36 for both columns A and B)
.00
.00
ADJUSTMENTS
COLUMN A - UTAH
COLUMN B - TOTAL
38 Educator expenses (1040 line 23)
.
.00
.00
39 Certain business expenses (1040 line 24)
.
.00
.00
40 Health savings account deduction (1040 line 25)
.
.00
.00
41 Moving expenses (1040 line 26; enter only expenses moving into Utah in col. A)
.
.00
.00
42 Deductible part of self-employment tax (1040 line 27)
.
.00
.00
43 Self-employed SEP, SIMPLE and qualified plans (1040 line 28)
.
.00
.00
44 Self-employed health insurance deduction (1040 line 29)
.
.00
.00
45 Penalty on early withdrawal of savings (1040 line 30)
.
.00
.00
46 Alimony paid (1040 line 31a)
.
.00
.00
47. IRA deduction (1040 line 32)
.00
.00
48. Student loan interest deduction (1040 line 33)
.00
.00
49 Tuition and fees (1040 line 34)
.
.00
.00
50. Domestic production activities deduction (1040 line 35)
.00
.00
.00
.00
51 Taxable refunds, credits or offsets of state/local income tax (
.
1040, line 10
)
.00
.00
52. Subtractions from income from TC-40A, Part 2 (Utah portion only in Utah column)
.00
.00
See instr. (page 20)
53. Total adjustments (add lines 38 through 52 for both columns A and B)
.00
.00
54.
Subtract line
53
from line
37
for
both COLUMNS A and B.
Line 54, column B must equal TC-41C, line 8
.00
.00
NON OR PART-YEAR RESIDENT BANKRUPTCY ESTATE TAX
55. Divide line 54 column A by line 54 column B (to 4 decimal places)
.
_ _
_
_ _ _ _ _ _ _ _
_
_
_
_
Do not enter a number greater than 1.0000 or less than “0”.
56. Enter tax amount from TC-41, page 2, line 25
.00
57. Multiply the tax on line 56 by the decimal on line 55 and enter the result on TC-41, page 2, line 26
.00
Submit this page ONLY if data entered
Attach completed schedule to your 2012 Utah fiduciary return.
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