Form Ct-1040es - Estimated Connecticut Income Tax Payment Coupon For Individuals - 2011 Page 4
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4Social Security Benefi t Adjustment Worksheet
Enter the amount you expect to enter on Form CT-1040 or Form CT-1040NR/PY, Line 1.
If your fi ling status is single or fi ling separately, is the amount on Line 1 $50,000 or more?
Yes: Complete this worksheet.
No:
Do not complete this worksheet. Enter the amount of federally taxable Social Security benefits you expect to report on
federal Form 1040, Line 20b, or federal Form 1040A, Line 14b, on the 2011 Estimated Connecticut Income Tax Worksheet, Line 2.
If your fi ling status is fi ling jointly, qualifying widow(er) with dependent child, or head of household, is the amount on Line 1 $60,000 or more?
Yes: Complete this worksheet.
No:
Do not complete this worksheet. Enter the amount of federally taxable Social Security benefi ts you expect to report on federal
Form 1040, Line 20b, or federal Form 1040A, Line 14b, on the 2011 Estimated Connecticut Income Tax Worksheet, Line 2.
A.
Enter the amount you reported on federal Publication 505*, Tax Withholding and Estimated Tax,
A.
Worksheet 2.1, Line 1.
If Line A is zero or less, stop here. Otherwise, go to Line B.
B.
Enter the amount you reported on federal Publication 505*, Tax Withholding and Estimated Tax,
B.
Worksheet 2.1, Line 10.
If Line B is zero or less, stop here. Otherwise, go to Line C.
C.
Enter the lesser of Line A or Line B.
C.
D.
Multiply Line C by 25% (.25).
D.
E.
Expected taxable amount of Social Security benefi ts you reported on federal Publication 505*,
E.
Tax Withholding and Estimated Tax, Worksheet 2-1, Line 19.
F.
Social Security benefi t adjustment - Subtract Line D from Line E. Enter the amount here
F.
and as a subtraction on the 2011 Estimated Connecticut Income Tax Worksheet, Line 2.
If Line D is greater than or equal to Line E, enter “0.”
* Call the Internal Revenue Service (IRS) at 1-800-829-3676 or visit the IRS website at to get federal Publication 505. Parties to a civil union
should complete federal Publication 505, Tax Withholding and Estimated Tax Worksheet 2-1, as if their fi ling status for federal income tax purposes
were married fi ling jointly or married fi ling separately.
Payment Options: You may fi le and pay your Connecticut estimated taxes electronically using the Taxpayer Service Center (TSC) or visit our website at
and follow the prompts to make a direct payment.
You may elect to pay your estimated 2011 Connecticut income tax liability using your credit card (American Express ® , Discover ® , MasterCard ® , VISA ® ) or
comparable debit card. A convenience fee will be charged by the service provider. You will be informed of the amount of the fee and you may elect to cancel
the transaction. At the end of the transaction you will be given a confi rmation number for your records.
To Pay by Credit Card:
•
Visit: and select State Payments; or
Call Offi cial Payments Corporation toll-free at 1-800-2PAY-TAX (1-800-272-9829) and follow the instructions. You will be asked to enter the Connecticut
•
Jurisdiction Code: 1777.
Do not send in Form CT-1040ES if you make your payment by credit card or debit card. Your payment will be effective on the date you make the charge.
To Pay by Mail: Make your check payable to Commissioner of Revenue Services. To ensure proper posting of your payment, write your Social Security
Number(s), optional, and “2011 Form CT-1040ES” on the front of your check. Be sure to sign your check and paper clip it to the front of your coupon. Do not
send cash. DRS may submit your check to your bank electronically.
Completing the Payment Coupon: Complete all required taxpayer identifi cation information. Enter the payment amount on Line 1 of the coupon. In determining
your payment amount, you may subtract from your installment amount any available overpayment of 2010 income tax. If you fi le this coupon, preprinted,
personalized coupons will be mailed to you for the 2011 taxable year.
.................................................................................................. Cut Here ...........................................................................................
CT-1040ES
2011
Estimated Connecticut Income Tax Payment
Your Social Security Number
Spouse’s Social Security Number
Due date
• •
• •
• •
• •
___ ___ ___ ___ ___ ___ ___ ___ ___
___ ___ ___ ___ ___ ___ ___ ___ ___
• •
• •
• •
• •
Your fi rst name and middle initial
Last name
1. Payment amount
00
Spouse’s fi rst name and middle initial
Last name
Mailing address (number and street), Apartment Number, PO Box
Send completed coupon and payment to :
Department of Revenue Services
City, town, or post offi ce
State
ZIP code
PO Box 2932
Hartford CT 06104-2932
• See Payment Options above.
• Print all information. Include your spouse’s SSN, if fi ling jointly.
• Cut along dotted line and mail coupon and payment to the address printed on the coupon.
• Make your check payable to Commissioner of Revenue Services.
• DRS may submit your check to your bank electronically.
• To ensure proper posting, write your SSN(s) (optional) and “2011 Form CT-1040ES” on your check.
Form CT-1040ES (Rev. 12/10)
Page 4 of 4
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