Form Ct-1065/ct-1120si - Supplemental Attachment Page 3

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Part VI – Connecticut-Sourced Portion of Items From Federal Schedule K-1 of Form 1065 or Form 1120S
Include member’s share of Connecticut modifi cations from Part V.
Member
Member
Member
Member
# ________
# ________
# ________
# ________
1. Ordinary business income (loss) ....................
1.




00
00
00
00
2. Net rental real estate income (loss) ...............
2.

00
 
00

00

00
3. Other net rental income (loss) ........................
3.

00

00

00

00
4. Guaranteed payments ...................................
4.

00

00
 
00

00
5. Interest income ..............................................
5.

00

00

00

00
6a. Ordinary dividends .........................................
6a.

00

00

00

00
6b. Qualifi ed dividends .........................................
6b.

00

00

00

00
7. Royalties ........................................................
7.

00

00

00

00
8. Net short-term capital gain (loss) ...................
8.

00

00

00

00
9a. Net long-term capital gain (loss) ....................
9a.

00
 
00

00

00
9b. Collectibles (28%) gain (loss) ........................
9b.

00

00

00

00
9c. Unrecaptured section 1250 gain ...................
9c.

00

00
 
00

00
10. Net section 1231 gain (loss) ..........................
10.

00

00

00

00
11. Other income (loss): Attach statement. ..........
11.

00

00

00

00
12. Section 179 deduction ...................................
12.

00

00

00

00
13. Other deductions: Attach statement. ..............
13.

00

00

00

00
Part VII
– Connecticut Income Tax Credit Summary
Member
Member
Member
Member
# ___________
# ___________
# ___________
# ___________
1. Qualifi ed small business tax credit ......................... 1.
00
00
00
00
2. Job expansion tax credit ......................................... 2.
00
00
00
00
3. Angel investor tax credit ......................................... 3.
00
00
00
00
4. Insurance reinvestment fund tax credit .................. 4.
00
00
00
00
5. Total credits: Add Lines 1 through 4. ...................... 5.
00
00
00
00
Form CT-1065/CT-1120SI Supplemental Attachment (Rev. 12/13)
Page 3 of 3

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