Form Tc40c - Non Or Part-Year Resident Utah Income Schedule

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TC-40C
Non or Part-year Resident Utah Income Schedule
Rev. 12/07
40076
Taxpayer last name
Taxpayer social security number
Residency
Part-year Utah resident from
/
/ 07
to
/
/ 07
Nonresident. Home state abbreviation:
status:
Column A - UTAH INCOME AND ADJUSTMENTS
Column B - FEDERAL INCOME AND ADJUSTMENTS
INCOME:
Enter the amount of income in this column from all sources,
INCOME:
Enter all income or loss 1) earned or received from Utah
as found on your federal return, as noted below.
sources while not a Utah resident, plus 2) earned or received from all
sources while a Utah resident, even if not from a Utah source.
ADJUSTMENTS:
Enter the amount of each adjustment applicable to
ADJUSTMENTS:
Enter each adjustment applicable to Utah income.
federal income, as found on your federal return, as noted below.
This includes payments to qualified IRA or self-employed retirement
Nonresident Military Personnel Adjustment:
Enter on line 30,
plans, alimony paid while a Utah resident, moving expenses when
Column B, the amount included on line 1, Column B, that is active duty
moving into Utah, etc.
military pay.
INCOME
1. Wages, salaries, tips, etc.
00
00
2. Taxable interest income
00
00
3. Ordinary dividends
00
00
4. Taxable refunds, credits, or offsets of state and local income taxes (1040 line 10)
00
00
5. Alimony received
00
00
6. Business income or (loss)
00
00
7. Capital gain or (loss)
00
00
00
00
8. Other gains or (losses)
9. IRA distributions - taxable amount
00
00
00
10. Pensions and annuities - taxable amount
00
11. Rental real estate, royalties, part., S corp., trusts, etc.
00
00
12. Farm income or (loss)
00
00
13. Unemployment compensation
00
00
14. Social Security benefits - taxable amount
00
00
15. Other income
00
00
16. Total income (add lines 1 through 15)
00
00
ADJUSTMENTS
00
17. Educator expenses
, 1040A line 16)
00
1 . 8 Certain business expenses
4
00
00
19. Health savings account deduction
00
00
20. Moving expenses
c
,
moving
Ut
00
00
21. One-half of self-employment tax
00
00
22 Self-employed SEP, SIMPLE, and qualified plans
.
00
00
23. Self-employed health insurance deduction (1040 line 29)
00
00
24. Penalty on early withdrawal of savings (1040 line 30)
00
00
25. Alimony paid
00
00
26. IRA deduction
00
00
27. Student loan interest deduction (1040 line 33, 1040A line 18)
00
00
28. Tuition and fees deduction
00
00
00
00
29. Domestic production activities deduction (1040 line 35)
00
30. Nonresident military active duty pay included on line 1 column B (page 7)
31. Total adjustments (add lines 17 through 30)
00
00
Subtract line 31 from line 16 for both COLUMNS A and B. COLUMN B total
32.
00
00
must equal the FAGI amount on TC-40, line 4a (unless line 30 is completed).
Enter this total on
Enter this total on
Attach this completed SCHEDULE to your Utah tax return.
TC-40, line 15, “Box a”
TC-40, line 15, “Box b”

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