041101
10-28-10
DDDD20DD
I
I
1001110194
FormCT-1040-2010,
Page1of4ConnecticutResidentIncomeTaxReturn
Othertaxableyear,beginning:
2010
andending:
N
s
Y
FJFC
N
FJC
N
FSFC
N
FSC
N
HH
VINCENT
KMCMAHONLINDAEMCMAHON
Y
Noforms
N
CT-8379
•
1.Federaladjustedgrossincome(fromfederalForm1040,Line37;F0m11040A,Line21;orForm1040EZ,Une4)
I
2.Additionstofederaladjustedgrossincome(fromSchedule1,Line39)3.AddLine1andLine24.Subtractionsfromfederaladjustedgrossincome(fromSchedule1,Line50)5.Connecticutadjustedgrossincome:Line4subtractedfromLine3.6.Incometax7.Creditforincometaxespaid
10
qualifyingjurisdictions(fromSchedule2,Line59)8.Line7subtractedfromLine6.Ifline?isgreaterthanline6,"0"Isentered.~9.Connecticutalternativeminimumtax(fromFormCT·6251)10.AddLine8andLine9.11.Creditforpropertytaxespaidonyourprimaryresidence,motorvehicle,orboth
[fromS,he~vlll,line61)
12.Line11subtractedfromLine10.Iflessthanzero,"0"isentered.13.Totalallowablecredits(fromScheduleCT·ITCredit,Part1,Line11)14.Conneoticutincometax;Line13subtractedfromLine12.lflessthanzero,'0"isentered.15.Individualusetax(fromSchedule4.Line69).Ifnotaxisdue,
"0·
isentered.16.Totaltax;AddLine14andLine15.•
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N
OW
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N
Dec.
N
Dec.
N
CT-2210
N
CT-1040CRC
1.
30575397
2.
2107266
3.
32682663
4.
0
5.
32682663
6.
2108973
7.
0
8.
2108973
9.
0
10.
2108973
11.
0
12.
2108973
13.
0
14.
2108973
15.
0
16.
2108973
•
10011101941001110194
•
04110210-28-10
I
1001210192
FormCT-1040,
Page2of4
1
7.AmountfromLine16
•
I
17.•
2108973
W-2,
W-2G,
and1099InformationCol.
A-
EmployerorPayer'sFed.
10#
Col.
B.
CTWages,Tips,etc.Col,C.CTIncomeTaxWithheld
18a.
•
827520
1ab.
•
0
18c.
•
0
18d.
•
0
18e.
•
0
18t.
•
0
18g.
•
0
18h.AdditionalConnecticutwithholding(fromSupplementalScheduleGT·1040WH,Line
3)
18.
Total
Connecticutincome
tax
withheld:AmountsinColumnC.19.All2010estimatedtaxpaymentsandanyoverpaymentsappliedfromaprioryear
20.
paymentsmadewithFormCT·1040
EXT
21.Totalpayments:AddLines
18,19,
and20.22.Overpayment:IfLine21ismorethanLine17.Line17subtractedfromline21.
23.
AmountofLine22youwantappliedtoyour
2011
estImatedtax24.Totalcontributionsofrefundtodesignatedcharities(fromSchedule
5,
line701
25.
Refund:Lines
23
and24subtractedfromLine
22.
25a.Acct.typeCk.
sv,
25b.Rout.
#
25c.Acct.
#
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21.
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22.
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674539
24.
a
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0
25d.Refundgoingto
a
bankaccountoutsidetheU.S.25d.
N
26.Taxdue:IfLine17ismorethanLine21.Line
21
subtractedfromline17.27.Iflate:Penaltyentered.Line26multipliedby10%(.10).28.Iflate:Interestentered.line26multipliedbynumberofmonthsorfractionofamonthlate,
then
by1%(.01).29.Interestonunderpaymentofestimatedtax(fromFormCT·221OJ
30.
Totalamountdue:Addlines26through29.
26.
0
27.
0
28.
0
29.
0
I
~
0
IdeclareunderpenaltyoflawthatIhaveexaminedthisreturn(includinganyaccompanyingschedulesandstatements)and,tothebestofmyknowledgeandbelief,itistrue,complete,andcorrect.Iunderstandthepenaltyforwillfullydeliveringafalsereturnordocumentto
DRS
isafineofnotmorethan$5,000,orimprlsonmentfornotmorethanfiveyears,orboth.Thedeclarationofapaidpreparerotherthanthetaxpayerisbased
OIl
aUinformationofwhichthepreparerhasanyknowledge.
il
Yoursignature
8•
e
2!'"
£~
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(/)s-
'"
!il-
'"
Date
•
•K&LGATESLLPPITTSBURGH,FA15222-2613
•
FEIN
Daytimetelephonenumber
•
•
•
Prepar.,'sSSf'!orPTlN
.PAUL
LATTNER.412-355-6500
ThirdPartyDesignee-CompletethefollowingtoauthorizeDRStocontactanotherpersonaboutthisreturn.
DesIgnee·s
name
Telephone
number
Personalfdentlflcatfonnumber(PIN)
•
1001210192
•
1001210192
•
I
•
ormCT
-1040,
Page3of4Schedule1-ModificationstoFederalAdjustedGrossIncome31.InterestonstateandlocalgovernmentobligationsotherthanConnecticut32.Mutualfundexernpt-mterestdividendsfromnon-Connecticutstateormunicipalgovernmentobligations
33.
Cancellationofdebtincome34.Taxableamountoflump-sumdistributions
from
qualifiedplansnotincludedinfederaladjustedgrossincome35.Beneficiary'sshareofConnecticutfiduciaryadjustment:Enteredonlyifgreaterthan
zero.
36.
LossonsaleofConnecticutstateandlocalgovernmentbonds37.Domesticproductionactivities(fromfederalForm
1040,
Line35)
I
31.
32.33.34.35.
36.
37.
38_
Other-specify•
38.
39.
Totaladditions:AddLines
31
through
38.40.
InterestonU.S.
government
obligations
41.
ExemptdividendsfromcertainqualifyingmutualfundsderivedfromU.S.governmentobligations
42.
SocialSecuritybenefitadjustment(fromSocialSecurityBenefitAdjustmentWorksheet)
43.
Refundsofstateandlocalincometaxes44.Tier1andTier2railroadretirementbenefitsandsupplementalannuities45.50%ofmilitaryretirementpay
46.
Beneficiary'sshareofConnecticutfiduciaryadjustment:Enteredonlyiflessthanzero.47.GainonsaleofConnecticutstateandlocalgovernmentbonds
39.40.41.
42.43.
44.45.
46.
47_48.CHETcontrlbutionsAcct.#:
48.
49.
Other-specify-49.
50.
Totalsubtractions:Addlines
40
through
49.
50.
Schedule
2-
Credit
for
IncomeTansPaid
to
QualifyingJurisdictions
51.
ModifiedConnecticutadjustedgrossincome
I
51.
Col.A
•
a
0.00000
a
0
0
59.
1001310190
52.Qualifyingjurisdiction'snameandtwo-tettercode
I
52.•
53.Non·ConnecticutincomeincludedonLine51andreportedonaqualifyingjurisdiction'sincometaxreturn
53.
54.line53dividedbyline51
54.
55.Incometaxliability:Line11subtractedfromLine6.
55.
56.Line54multipliedbyLine55
56.
57.Incometaxpaidtoaqualifyingjurisdiction57_58.Lesserofline56orLine5758.59.Totalcredit:AddLine58,allcolumns.
•
4110310-28-\0
•
1001310190
I
2107224
42
a
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a
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2107266
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ao
o
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Col.B
a
0.0000
a
aa
o
a
•
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