Free 2004 Utah Individual Income Tax Return, TC-40 - Utah

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Utah State Tax Commission

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Utah Individual Income Tax Return
All State Income Tax Dollars Fund Education
incometax.utah.gov

2004
TC-40

If fiscal year, enter ending date (mm/yy)

FOR AMENDED RETURN - ENTER CODE (1 - 5) from page 3
Your Social Security number Your full name (first, middle initial, last) Spouse's Social Security number Spouse's name (first, middle initial, last) Mailing address Deceased in 2004 or 2005 Deceased in 2004 or 2005 Daytime telephone number State ZIP code + 4 Evening telephone number Foreign country

IMPORTANT!
Social Security Number(s) Required

City Foreign city

Foreign state & zip

1. Filing status (page 4) a Single b c d e Head of household Married filing jointly Married filing separately Qualifying widow(er)

}

If filing married jointly or separately, enter spouse's name and social security number above.

2. Exemptions (page 4) a Yourself b from federal return Spouse c Dependents d Disabled (see Utah instructions)

3. Election campaign fund (page 4)
Yourself Spouse

}

e

Total exemptions (add a through d)

Constitution Democrat Green Libertarian Personal Choice Republican
4 5

C D G L P R

Checking a party does not increase your tax or reduce your refund.

Staple W-2 and other withholding forms here

INCOME/ADDITIONS

4. Federal adjusted gross income from federal return (see instructions on page 5) 5. State income tax deducted as an itemized deduction on federal form 1040, Schedule A, line 5 (page 5)

6. Additions to income (page 5 - add lines 6a through 6d and enter total additions to income on line 6)
CODE AMOUNT CODE AMOUNT

.00 .00 .00 .00 .00 .00 .00 .00 .00

6a 6c

.00 .00

6b 6d

.00 .00

6 7 8 9 10 11 12

7. Total adjusted income (add lines 4 through 6) 8. Standard or itemized deduction (page 6) 9. Personal exemptions deduction. Multiply $2,325 by line 2e. (page 6) 10. One-half of the federal tax (page 6)
DEDUCTIONS

11. State tax refund included on line 10 of federal form 1040 (page 6) Taxpayer is Spouse is 12. Retirement exemption/deduction (pages 6 and 7) 65 or older 65 or older 13. Other deductions (pages 7 through 9 - add lines 13a through 13f and enter total other deductions on line 13)
CODE AMOUNT CODE AMOUNT

13a 13c 13e

.00 .00 .00
For Native Primary taxpayer Americans enrollment number: ________________

13b 13d 13f

.00 .00 .00
Secondary taxpayer enrollment number: ________________
13 14 15

14. Total deductions (add lines 8 through 13) 15. Utah 2004 taxable income (subtract line 14 from line 7) If less than zero, enter zero. 16. CALCULATE INCOME TAX: Read instructions on page 9 for lines 16a and 16b.
16a

.00 .00 .00 .00

TAX

Qualified Amount from worksheet taxpayers

.00

16b Tax

17. FOR NON OR PART-YEAR RESIDENTS ONLY - Attach form TC-40C. (page 9)
Nonresident. Home state abbreviation: Part-year resident from / / 04 to / / 04

Enter information below from state form TC-40C (divide "Box a" by "Box b" to get a ratio (decimal) for "Box c")
Box a. From Column A, line 31 Box b. From Column B, line 31 Box c. Utah income tax ratio 17

(Multiply line 16b by the decimal in "Box c")

.00
40041

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NONREFUNDABLE CREDITS

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Utah Income Tax Return TC-40 (2004) Page 2
18 19

18. Enter tax (full-year Utah resident, enter tax from line 16b - non or part-year resident, enter tax from line 17) 19. Credit for income tax paid to another state (page 10). Attach form TC-40A. Nonresidents do not qualify.
CODE AMOUNT CODE AMOUNT

.00 .00

20. Nonrefundable credits (pages 10 through 12 - add lines 20a through 20f and enter total nonrefundable credits on line 20)
20a 20c 20e

.00 .00 .00

20b 20d 20f

.00 .00 .00

20 21 22

.00 .00 .00

If claiming Qualified Sheltered Workshop (code 02), write the Workshop name here: __________________________________

21. Subtotal (add lines 19 and 20) 22. Subtract line 21 from line 18 (Note: if line 21 is greater than or equal to line 18, enter zero)
USE TAX/ADDITIONS TO TAX

23. Contributions (pages 12 through 13 - add lines 23a through 23f and enter total contributions on line 23) NOTE: SCH/TECH CODE used only for Nonprofit School District Foundation and Utah College of Applied Technology.
CODE AMOUNT SCH/TECH CODE CODE AMOUNT SCH/TECH CODE

23a 23c 23e

23b 23d 23f 23 24 25 26 27

24. AMENDED RETURNS ONLY - previous refunds (page 13) 25. Tax from recapture of credits (page 13) 26. Utah use tax (page 13) 27. Total tax, use tax and additions to tax (add lines 22 through 26)

WITHHOLDING AND CREDITS

28. UTAH TAX WITHHELD (must attach Utah W-2 and/or 1099 forms) (page 14) 29. Credit for Utah income taxes prepaid (page 14) 30. AMENDED RETURNS ONLY - previous payments (page 14)

UTAH TAX WITHHELD

28 29 30

.00 .00 .00 .00 .00 .00 .00 .00

31. Refundable credits (pages 14 through 15 - add lines 31a through 31f and enter total refundable credits on line 31)
CODE AMOUNT CODE AMOUNT

31a 31c 31e

.00 .00 .00

31b 31d 31f

.00 .00 .00

31

.00 .00 .00 .00 .00
Amount to be applied to 2005

If claiming the nonresident shareholder's tax credit (code 43), enter S corporation's federal ID number

32. Total (add lines 28 through 31) 33. Tax due - If line 27 is greater than line 32, subtract line 32 from line 27. This is the amount you owe. You will be billed for any penalty and interest owed. See page 15 about payment options. TAX DUE Use enclosed envelope or mail to Utah State Tax Commission, 210 N 1950 W, SLC, UT 84134-0266 34. Refund - If line 32 is greater than line 27, subtract line 27 from line 32. This is your refund. (page 15) REFUND Use enclosed envelope or mail to Utah State Tax Commission, 210 N 1950 W, SLC, UT 84134-0260 35. Enter the amount of refund you want applied to your 2005 taxes. Your refund will be reduced by this amount. If AMENDING, you cannot apply refund to 2005 tax liability. (page 15) 36. DIRECT DEPOSIT YOUR REFUND. Complete information below. (page 15) Routing number Account number
35

32 33

TAX DUE OR REFUND

34

What type of account is it? Checking Savings account account

Under penalties of perjury, I declare to the best of my knowledge and belief, this return and accompanying schedules reflect my true tax status. Date signed Spouse' s signature (if filing jointly, both MUST sign even if only one had income) Date signed Your signature SIGN HERE

Third Party Name of designee (if any) you authorize to discuss this return with the Tax Commission (page 15) Designee Preparer' s signature (page 16) Paid Preparer's Section Firm' s name and address

Designee' s telephone number Designee' s personal ID number (PIN) Preparer' s telephone number Preparer' s Social Security no. or PTIN Preparer' s EIN

40042