Connecticut Free Printable CT-1040NRPY W 20161121.indd for 2017 Connecticut 2015 Nonresident/Part-Year Resident Tax Return

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2015 Nonresident/Part-Year Resident Tax Return
CT-1040NRPY W 20161121.indd

Department of Revenue Services State of Connecticut (Rev. 12/16) NRPY 1216W 01 9999 Form CT-1040NR/PY 2016 Connecticut Nonresident and Part-Year Resident Income Tax Return CT-1040NR/PY For DRS Use Only Taxpayers must sign declaration on reverse side. Complete return in blue or black ink only. M M - D D - Y Y Y Y For January 1 - December 31, 2016, or other taxable year Year Beginning and Ending M M - D D - Y Y Y Y 1  Print your SSN, name, mailing address, and city or town here. M M - D D - Y Y Y Y Filing Status - Check only one box. Single Head of household Married filing jointly Qualifying widow(er) with dependent child Married filing separately  Enter spouse’s name here and SSN below. Your Social Security Number Spouse’s Social Security Number Check if deceased Check if deceased Your first name MI Last name (If two last names, insert a space between names.) Suffix (Jr./Sr.) If joint return, spouse’s first name MI Last name (If two last names, insert a space between names.) Suffix (Jr./Sr.) Mailing address (number and street, apartment number, suite number, PO Box) City, town, or post office (If town is two words, leave a space between the words.) 2016 Resident Status ZIP code State Nonresident Enter city or town of residence if different from above. ZIP code  Part-Year Resident Check the appropriate box to identify if you: Filed Form CT-1040CRC (Attach to the back of the return.) Filed Form CT-2210 and checked any boxes on Part 1.  Clip check here. Do not staple. Do not send W-2 or 1099 forms.  2 Filed Form CT-AIT Filed Form CT-8379 (Attach to the front of the return.) Whole Dollars Only 1. Federal adjusted gross income from federal Form 1040, Line 37; Form 1040A, Line 21; or Form 1040EZ, Line 4 1. .00 2. Additions to federal adjusted gross income from Schedule 1, Line 40 2. .00 3. Add Line 1 and Line 2. 3. .00 4. Subtractions from federal adjusted gross income from Schedule 1, Line 52 4. .00 5. Connecticut adjusted gross income: Subtract Line 4 from Line 3. 5. .00 6. Income from Connecticut sources from Schedule CT-SI, Line 30 6. .00 7. Enter the greater of Line 5 or Line 6. If zero or less, go to Line 12 and enter “0.” 8. Income tax on the amount on Line 7 from tax tables or Tax Calculation Schedule: See instructions, Page 16. 7. .00 8. .00 9. Divide Line 6 by Line 5. If Line 6 is equal to or greater than Line 5, enter 1.0000. 9. . 10. Multiply Line 9 by Line 8. 11. Credit for income taxes paid to qualifying jurisdictions during resident portion of taxable year — part-year residents only (from Schedule 2, Line 61) 10. .00 11. .00 12. Subtract Line 11 from Line 10. If Line 11 is greater than Line 10, enter “0.” 12. .00 13. Connecticut alternative minimum tax from Form CT-6251 13. .00 14. Add Line 12 and Line 13. 14. .00 15. Total allowable credits from Schedule CT-IT Credit, Part I, Line 11 15. .00 16. Connecticut income tax: Subtract Line 15 from Line 14. If less than zero, enter “0.” 16. .00 17. Individual use tax from Schedule 3, Line 62: If no tax is due, enter “0.” 17. .00 18. Add Line 16 and Line 17. 18. .00 Due date: April 15, 2017 - Attach a copy of all applicable schedules and forms to this return. For a faster refund, file your return electronically at www.ct.gov/DRS/TSC and choose direct deposit. Form CT-1040NR/PY Page 2 of 4 (Rev. 12/16) NRPY 1216W 02 9999 Your Social Security Number  19. Enter amount from Line 18. 3 W-2 and 1099 Information Only enter information from your W-2, Schedule CT K-1, and 1099 forms if Connecticut income tax was withheld. 4 .00 19. Column A - Employer’s federal ID No. from Box b of W-2, or payer’s federal ID No. from Schedule CT K-1 or 1099 Column B - Connecticut wages, tips, etc. Schedule. CT K-1 Column C - Connecticut income tax withheld Check box at left if from Schedule CT K-1. 20a.  .00  20a. .00 20b.  .00  20b. .00 20c.  .00  20c. .00 20d.  .00  20d. .00 20e.  .00  20e. .00 20f. Additional CT withholding from Supplemental Schedule CT-1040WH 20. Total Connecticut income tax withheld: Add amounts in Column C and enter here. You must complete Columns A, B, and C or your withholding will be disallowed. 20f. .00 20. .00 21. All 2016 estimated tax payments and any overpayments applied from a prior year 21. .00 22. Payments made with Form CT-1040 EXT (Request for extension of time to file) 22a. Claim of right credit: From Form CT-1040CRC, Line 6. Attach Form CT-1040CRC to the back of this return. 22. .00 22a. .00 23. Total payments: Add Lines 20, 21, 22, and 22a. 23. .00 24. Overpayment: If Line 23 is more than Line 19, subtract Line 19 from Line 23. 24. .00 25. Amount of Line 24 overpayment you want applied to your 2017 estimated tax 26. CHET contribution from Schedule CT-CHET, Line 4. Attach Schedule CT-CHET to the back of this return. 25. .00 26. .00 26a. .00 27. .00 26a. Total contributions of refund to designated charities from Schedule 4, Line 63 27. Refund: Subtract Lines 25, 26, and 26a from Line 24. For direct deposit, complete Lines 27a, 27b, and 27c. Direct deposit is not available to first-time filers. 27a. Checking Savings 27c. Account number 27b. Routing number 27d. Will this refund go to a bank account outside the U.S.? If you do not elect direct deposit, a refund check will be issued and processing may be delayed. 5 6 Yes 28. Tax due: If Line 19 is more than Line 23, subtract Line 23 from Line 19. 28. .00 29. If late: Enter penalty. Multiply Line 28 by 10% (.10). 30. If late: Enter interest. Multiply Line 28 by number of months or fraction of a month late, then by 1% (.01). 29. .00 30. .00 31. Interest on underpayment of estimated tax from Form CT-2210: See instructions, Page 18. 32. Total amount due: Add Lines 28 through 31. 31. .00 32. .00 Declaration: I declare under penalty of law that I have examined this return and all accompanying schedules and statements, including reporting and payment of any use tax due, and, to the best of my knowledge and belief, it is true, complete, and correct. I understand the penalty for willfully delivering a false return or document to DRS is a fine of not more than $5,000, or imprisonment for not more than five years, or both. The declaration of a paid preparer other than the taxpayer is based on all information of which the preparer has any knowledge. Your signature Sign Here Date (MMDDYYYY)  Home/cell telephone number  Your email address Keep a copy of this return for your records. Spouse’s signature (if joint return) Date (MMDDYYYY)  Daytime telephone number  Paid preparer’s signature  Date (MMDDYYYY)  Telephone number   Preparer’s SSN or PTIN Firm’s Federal Employer Identification Number (FEIN) Firm’s name, address, and ZIP code  Third Party Designee - Complete the following to authorize DRS to contact another person about this return. Designee’s name  Personal identification number (PIN) Telephone number   Complete applicable schedules on Pages 3 and 4 and send all four pages of the return to DRS. Form CT-1040NR/PY Page 3 of 4 (Rev. 12/16) NRPY 1216W 03 9999 Your Social Security Number  Schedule 1 - Modifications to Federal Adjusted Gross Income Enter all items as positive numbers. See instructions, Page 20. 33. Interest on state and local government obligations other than Connecticut 34. Mutual fund exempt-interest dividends from non-Connecticut state or municipal government obligations 35. Taxable amount of lump-sum distributions from qualified plans not included in federal adjusted gross income 33. .00 34. .00 35. .00 36. Beneficiary’s share of Connecticut fiduciary adjustment: Enter only if greater than zero. 36. .00 37. Loss on sale of Connecticut state and local government bonds 37. .00 38. Domestic production activity deduction from federal Form 1040, Line 35 38. .00 39. .00 40. Total additions: Add Lines 33 through 39. Enter here and on Line 2. 40. .00 41. Interest on U.S. government obligations 41. .00 42. Exempt dividends from certain qualifying mutual funds derived from U.S. government obligations 42. .00 43. Social Security benefit adjustment: See Social Security Benefit Adjustment Worksheet, Page 23. 43. .00 44. Refunds of state and local income taxes 44. .00 45. Tier 1 and Tier 2 railroad retirement benefits and supplemental annuities 45. .00 46. Military retirement pay 46. .00 47. 25% of income received from the Connecticut teacher’s retirement system 47. .00 48. Beneficiary’s share of Connecticut fiduciary adjustment: Enter only if less than zero. 48. .00 49. Gain on sale of Connecticut state and local government bonds 49. .00 50. Connecticut Higher Education Trust (CHET) contributions Enter CHET account number: Do not add spaces or dashes. 50. .00 51. .00 52. .00 39. Other - specify  51. Other - specify: Do not include out of state income.  52. Total subtractions: Add Lines 41 through 51. Enter here and on Line 4. Schedule 2 - Credit for Income Taxes Paid to Qualifying Jurisdictions - Part-Year Residents Only You must attach a copy of your return filed with the qualifying jurisdiction(s) or your credit will be disallowed. See instructions, Page 27. .00 53. Connecticut adjusted gross income during the residency portion of the taxable year. ........... 53. See instructions, Page 27. Column A  Name 54. Enter qualifying jurisdiction’s name and two-letter code. ......................... 54. See instructions, Page 27. 55. Non-Connecticut income included on Line 53 and reported on a qualifying jurisdiction’s income tax return: Complete Schedule 2 Worksheet, Page 26. . 55. 56. Divide Line 55 by Line 53. May not exceed 1.0000. ................................. 56. Code Column B  Name Code .00 . .00 . 57. Apportioned income tax: See instructions, Page 28. .................................... 57. .00 .00 58. Multiply Line 56 by Line 57. ...................................................................... 58. .00 .00 59. Income tax paid to a qualifying jurisdiction. See instructions, Page 25. ... 59. .00 .00 60. Enter the lesser of Line 58 or Line 59. ..................................................... 60. .00 .00 61. Total credit: Add Line 60, all columns. Enter here and on Line 11. ......................................... 61. .00 Complete applicable schedules on Page 4 and send all four pages of the return to DRS. Form CT-1040NR/PY Page 4 of 4 (Rev. 12/16) NRPY 1216W 04 9999 Your Social Security Number Schedule 3 - Individual Use Tax  Failure to report and pay use tax is subject to as much as a $5,000 fine, imprisonment for as much as 5 years, or both. Do you owe use tax for online or other purchases where you paid no sales tax? See instructions, Page 37. Complete the Connecticut Individual Use Tax Worksheet on Page 38 to calculate your use tax liability. 62a. Total use tax due at 1%: From Connecticut Individual Use Tax Worksheet, Section A, Column 7 62a. .00 62b. Total use tax due at 6.35%: From Connecticut Individual Use Tax Worksheet, Section B, Column 7 62b. .00 62c. Total use tax due at 7.75%: From Connecticut Individual Use Tax Worksheet, Section C, Column 7 62c. .00 62.  .00 63a. AIDS Research 63a. .00 63b. Organ Transplant 63b. .00 63c. Endangered Species/Wildlife 63c. .00 63d. Breast Cancer Research 63d. .00 63e. Safety Net Services 63e. .00 63f. Military Relief 63f. .00 63g. CHET Baby Scholar 63g. .00 63. .00 62. Individual use tax: Add Lines 62a through 62c. If no use tax is due, you must enter “0.” Enter here and on Line 17. Schedule 4 - Contributions to Designated Charities - See more information on Page 57. 63. Total Contributions: Add Lines 63a through 63g. Enter amount here and on Line 26a. Complete and send all four pages of the return to DRS. Use the correct mailing address for returns with a payment or requesting a refund. For all tax forms with payment: Department of Revenue Services PO Box 2969 Hartford CT 06104-2969 For refunds and all other tax forms without payment: Department of Revenue Services PO Box 2968 Hartford CT 06104-2968 Make your check payable to: Commissioner of Revenue Services To ensure proper posting, write your SSN(s) (optional) and “2016 Form CT-1040NR/PY” on your check.
Extracted from PDF file 2016-connecticut-form-ct-1040nr-py.pdf, last modified November 2016

More about the Connecticut Form CT-1040NR-PY Individual Income Tax Nonresident TY 2016

CT-1040NR/PY is a special income tax return for nonresidents or part-time residents of Connecticut who file a Connecticut tax return.

We last updated the 2015 Nonresident/Part-Year Resident Tax Return in February 2017, so this is the latest version of Form CT-1040NR-PY, fully updated for tax year 2016. You can download or print current or past-year PDFs of Form CT-1040NR-PY directly from TaxFormFinder. You can print other Connecticut tax forms here.

Other Connecticut Individual Income Tax Forms:

TaxFormFinder has an additional 85 Connecticut income tax forms that you may need, plus all federal income tax forms.

Form Code Form Name
Form CT-1040 Connecticut Resident Income Tax Return
Tax Instruction Booklet Form CT-1040 Instruction Booklet
Form CT-3911 Taxpayer Statement Regarding State of Connecticut Tax Refund
Form CT-1040ES 2016 Estimated Connecticut Income Tax Payment Coupon for Individuals
Form CT-8379 Nonobligated Spouse Claim

Download all CT tax forms View all 86 Connecticut Income Tax Forms


Form Sources:

Connecticut usually releases forms for the current tax year between January and April. We last updated Connecticut Form CT-1040NR-PY from the Department of Revenue Services in February 2017.

Show Sources >

Form CT-1040NR-PY is a Connecticut Individual Income Tax form. Many states have separate versions of their tax returns for nonresidents or part-year residents - that is, people who earn taxable income in that state live in a different state, or who live in the state for only a portion of the year. These nonresident returns allow taxpayers to specify which which income is subject to the state's taxes, and which is not.

About the Individual Income Tax

The IRS and most states collect a personal income tax, which is paid throughout the year via tax withholding or estimated income tax payments.

Most taxpayers are required to file a yearly income tax return in April to both the Internal Revenue Service and their state's revenue department, which will result in either a tax refund of excess withheld income or a tax payment if the withholding does not cover the taxpayer's entire liability. Every taxpayer's situation is different - please consult a CPA or licensed tax preparer to ensure that you are filing the correct tax forms!

Historical Past-Year Versions of Connecticut Form CT-1040NR-PY

We have a total of six past-year versions of Form CT-1040NR-PY in the TaxFormFinder archives, including for the previous tax year. Download past year versions of this tax form as PDFs here:


2016 Form CT-1040NR-PY

CT-1040NRPY W 20161121.indd

2015 Connecticut Nonresident and Part-Year Resident  Income Tax Return 2015 Form CT-1040NR-PY

CT-1040NRPY, 2015 Connecticut Nonresident and Part-Year Resident Income Tax Return

2014 Connecticut Nonresident and Part-Year Resident Income Tax Return 2014 Form CT-1040NR-PY

CT-1040NRPY, 2014 Connecticut Nonresident and Part-Year Resident Income Tax Return

2013 Connecticut Nonresident and Part-Year Resident Income Tax Return 2013 Form CT-1040NR-PY

CT-1040NRPY, 2013 Connecticut Nonresident and Part-Year Resident Income Tax Return

2012 Connecticut Nonresident and Part-Year Resident Income Tax Return 2012 Form CT-1040NR-PY

CT-1040NRPY, 2012 Connecticut Nonresident and Part-Year Resident Income Tax Return

2011 Connecticut Nonresident and Part-Year Resident Income Tax Return 2011 Form CT-1040NR-PY

CT-1040NRPY, 2011 Connecticut Nonresident and Part-Year Resident Income Tax Return


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