Connecticut Schedule CT-IT Credit

Schedule CT-IT Credit
Form CT-IT Credit
Department of Revenue Services
State of Connecticut
450 Columbus Blvd Ste 1
Hartford CT 06103-1837
(Rev. 12/19)

2019

Form CT-19IT
Title 19 Status Release

Place this form on top of your completed Connecticut income tax return. Complete in blue or black ink only.
Please note that each form is year specific. To prevent any delay in processing your return, the correct year’s form must be
submitted to the Department of Revenue Services (DRS).
Your first name and middle initial	

Last name	

	

Social Security Number
•

•

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Mailing address (number and street), apartment number, PO Box	

City, town, or post office		

		 Telephone

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State		

ZIP code

Purpose

Who May Not File Form CT‑19IT

Use Form CT‑19IT to claim your Title 19 status. You
must include a copy of the Department of Social
Services (DSS) acceptance or redetermination letter
for the 2019 taxable year.

You may not use this form if you filed a joint return with
your spouse. As joint filers, you are jointly and severally
liable for payment of the tax. If one spouse is on Title 19,
this does not relieve the other spouse from paying the
full amount of tax due.

Who May File Form CT‑19IT
If you are required to file a Connecticut income tax
return, you may file Form CT‑19IT if you meet all the
following conditions:

General Information

1.	 You were a Title 19 recipient during the taxable year;

1.	 You meet the gross income test (See the instructions
for Form CT‑1040 or Form CT‑1040NR/PY.);

2.	 Medicaid assisted in the payment of your long‑term
care in a nursing or convalescent home or under the
Connecticut Home Care Program for Elders (CHCPE);
and
3.	You do not have the funds to pay your Connecticut
income tax or income available from future earnings
to pay the tax.

You are required to file a Connecticut income tax return
if you meet any of the following conditions:

2.	 You had Connecticut income taxes withheld;
3.	You made estimated tax payments to Connecticut
or made a payment with Form CT‑1040 EXT,
Application for Extension of Time to File Connecticut
Income Tax Return for Individuals; or
4.	 You had a federal alternative minimum tax liability.
Complete Form CT‑19IT and place it on top of your
completed Connecticut income tax return.

If the recipient has given power of attorney to another person to file Connecticut income tax returns or other
Connecticut tax forms on the recipient’s behalf, attach a copy of the Power of Attorney.
Signature of recipient 	

Date

Signature of person with power of attorney	

Date

Name of person with power of attorney (print or type)	

Telephone number
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