41083
Fiduciary Supplemental Schedule
Name of estate or trust
Clear form
EIN
TC-41A
Rev. 12/08
Part 1 - Additions to Income (write the code and amount of each addition to income, see pages 4 and 5)
Code Code Code Amount
51 Lump sum distribution 54 Utah Educational Savings Plan (UESP) (to the extent deducted from Utah income) 57 Municipal bond interest
58 ESBT S-corporation income 62 Fiduciary adjustments - attach explanation 69 Equitable adjustments - attach explanation
Total additions to income (add all additions to income and enter total here and on TC-41, line 5) Part 2 - Deductions from Income (write the code and amount of each deduction from income, see pages 5 and 6)
Code Code Code Amount
71 Interest from U. S. Government Obligations 78 Railroad retirement income 77 Native American income Enrollment number Tr. Code
79 Equitable adjustments - attach explanation 80 State tax refund included in federal income 84 Nontaxable income from irrevocable resident trust 86 Nongrantor charitable lead trust charitable contribution 87 Fiduciary adjustments - attach explanation
Total deductions from income (add all deductions and enter total here and on TC-41, line 11) Part 3 - Apportionable Nonrefundable Credits (write the code and amount of each nonrefundable credit, see pages 7 and 8)
Code Code Amount
04 Capital gains transactions credit 20 Utah Educational Savings Plan (UESP) credit
Total apportionable nonrefundable credits (add all credits and enter total here and on TC-41, line 22) Part 4 - Nonapportionable Nonrefundable Credits (write the code and amount of each nonrefundable credit, see pages 8 - 10)
Code Code Code Amount
02 Qualified sheltered workshop credit Name 03 Carryover of 2004, 2005 or 2006 energy credit 05 Clean fuel vehicle credit 06 Historic preservation credit 07 Enterprise zone credit
08 Low-income housing credit 10 Recycling market credit 12 Research activities credit 13 Research machinery/equipment credit 17 Tax paid to another state (attach TC-41S) 21 Renewable residential energy systems credit
Total nonapportionable nonrefundable credits (add all credits and enter total here and on TC-41, line 25) Part 5 - Refundable Credits (write the code and amount of each refundable credit, see pages 12 and 13)
Code Code Code Amount
39 Renewable commercial energy systems credit 40 Targeted business tax credit 43 Nonresident shareholder' s withholding FEIN
46 Mineral production withholding 47 Agricultural off-highway gas/undyed diesel 48 Farm operation hand tools
Total refundable credits (add all refundable credits and enter total here and on TC-41, line 33) Attach completed schedule to your 2008 Utah fiduciary return