Free 2001 TC-40 - Utah

Utah State Tax Commission 210 N 1950 W, Salt Lake City, Utah 84134 (801) 297-2200 or 1-800-662-4335

2001
TC-40
Rev. 12/01

1 2 3 4 5 6 7

Utah Individual Income Tax Return
All State Income Tax Dollars Fund Education

For calendar year January 1, 2001 through December 31, 2001 or other taxable periods beginning date ________________, and ending date _______________.

Please print legibly or use preprinted label.

AMENDED RETURN
if died in 2001 or 2002 (page 5)

See page 4 for the "REASONS FOR AMENDING" and enter the number in this box
if died in 2001 or 2002 (page 5)

L A B E L H E R E
a. b. c. d. e.

Your Social Security number Your full name (first, middle initial, last) Mailing address

Spouse's Social Security number Spouse's name (first, middle initial, last)

8
City Foreign city If filing married joint or separate return, enter spouse' s name and social security number in the address area above. State ZIP code + 4 County Foreign country Daytime telephone number

(
Foreign state & zip

) )
Spouse

9 10 11 12 13 14 15 16 17 18 19

Evening telephone number

(
Single Head of household 2. Exemptions (enter the same number claimed on federal return) (page 5) a. Yourself If parents, or someone else, can claim you (or your spouse) as b. Spouse dependents, enter "0"). c. Other dependents d. Disabled (attach form TC-40D) e. Total exemptions

1. Filing status (page 5)

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

3. Election campaign fund (page 5) Democrat Libertarian Natural Law Republican A B C D

Married filing joint return Married filing separate return Qualifying widow(er)

No Contribution

Attach W-2 and other withholding forms here

4. Federal adjusted gross income from federal return (Telefile Record line I, 1040EZ line 4, 1040A line 19, or 1040 line 33)(page 6)
INCOME

4 5 6 7

5. State income tax deducted as an itemized deduction on your 2001 federal form 1040, Schedule A, line 5 (page 6) 6. Enter entire amount of lump sum distribution reported on federal form 4972 (page 6) 7. State taxes allocated from an estate or trust (page 6) 8. Additions to income (page 6) MSA $___________ UESP $___________ Reimbursed $___________ Adoption expenses
10 11 12 13

8 9

9. Total adjusted income (add lines 4 through 8) 10. Standard or itemized deduction (page 6) 11. Personal exemptions deduction. Multiply $2,175 by line 2e. (High income see pages 6 & 7)
DEDUCTIONS

00 00 00 00 00 00

12. One-half of the federal tax (page 7) 13. State tax refund included on line 10 of federal form 1040 (page 7) 14. Retirement exemption/deduction Check box if age 65 or older (Attach schedule TC-40A, Part 2) (see page 7) 15. Interest from U. S. government obligations deduction (page 7 & 8) 16. MSA and UESP deductions (page 8) MSA $___________ 17. Health Care Insurance Premium deduction (page 8) 18. Long-Term Care Insurance Premium deduction (pages 8 & 9) Adoption exp. $___________ R.R. Retire. $___________ 19. Other deductions (page 9) Other $___________ Native Amer. income $___________ 20. Total deductions (add lines 10 through 19) 21. Utah 2001 taxable income (subtract line 20 from line 9) If less than zero, enter zero. Taxpayer is 65 or older Spouse is 65 or older UESP $___________

14 15 16 17 18 19

00 00 00 00 00 00 00 00 00 00

Round to nearest whole dollar.

20 21 22 23 24

20 21 22

TAX

00 00

25 26 27

22. CALCULATE INCOME TAX (MUST READ INSTRUCTIONS on page 9) Worksheet on page 17.

00
to / / 01

23. FOR NON OR PART-YEAR RESIDENTS ONLY - Use form TC-40A, PART 3. Check "Nonresident" or "Part-year resident" below.
Nonresident. Home state abbreviation: Box a. From Column A, line h Box b. From Column B, line h Part-year resident from Box c. Utah income tax ratio / / 01

Information in the boxes below is from state form TC-40A, Part 3. (see page 9)
24. Utah use tax (see pages 9 & 10)

23 24

00 00

Non or Part-year Residents must attach a copy of their FEDERAL RETURN.

28 29 30

25. Subtotal - Utah income tax and use tax (see page 10) UTAH RESIDENTS: Add lines 22 and 24. CONTINUE ON LINE 26 NON OR PART-YEAR RESIDENTS: Add lines 23 and 24.

25

00

CONTINUE ON LINE 26

Utah Income Tax Return TC-40 (2001) Page 2 26. Enter amount from line 25 (Subtotal - Utah income tax and use tax) 27. Contributions (page 10) 27a. Homeless trust fund 27b. Kurt Oscarson Children' s organ transplant fund 27c. Utah nongame wildlife fund 27d. State colleges and universities College code 27e. Nonprofit school district foundation School district code Total contributions (add lines 27a through 27e) 28. AMENDED RETURNS ONLY - previous refunds (page 11) 29. Total tax and contributions (add lines 26, 27, and 28) 30. UTAH TAX WITHHELD (must attach Utah W-2 and/or 1099 forms) (page 11) 31. Credit for income tax paid to another state (page 11). Complete state form TC-40A, PART 1. Nonresidents do not qualify for this credit. 32. Credit for Utah income taxes prepaid (page 11) 33. AMENDED RETURNS ONLY - previous payments (page 11) 34. Nonrefundable credits (pages 11 through 14) 34a. Credit 34b. Credit 34c. Credit 34d. Credit 34e. Credit CODE
34a 34b 34c 34d 34e 30 31 32 33 26 27a 27b 27c 27d 27e

00

CONTRIBUTIONS

00 00 00 00 00

27 28 29

00 00 00
Attach a copy of each state return for which you are claiming credit for taxes paid.

00 00 00 00 00 00 00 00 00

WITHHOLDING AND CREDITS

CODES for lines 34a - 34e are located on pages 11 - 14.

Total nonrefundable credits (add lines lines 34a through 34e) 34 00 UTAH RESIDENT: The total nonrefundable credits on line 34 cannot exceed the amount on line 22 less line 31. NON or PART-YEAR RESIDENT: The total nonrefundable credits on line 34 cannot exceed the amount on line 23 less line 31. 35. Refundable credits (page 14) 35a. Mineral production withholding tax credit (attach TC-675R and/or K-1) 35a 00 Attach copy of federal form 35b. Agricultural off-highway gas/undyed diesel tax credit. Gallons ______ X .245 35b 00 1040 Schedule F or K-1 for credit on line 35b. 35c. NON or PART-YEAR Nonresident shareholder' s withholding tax credit 35c 00 RESIDENTS ONLY Federal ID number 35d. Special needs adoption tax credit
Total other credits (add lines 35a through 35d) 35d

00
35 36

00 00 00 00
Amount to be applied to 2002

36. Total withholding and credits (add lines 30, 31, 32, 33, 34, and 35) 37. Tax due - If line 29 is larger than line 36, subtract line 36 from line 29. This is the amount you owe. The taxpayer will be billed for any penalty and interest owed. See page 15 about payment and payment agreements. Mail payment to the Utah State Tax Commission, 210 N 1950 W, SLC, UT 84134-0200 38. Refund - If line 36 is larger than line 29, subtract line 29 from line 36. This is your refund. (page 15)
REFUND TAX DUE

TAX DUE

37

REFUND

38

39. Enter the amount of refund you want applied to your 2002 taxes. Your refund will be reduced by this amount. (page 15) If this is an AMENDED return, you cannot apply your refund to next year's tax liability.
39

00

40. Do you want your REFUND DEPOSITED DIRECTLY into your account? If you choose to DIRECT DEPOSIT, provide the routing and account information below. You will not receive a check in the mail. (See page 15) What type of account is it? Routing number Account number Checking Savings account account
Under penalties of perjury, I declare that to the best of my knowledge and belief, this return and accompanying schedules reflect my true tax status.
Your signature Spouse' s signature (if filing jointly, both MUST sign even if only one had income) Paid preparer' s signature Date signed Occupation Occupation Preparer' s Social Security no. or PTIN E.I. number State ZIP code

Date signed Date signed Check if self-employed Telephone number City

Paid Preparer' s Section

Firm' s name (or yours if self-employed) Paid preparer' s complete address