Tax Form: Income Tax Supplemental Schedule - Utah

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TC-40A
Rev. 12/08

40083
Code

Income Tax Supplemental Schedule
Last name SSN Code

Part 1 - Additions to Income (write the code and amount of each addition to income)
5 5 5 5 5 1 3 4 5 6 Lump sum distribution Medical Savings Account (MSA) addback * Utah Educational Savings Plan (UESP) addback * Reimbursed adoption expenses * Child's income excluded from parent's return
* to the extent previously deducted from Utah income

5 6 6 6

7 0 1 9

Municipal bond interest Untaxed income of a resident trust Untaxed income of a nonresident trust Equitable adjustments

Total additions to income (add all additions to income and enter total here and on TC-40, line 5)

Part 2 - Deductions from Income (write the code and amount of each deduction from income)
Code Code

7 1 7 7

Interest from U.S. Government Obligations Native American income: Enrollment number & Tribe Your Spouse's

78 7 8 8 8 9 0 2 5

Railroad retirement income Equitable adjustments State tax refund included on 1040, line 10 Nonresident active duty military pay State tax refund distributed to beneficiary

Total deductions from income (add all deductions from income and enter total here and on TC-40, line 7)

Part 3 - Apportionable Nonrefundable Credits (write the code and amount of each credit)
Code

0 4 1 8 2 0 2 2

Capital gain transactions credit Retirement tax credit from attached TC-40C ……… Utah Educational Savings Plan (UESP) credit Medical Care Savings Plan (MSA) credit

"X" if age 65 or older:

TP

Spouse

Total apportionable nonrefundable credits (add all credits and enter total here and on TC-40, line 22)

Part 4 - Nonapportionable Nonrefundable Credits (write the code and amount of each credit)
Code

0 1 0 2 0 3 0 5 0 6 0 7 0 8

At-home parent credit Qualified sheltered workshop credit - name: Carryover of 2004, 2005 or 2006 energy credit Clean fuel vehicle credit Historic preservation credit Enterprise zone credit Low-income housing credit

10 11 12 13 17 19 21

Recycling market dev. zone credit Tutoring disabled dependent credit Research activities credit Research machinery/equipment credit Tax paid to another state (attach TC-40S) Live organ donation expenses credit Renewable residential energy systems credit

Total nonapportionable nonrefundable credits (add all credits and enter total here and on TC-40, line 25)

Attach completed schedule to your 2008 Utah Income Tax return

Fill-in fields may not show when you open this form. If you are using Reader 7.0 or greater, checking the "Highlight field" option on your Reader will show where fields are located. Otherwise, start at "Last name" and use the tab key to move from field to field.

Clear form
TC-40A
SSN

40084

Continued - Income Tax Supplemental Schedule
Last name

Page 2

Part 5 - Refundable Credits (write the code and amount of each refundable credit)
Code Code

3 9 4 0 4 1

Renewable commercial energy systems Targeted business tax credit Special needs adoption credit

47 48

Agricultural off-highway gas/undyed diesel Farm operation hand tools

Total refundable credits (add all refundable credits and enter total here and on TC-40, line 37)

Attach completed schedule to your 2008 Utah Income Tax return


				
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Description: Tax Form: Income Tax Supplemental Schedule - Utah. TC-40A