Form TC-40 Mini Packet Fillable Utah Individual Income Tax Return Mini Packet (contains just TC-40, TC-40A, and TC-40W, no instructions)
(all forms fillable on Windows, Mac, Android tablets, and iPad using Adobe Reader XI)

00 00 14 characters no hyphens 14 characters no hyphens (14 characters ending in WMP no hyphens) (14 characters ending in WTH no hyphens) (enter EIN from Utah Schedule K 1) * See illustration instructions * * To the extent previously deducted <14 characters no hyphens <14 characters no hyphens 01 At home parent credit 02 Qualified sheltered workshop credit 04 Capital gain transactions credit 22 Medical Care Savings Account (MSA) credit 05 Clean fuel vehicle credit 06 Historic preservation credit 07 Enterprise zone credit 08 Low income housing credit 1 Employer payer ID number (from W 2 box b or 1099) 1 Pass through entity EIN from Utah Schedule K 1 box A 1 Producer s EIN from box 2 of TC 675R 10 Recycling market dev zone credit 12 Research activities credit 13 Carryover of mach /equip research credit 17 Tax paid to another state (attach TC 40S) 18 Retirement tax credit (attach TC 40C) 19 Live organ donation expenses credit 2 Name of pass through entity from Utah Schedule K 1 box B 2 Producer s name from box 1 of TC 675R 2 Utah withholding ID number (from W 2 box 15 or 1099) 20 Utah Educational Savings Plan (UESP) credit 21 Renewable residential energy systems credit 23 Health benefit plan credit 24 Qualifying solar project credit 25 Combat related death credit 26 Gold and silver coin sale credit 27 Veteran employment tax credit 3 Employer payer name and address (from W 2 box c or 1099) 3 Producer s Utah withholding ID # from box 3 of TC 675R 3 Utah withholding tax paid by pass through entity 39 Renewable commercial energy systems 4 Enter X if reporting Utah withholding from form 1099 4 Pass through entity EIN if credit from partnership or S corporation 40 Targeted business tax credit 40304 40305 40309 40310 41 Special needs adoption credit 47 Agricultural off highway gas/undyed diesel 48 Farm operation hand tools 5 Employee s SSN (from W 2 box a or 1099) 5 Utah mineral production withholding tax from box 6 of TC 675R or 51 Lump sum distribution 53 Medical Savings Account (MSA) addback* 54 Utah Educational Savings Plan (UESP) addback * 55 Reimbursed adoption expenses * 56 Child's income excluded from parent's return 57 Municipal bond interest 6 Utah wages/income (from W 2 box 16 or 1099) 60 Untaxed income of a resident trust 61 Untaxed income of a nonresident trust 69 Equitable adjustments attach explanation 7 Utah withholding tax (from W 2 box 17 or 1099) 71 Interest from U S Government Obligations 77 Native American income 78 Railroad retirement income 79 Equitable adjustments attach explanation 82 Nonresident active duty military pay 85 State tax refund distributed to beneficiary 88 Nonresident military spouse income Amount and/or 1099s with Utah withholding tax Attach completed schedule to your 2013 Utah income tax return Attach completed schedule to your 2013 Utah Income Tax return Code Amount Code Code Code Code Amount Code Code Code Amount Continued Income Tax Supplemental Schedule Rev 12/13 Do not send TC 675Rs or Utah Schedules K 1 Do not send TC 675Rs or Utah Schedules K 1 with return Enter TC 675R or Schedule K 1 information below Use additional TC 40Ws if needed Do not send Utah Schedule(s) K 1 with return Enter information below Use additional TC 40Ws if needed Do not send W 2s or 1099s Do not send your W 2s and 1099s with your return Enter mineral production withholding from TC 675R in Part 2 of Enter this total on form TC 40 page 2 line 33 Enter total income tax withholding from all lines 7 Enter total mineral production withholding tax from all lines 5 Enter this total on form TC 40 page 2 line 36 Enter total pass through withholding tax from all lines 3 Enter on TC 40 page 2 line 35 enter W 2 and 1099 information below but if there is Utah First TC 675R or Utah Schedule K 1 First Utah Schedule K 1 Second Utah Schedule K 1 First W 2 or 1099 Second W 2 or 1099 from Utah Schedule K 1 IMPORTANT Instead Line explanations: Line explanations: or credited on Utah return Part 1 Additions to Income (write the code and amount of each addition to income see insructions) Part 2 Subtractions from Income (write the code and amount of each subtraction from income see instructions) Part 2 Utah Mineral Production Withholding Tax TC 675R Part 3 Apportionable Nonrefundable Credits (write the code and amount of each nonrefundable credit see instructions) Part 3 Utah Pass through Entity Taxpayer Withholding Utah Schedule K 1 Part 4 Nonapportionable Nonrefundable Credits (write the code and amount of each nonrefundable credit see instructions) Part 5 Refundable Credits (write the code and amount of each refundable credit see instructions) Rev 12/13 Income Tax Supplemental Schedule Rev 12/13 Mineral Production and Pass through Withholding Tax Rev 12/13 Part 1 Utah Withholding Tax Schedule Second TC 675R or Utah Schedule K 1 Spouse's enrollment number Submit this page ONLY if data entered Submit this page ONLY if data entered TC 40; enter pass through entity withholding in Part 3 of TC 40W TC 40A TC 40W Third TC 675R or Utah Schedule K 1 Fourth TC 675R or Utah Schedule K 1 Third Utah Schedule K 1 Fourth Utah Schedule K 1 Third W 2 or 1099 Fourth W 2 or 1099 Total additions to income (add all additions to income and enter total here and on TC 40 line 5) Total apportionable nonrefundable credits (add all credits and enter total here and on TC 40 line 24) Total nonapportionable nonrefundable credits (add all Part 4 credits and enter total here and on TC 40 line 26) Total refundable credits (add all refundable credits and enter total here and on TC 40 line 38) Total subtractions from income (add all subtractions and enter total here and on TC 40 line 8) Tribe Use additional forms TC 40W Part 2 or Part 3 if needed Use additional TC 40W forms if you have more than four W 2s withholding on the form Your enrollment number Your last name Your last name Your social security number Your social security number