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40304
40305
Agricultural off highway gas/undyed diesel
Amount
At home parent credit
Attach completed schedule to your 2013 Utah Income Tax return
Capital gain transactions credit 22
Carryover of mach /equip research credit
Child's income excluded from parent's return
Clean fuel vehicle credit
Code Code Amount
Code Code Code Amount
Code Code Code Amount
Combat related death credit
Continued Income Tax Supplemental Schedule Rev 12/13
Enterprise zone credit 25
Equitable adjustments attach explanation
Farm operation hand tools
Gold and silver coin sale credit
Health benefit plan credit
Historic preservation credit
Income Tax Supplemental Schedule Rev 12/13
Interest from U S Government Obligations 78
Live organ donation expenses credit
Low income housing credit
Lump sum distribution 56
Medical Care Savings Account (MSA) credit
Medical Savings Account (MSA) addback*
Municipal bond interest
Native American income
Nonresident active duty military pay
Nonresident military spouse income 00
or credited on Utah return
Part 1 Additions to Income (write the code and amount of each addition to income see insructions)
Part 3 Apportionable Nonrefundable Credits (write the code and amount of each nonrefundable credit see instructions)
Part 4 Nonapportionable Nonrefundable Credits (write the code and amount of each nonrefundable credit see instructions)
Part2 Subtractions from Income (write the code and amount of each subtraction from income see instructions)
Part5 Refundable Credits (write the code and amount of each refundable credit see instructions)
Qualified sheltered workshop credit
Qualifying solar project credit
Railroad retirement income
Recycling market dev zone credit
Reimbursed adoption expenses *
Renewable commercial energy systems 47
Renewable residential energy systems credit
Research activities credit
Retirement tax credit (attach TC 40C) 23
Special needs adoption credit
Spouse's enrollment number Code
State tax refund distributed to beneficiary
Submit this page ONLY if data entered
Targeted business tax credit 48
Tax paid to another state (attach TC 40S)
TC 40A
To the extent previously deducted 69
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
Untaxed income of a nonresident trust
Untaxed income of a resident trust
Utah Educational Savings Plan (UESP) addback *
Utah Educational Savings Plan (UESP) credit 24
Veteran employment tax credit
Your enrollment number Code 82
Your last name
Your social security number