$13 590 $20 385
$27 180
40 TAX DUE
45 DIRECT DEPOSIT YOUR REFUND
at irs gov
C D M = L
incometax utah gov/contributions V
incometax utah gov/topics/fiscal year filing
Reportable Transaction Disclosure Statement
uesp org
(14 characters ending in WMP no hyphens) from Utah Schedule K 1
(14 characters ending in WTH no hyphens) on the form
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(Clear form) Clear form
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* to the extent previously deducted or credited on Utah return
01 At home parent credit 12 Research activities credit
02 Qualified sheltered workshop credit name: 13
04 Capital gain transactions credit 22 Medical Care Savings Account (MSA) credit
05 Clean fuel vehicle credit 19
06 Historic preservation credit 21 Renewable residential energy systems credit
07 Enterprise zone credit 25
08 Low income housing credit 27 Veteran employment tax credit
1 Employer/payer ID number from W 2 box b or 1099 Do not send your W 2s or 1099s with your return Instead enter
1 Filing Status enter code
1 Pass through entity EIN from Utah Schedule K 1 box A
1 Producer s EIN number from box 2 of TC 675R 4 Pass through entity EIN if credit from partnership or S corporation
10 Utah tax
17 Tax paid to another state (attach TC 40S)
18 Retirement tax credit (attach TC 40C) 23
2 (14 characters no hyphens)
2 (14 characters no hyphens)
2 Name of pass through entity from Utah Schedule K 1 box B
2 Producer s name from box 1 of TC 675R (enter EIN from Utah Schedule K 1)
2 Utah withholding ID number from W 2 box 15 or 1099 W 2 or 1099 information below but only if there is Utah withholding
20 Utah Educational Savings Plan (UESP) credit 24 Qualifying solar project credit
22 Utah income tax
3 Election Campaign Fund enter code
3 Employer/payer name and address from W 2 box c or 1099
3 Producer s Utah withholding number from box 3 of TC 675R 5 Utah mineral production withholding tax from box 6 of TC 675R or
3 Utah withholding tax paid by pass through entity
32 Total tax use tax and additions to tax
39 Renewable commercial energy systems 47 Agricultural off highway gas/undyed diesel
4 Enter X if reporting Utah withholding from form 1099 Use additional forms TC 40W if you have more than four W 2s and/or
40 Targeted business tax credit 48
40402
40403
40404
40405
40409
40410
41 Special needs adoption credit
42 TOTAL DUE PAY THIS AMOUNT
43 REFUND
5 Employee s Social Security number from W 2 box a or 1099 1099s with Utah withholding tax
51 Lump sum distributions 57 Municipal bond interest
53 Medical Savings Account (MSA) addback* 60
54 Utah Educational Savings Plan (UESP) addback* 61 Untaxed income of a nonresident trust
56 Child s income excluded from parent s return 69
6 Utah wages or income from W 2 box 16 or 1099
7 Utah withholding tax from W 2 box 17 or 1099 Enter mineral production withholding from TC 675R in Part 2 of TC 40W;
71 Interest from U S Government Obligations 78 Railroad retirement income
77 Native American Income: Tribe 79
88 Nonresident military spouse income
9 Utah taxable income (loss)
All State Income Tax Dollars Fund Education
Amount
Attach completed schedule to your Utah Income Tax return
Attach completed schedule to your Utah Income Tax Return
Attach completed schedule to your Utah Income Tax Return
Code Amount
Code Amount Code
Code Code
Code Code
Code Code
Do not attach W 2s or 1099s to your Utah return
Do not send TC 675R 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
Electronic filing
Enrollment Number Code 82 Nonresident active duty military pay
enter pass through entity withholding in Part 3 of TC 40W
Enter total mineral production withholding tax from all lines 5 here and on TC 40 page 2 line 36
Enter total pass through withholding tax from all lines 3 here and on TC 40 page 2 line 35:
Enter total Utah withholding tax from all lines 7 here and on TC 40 page 2 line 33:
Exemptions enter number
First TC 675R or Utah Schedule K 1
First Utah Schedule K 1
First W 2 or 1099 Second W 2 or 1099
Fourth TC 675R or Utah Schedule K 1
Fourth Utah Schedule K 1
free and will
go to
Income Tax Supplemental Schedule TC 40A Pg 1
Income Tax Supplemental Schedule TC 40A Pg 2
is quick easy and
Last name
Last name
Line Explanations
Line Explanations IMPORTANT
Mineral Production and Pass through Withholding TC 40W Pg 2
Part 1 Additions to Income (write the code and amount of each addition to income)
Part 1 Deceased Taxpayer Information
Part 1 Utah Withholding Tax Schedule TC 40W Pg 1
Part 2 Fiscal Year Filer
Part 2 Subtractions from Income (write the code and amount of each subtraction from income)
Part 2 Utah Mineral Production Withholding Tax TC 675R
Part 3 Apportionable Nonrefundable Credits (write the code and amount of each credit)
Part 3 Federal Form 8886 filed
Part 3 Utah Pass through Entity Taxpayer Withholding Utah Schedule K 1
Part 4 Nonapportionable Nonrefundable Credits (write the code and amount of each credit) Code
Part 4 Voluntary Contributions
Part 5 Refundable Credits (write the code and amount of each refundable credit) Code Amount
Part 5 Utah Educational Savings Plan Refund Application
Part 6 Direct Deposit to Foreign Account
Part 7 Property Owner s Residential Exemption Termination Declaration
Sch Dist
Second TC 675R or Utah Schedule K 1
Second Utah Schedule K 1
speed up your refund
Submit page ONLY if data entered
Submit page ONLY if data entered
Submit page ONLY if data entered
taxexpress utah gov
TC 404040199989998
Third TC 675R or Utah Schedule K 1
Third Utah Schedule K 1
Third W 2 or 1099 Fourth W 2 or 1099
To learn more
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 Part 3 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 from income and enter total here and on TC 40 line 8)
Total voluntary contributions
Utah Individual Income Tax Return
Utah Individual Income Tax Return (continued) TC 40
Utah State Tax Commission