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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
17 Tax paid to another state (attach TC 40S)
18 Retirement tax credit (attach TC 40C) 23
20 Utah Educational Savings Plan (UESP) credit 24 Qualifying solar project credit
39 Renewable commercial energy systems 47 Agricultural off highway gas/undyed diesel
40 Targeted business tax credit 48
40404
40405
41 Special needs adoption credit
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
71 Interest from U S Government Obligations 78 Railroad retirement income
77 Native American Income: Tribe 79
88 Nonresident military spouse income
Amount
Attach completed schedule to your Utah Income Tax Return
Code Amount
Code Code
Code Code
Code Code
Enrollment Number Code 82 Nonresident active duty military pay
Income Tax Supplemental Schedule TC 40A Pg 1
Income Tax Supplemental Schedule TC 40A Pg 2
Last name
Part 1 Additions to Income (write the code and amount of each addition to income)
Part 2 Subtractions from Income (write the code and amount of each subtraction from income)
Part 3 Apportionable Nonrefundable Credits (write the code and amount of each credit)
Part 4 Nonapportionable Nonrefundable Credits (write the code and amount of each credit) Code
Part 5 Refundable Credits (write the code and amount of each refundable credit) Code Amount
Submit page ONLY if data entered
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)