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Form CT-1040NR/PY 2017

Department of Revenue Services State of Connecticut Form CT- 1040nr /PY. Connecticut Nonresident and Part-Year 2017. (Rev. 12/17) Resident Income Tax Return CT- 1040nr /PY. NRPY 1217W 01 9999 For DRS. Use Only Taxpayers must sign declaration on reverse side. M M - D D - Y Y Y Y Complete return in blue or black ink only. For January 1 December 31, 2017, or other taxable year Year Beginning and Ending M M - D D - Y Y Y Y M M - D D - Y Y Y Y. 1 Filing Status - Check only one box. Single Head of household Married filing separately . Married filing jointly Qualifying widow(er) with dependent child Enter spouse's name here and SSN below.

Schedule 2 - Credit for Income Taxes Paid to Qualifying Jurisdictions - Part-Year Residents Only You must attach a copy of your return filed with the qualifying jurisdiction(s) or your credit will be disallowed.

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