Non and Part-year Resident Schedule TC-40B
40206 SSN Last name 2022
USTC ORIGINAL FORM
Residency• Nonresident: Home state abbreviation: • Part-year resident from: / / to / / Status:
mm/dd/yy mm/dd/yy
Income Col. A - UTAH Col. B - TOTAL
1 Wages, salaries, tips, etc. (1040 line 1z) .00 .00
2 Taxable interest income (1040 line 2b) .00 .00
3 Ordinary dividends (1040 line 3b) .00 .00
4 IRAs, pensions and annuities - taxable amount (1040 lines 4b and 5b) .00 .00
5 Social Security benefits - taxable amount (1040 line 6b) .00 .00
6 Taxable refunds/credits/offsets of state/local income taxes (1040, Schedule 1, line 1) .00 .00
7 Alimony received (1040, Schedule 1, line 2a) .00 .00
8 Business income or loss (1040, Schedule 1, line 3) .00 .00
9 Capital gain or loss (1040, line 7) .00 .00
10 Other gains or losses (1040, Schedule 1, line 4) .00 .00
11 Rental real estate, royalties, partnerships, S corps, trusts, etc. (1040, Schd 1, line 5) .00 .00
12 Farm income or loss (1040, Schedule 1, line 6) .00 .00
13 Unemployment compensation (1040, Schedule 1, line 7) .00 .00
14 Other income (1040, Schedule 1, line 9) .00 .00
15 Additions to income from TC-40A, Part 1 (Utah portion only in Utah column) .00 .00
16 Reserved .00 .00
17 Reserved .00 .00
18 Total income/loss - add lines 1 through 17 for both columns A and B .00 .00
Adjustments Col. A - UTAH Col. B - TOTAL
19 Educator expenses (1040, Schedule 1, line 11) .00 .00
20 Certain bus. expenses of reservists, performing artists, etc. (1040, Schd 1, line 12) .00 .00
21 Health savings account deduction (1040, Schedule 1, line 13) .00 .00
22 Moving expenses (1040, Schedule 1, line 14) - col. A only expenses moving into Utah .00 .00
23 Deductible part of self-employment tax (1040, Schedule 1, line 15) .00 .00
24 Self-employed SEP, SIMPLE and qualified plans (1040, Schedule 1, line 16) .00 .00
25 Self-employed health insurance deduction (1040, Schedule 1, line 17) .00 .00
26 Penalty on early withdrawal of savings (1040, Schedule 1, line 18) .00 .00
27 Alimony paid (1040, Schedule 1, line 19a) .00 .00
28 IRA deduction (1040, Schedule 1, line 20) .00 .00
29 Student loan interest deduction (1040, Schedule 1, line 21) .00 .00
30 Reserved .00 .00
31 Reserved .00 .00
32 State tax refund included on federal form 1040, Schedule 1, line 1 .00 .00
33 Subtractions from income from TC-40A, Part 2 (Utah portion only in Utah column) .00 .00
34 Reserved .00 .00
35 Reserved .00 .00
36 (see instructions): .00 .00
37 Total adjustments - add lines 19 through 36 for both columns A and B .00 .00
38 Subtract line 37 from line 18 for both columns A and B • .00 • .00
Line 38, column B must equal TC-40, line 9
Non or Part-year Resident Utah Tax
39 Divide line 38 column A by line 38 column B (to 4 decimal places, not more than 1.0000 or less than 0.0000) 39
40 Subtract TC-40, line 24 from TC-40, line 23 and enter the result (not less than zero) here .00 40
41 UTAH - Multiply line 40 by the decimal on line 39. Enter on TC-40, page 2, line 25 .00• 41 TAX
Submit this page ONLY if data entered.
Attach completed schedule to your Utah Income Tax Return.