NJ-1080-C                                                 New Jersey Income Tax 
                                                             Nonresident Composite Return
       2021                                                 For Tax Year January 1 – December 31, 2021

ID Number                               Legal Name

                                        Trade Name (if different from legal name)

          Number of individuals         Address (number and street)
          participating in 
          this return
                                        City                                                                                                 State                                      ZIP Code

Check if:      1.                 Professional Athletic Team 2.   Partnership                                                        3.   New Jersey Electing S Corporation
               4.                 Limited Liability Company  5.   Limited Liability Partnership                                      6.   Estate or Trust
 7.  ElectionsGubernatorialFund Do you want to designate $1 of your taxes for this fund?                                         Yes    No   Note: If you check the “Yes” box it will not 
                                                                                                                                             increase the tax or reduce the refund.
                                                                                                                                                                                        Income From  
                                                Income Information
                                                                                                                                                                                    New Jersey Sources
  8.   Wages, salaries, tips, and other employee compensation ........................................................................................                              8.
  9.   Taxable interest .........................................................................................................................................................   9.
  10.  Dividends .................................................................................................................................................................. 10.
 11.   Net gain or income from disposition of property .......................................................................................................                      11.
  12.   Distributive share of partnership income ..................................................................................................................                 12.
  13.   Net Pro Rata Share of S corporation income ...........................................................................................................                      13.
  14.   Net gains or income from rents, royalties, patents, and copyrights ..........................................................................                               14.
  15.   Net gains or income derived through estates or trusts .............................................................................................                         15.
  16.   Other – state nature and source                                    .........................................................................                                16.
  17.  Total New Jersey Taxable Income (Add lines 8 through 16) .....................................................................................                               17.
  18.  Tax (Multiply line 17 by 10.75%) ...............................................................................................................................             18.
  19.   Penalty for Underpayment of Estimated Tax
       Fill in               if Form NJ-2210 is enclosed .................................................................................................................          19.
  20.  Total Tax and Penalty (Add lines 18 and 19).............................................................................................................                     20.
  21.   Total New Jersey Tax Withheld ..............................................................................          21.
  22.   Estimated payments/credit from 2020 composite return .......................................                          22.
  23.   Tax Paid on Partners’ Behalf by Partnership .........................................................                 23.
  24.   Pass-Through Business Alternative Income Tax Credit .........................................                         24.
  25.  Total payments/credits (Add lines 21 through 24) .....................................................................................................                       25.
  26.   If line 25 is less than line 20, tax is due. Subtract line 25 from line 20 and enter the amount due ...........................                                             26.
  27.   If line 25 is more than line 20, there is an overpayment. Subtract line 20 from line 25 and enter the overpayment                                                           27.
  28.  Refund (Amount of line 27 to be refunded) ...............................................................................................................                    28.
  29.   Credit to 2022 Tax .................................................................................................. 29.
Signature (See instructions)                   Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, 
                                               and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer is based on all infor-
                                               mation of which preparer has any knowledge.
                                               Paid Preparer’s Signature                                                                                                            Date
Title                                                                                                                                                                                 Check if Self-Employed
                                               Firm’s Name (or yours if self-employed)                                                                                              Preparer’s SS #
Date
                                               Preparer’s Address                                                                                                                   Preparer’s Federal EIN #

   UseDivision          1           2       3                           4              5                                          6         7

SCHEDULE A  –  PARTICIPANT DIRECTORY
See instructions for the diskette requirements.

Legal name as shown on Form NJ-1080-C                   ID Number

List all participants, including principal address. Add additional sheets as necessary.
Social Security Number or EIN                    Name

Taxable Income                                   Address

NJ Income Tax                                    City                                                                                                    State ZIP Code

Social Security Number or EIN                    Name

Taxable Income                                   Address

NJ Income Tax                                    City                                                                                                    State ZIP Code

Social Security Number or EIN                    Name

Taxable Income                                   Address

NJ Income Tax                                    City                                                                                                    State ZIP Code

Social Security Number or EIN                    Name

Taxable Income                                   Address

NJ Income Tax                                    City                                                                                                    State ZIP Code

Social Security Number or EIN                    Name

Taxable Income                                   Address

NJ Income Tax                                    City                                                                                                    State ZIP Code

Social Security Number or EIN                    Name

Taxable Income                                   Address

NJ Income Tax                                    City                                                                                                    State ZIP Code

Total Taxable Income This Page .........................................................................................................................
                Additional Pages Attached
Total Taxable Income All Pages (Carry to line 17) .......................................................................................

Total NJ Income Tax This Page ...........................................................................................................................
                Additional Pages Attached
Total NJ Income Tax All Pages (Carry to line 18) .........................................................................................

SCHEDULE B  –  NONPARTICIPANT DIRECTORY
See instructions for the diskette requirements.

Legal name as shown on Form NJ-1080-C                 ID Number

List all nonparticipants, including principal address. Add additional sheets as necessary.
Social Security Number or EIN                  Name

Taxable Income                                 Address

                                               City                                       State ZIP Code

Social Security Number or EIN                  Name

Taxable Income                                 Address

                                               City                                       State ZIP Code

Social Security Number or EIN                  Name

Taxable Income                                 Address

                                               City                                       State ZIP Code

Social Security Number or EIN                  Name

Taxable Income                                 Address

                                               City                                       State ZIP Code

Social Security Number or EIN                  Name

Taxable Income                                 Address

                                               City                                       State ZIP Code

Social Security Number or EIN                  Name

Taxable Income                                 Address

                                               City                                       State ZIP Code

Social Security Number or EIN                  Name

Taxable Income                                 Address

                                               City                                       State ZIP Code

Social Security Number or EIN                  Name

Taxable Income                                 Address

                                               City                                       State ZIP Code