TC-40 Forms & Instructions TC-40 Forms & Instructions UTAH Get a faster refund! tap.utah.gov All State income tax dollars support education, children and individuals with disabilities. All State income tax dollars support education, children and individuals with disabilities. All State income tax dollars support education, children and individuals with disabilities. Utah State Tax Commission • 210 North 1950 West • Salt Lake City, Utah 84134 • tax.utah.gov

Shopping online is easy, but it’s not free. Utah loses tax revenue every year to online sales. This makes it harder for the state to pay for everything from education to healthcare. When online sellers do not collect sales tax, it becomes your responsibility to pay use tax. You must pay this use tax when you file your Utah income tax return. See page 10 for more information and a worksheet to help you calcu- late how much use tax you owe. You Should Know: • Purchases are not exempt from tax just because you make them online. • Use tax applies to any pur- chase that sales tax would. • Your use tax rate depends on where you live. See page 10. • Grocery food is taxed at a flat 3 percent across Utah. • Some online sellers have tools to help you calculate the use tax you owe. Y S &+(&.287 DID YOU BUY ANYTHING ONLINE LAST YEAR? YOU MIGHT OWE USE TAX! 9 The Fastest Refund Possible! 9 Error-free filing! 9 The Fastest Refund Possible! 9 Error-free filing! tap.utah.gov tap.utah.gov Your one-stop shop for everything you need to file electronically. To learn more, go to: Cover photo: Antelope Island, by Colton Matheson Three good reasons to e-file: & Electronic returns get processed faster than paper returns. & Electronic filing catches mistakes, ensuring your return is filed right the first time. & If you owe taxes, you can wait to pay until April 18, 2022, no matter how early you file your return. Still want to file a paper return? Are you sure? ' Each paper return must be removed from the envelope, sorted, examined and processed by hand. ' If you make even a simple mistake, fixing it will add several more weeks of processing time. ' If we can’t figure out how to fix your return, we will have to contact you and wait for your response before we can process your return. ' If you are waiting for a refund, we cannot issue it until your paper return has been manually processed and posted to your account.

1 2021 Utah TC-40 Instructions Paper Returns To avoid errors and get the fastest refund possible, fi le your return electronically. If you must fi le a paper return, follow these guidelines: • Use black or dark blue ink only. Do not use felt tip pen. • Enter only whole dollar amounts – no cents. • If a line or box does not apply to you, leave it blank. • Do not use dollar signs, commas or parentheses. • If entering a loss, use a minus sign in front of the number. • Sign and mail the original return – keep a copy for your records. Get Utah Forms tax.utah.gov/forms References UC Utah Code (le.utah.gov) IRC Internal Revenue Code (law.cornell.edu/uscode/26) USC U.S. Code (law.cornell.edu/uscode) Online instructions and information: incometax.utah.gov Employee Verifi cation for Employers Employers can help prevent identity theft by verifying the Social Se- curity numbers of job applicants. E-Verify is a free service of the U.S. Department of Homeland Security that verifi es employment eligibility through the Internet. Employers can use E-Verify at e-verify.gov. Utah Taxpayer Bill of Rights Learn about your rights and responsibilities as a Utah taxpayer in Pub 2, Utah Taxpayer Bill of Rights. Get publications online at tax.utah.gov/forms. Customer Service Hours: Monday - Friday, 8:00 a.m. - 5:00 p.m. Help from tax pros: taxmaster@utah.gov Taxpayer help line: 801-297-2200

1-800-662-4335 (outside SLC area) Visit us in person: Ogden: 2540 Washington Blvd., 6th Floor Provo: 150 E Center St., #1300 SLC: 210 N 1950 W Hurricane: 100 S 5300 W Tax Commission Mailing address Mail your Utah return to one of the following addresses: ALL RETURNS WITH PAYMENTS Utah State Tax Commission 210 N 1950 W Salt Lake City, UT 84134-0266 ALL OTHER RETURNS (including refunds) Utah State Tax Commission 210 N 1950 W Salt Lake City, UT 84134-0260 Utah Taxpayer Advocate Service The Taxpayer Advocate Service helps taxpayers who have made multiple, unsuccessful attempts to resolve concerns with the Tax Commission. This service helps resolve problems when normal agency processes break down, identifi es why problems occurred, and suggests solutions. See tax.utah.gov/contact, or contact us to fi nd out if you qualify for this service at 801-297-7562 or 1-800-662-4335, ext. 7562, or by email at taxpayeradvocate@utah.gov. Do not use the Taxpayer Advocate Service to bypass normal methods for resolving issues or disputes. If you need an accommodation under the Americans with Dis- abilities Act, email taxada@utah.gov, or call 801-297-3811 or TDD 801-297-2020. Please allow three working days for a response. Contents TC-40 - General Instructions .................................................... 2 What's New ......................................................................... 2 Free Tax Help ...................................................................... 2 Federal Earned Income Tax Credit (EITC) .......................... 2 Who Must File ..................................................................... 2 When to File and Pay .......................................................... 2 How to File .......................................................................... 3 What to Attach and What to Keep ....................................... 3 Rounding Off to Whole Dollars ........................................... 3 Utah Domicile ..................................................................... 3 "Resident" Defi ned .............................................................. 4 "Part-Year Resident" Defi ned .............................................. 4 Military ................................................................................ 4 Native Americans ................................................................ 4 Students .............................................................................. 4 Income from Other States ................................................... 4 Income from Other Countries ............................................. 5 Foreign Nationals & Expatriates ......................................... 5 Injured Spouse .................................................................... 5 Innocent Spouse ................................................................. 5 Fiscal Year Filers ................................................................. 5 Amended Return................................................................. 5 Federal Tax Credits ............................................................. 6 Utah Losses and Loss Carries ............................................ 6 Deadlines to Claim a Refund or Credit ............................... 6 TC-40 - Line-by-Line Instructions ............................................. 6 TC-40A - Supplemental Schedule Instructions....................... 15 TC-40B - Non or Part-year Resident Schedule ...................... 25 TC-40W - Utah Withholding Tax Schedule ............................. 27 Special Instructions for Married Couples ................................ 29

2 2021 Utah TC-40 Instructions Who Must File You must fi le a Utah TC-40 return if you: 1. are a Utah resident or part-year resident who must fi le a federal return, 2. are a nonresident or part-year resident with income from Utah sources who must fi le a federal return, or 3. want a refund of any income tax overpaid. To fi le a Utah return, fi rst complete your federal return, even if you do not have to fi le with the IRS. You need the federal return information to complete your Utah return. Qualifi ed Exempt Taxpayer: You may be exempt from Utah individual income tax if your federal adjusted gross income is less than your federal standard deduction. See instructions for line 21. Nonresident Filing Exemption: You do not need to fi le a Utah return if: 1. you are a nonresident whose only Utah source of income is from a partnership, S corporation or trust (or other pass- through entity); 2. the partnership, S corporation, trust or other pass-through entities withheld Utah income tax on your Utah income; and 3. you are not claiming a Utah tax credit. When to File and Pay You must fi le your return and pay any tax due: 1. by April 18, 2022, if you fi le on a calendar year basis (tax year ends Dec. 31, 2021); or 2. by the 15th day of the fourth month after the fi scal year ends, if you fi le on a fi scal year basis. If the due date falls on a Saturday, Sunday or legal holiday, the due date is the next business day. Note: The due date may change if the IRS changes the due date of the federal return. Check incometax.utah.gov if you have questions. You must pay all Utah income taxes for the tax year by the due date. You may be subject to penalties and interest if you do not fi le your return on time or do not pay all income tax due by the due date. (See instructions for line 41). Utah does not require quarterly estimated tax payments. You can prepay at any time at tap.utah.gov, or by mailing your payment with form TC-546, Individual Income Tax Prepayment Coupon. Extension of Time to File

This is NOT an extension of time to pay your taxes – it is an extension to fi le your return. You get an automatic extension of up to six months to fi le your return. You do not need to fi le an extension form, but we will assess penalties if you have not met the prepayment requirements (see below). See instructions for line 41. All extension returns must be fi led by Oct. 17, 2022. TC-40 - General Instructions What's New • Solar Energy Systems Phase-out: The maximum Re- newable Residential Energy Systems Credit (credit 21) for solar power systems installed in 2021 is $1,200. • Special Needs Opportunity Scholarship Program: The 2020 legislature passed HB 4003, creating a nonrefund- able tax credit for donations made to the Special Needs Opportunity Scholarship Program. See page 24. • Schedule C Removed: We have removed TC-40C (Retire- ment Tax Credit Schedule) from the TC-40 forms package. In place of TC-40C, use the worksheet on page 18 of these instructions. If you claim the retirement tax credit, be sure to enter your birthdate on TC-40A, Part 3. • Social Security Benefi ts Tax Credit: The 2021 Utah Legislature passed HB 86, creating an apportionable, nonrefundable tax credit for taxable Social Security income. See page 20. • Military Retirement Tax Credit: The 2021 Utah Legislature passed SB 11, creating an apportionable, nonrefundable tax credit for taxable military retirement benefi ts. See page 20. • Payroll Protection Program (PPP) Grant or Loan Ad- dback: In certain situations you must add to your income the amount of PPP grants or loans forgiven in 2021. See page 16. Free Tax Help Volunteer Income Tax Assistance (VITA) VITA volunteers provide free tax preparation service to low- income and elderly taxpayers. Some VITA sites can fi le electroni- cally. Call 2-1-1 or 1-800-906-9887 to fi nd the closest VITA site. Tax Counseling for the Elderly (TCE) TCE offers free tax help to anyone, but gives priority to persons 60 years and older. Volunteers specialize in pension and retire- ment issues unique to seniors. See aarp.org, or call 2-1-1 or 1-888-227-7669. Earn it. Keep it. Save it. This coalition of statewide partners offers free tax preparation and free online DIY tax prep to certain low-income taxpayers. See UtahTaxHelp.org. Federal Earned Income Tax Credit (EITC) The federal earned income tax credit is a refundable federal (not Utah) tax credit for certain people who work and have earned income. The credit can mean a larger refund or a reduction in your federal tax. Check the IRS website at irs.gov/eitc, or call the IRS at 1-800-829-1040 to see if you qualify.

3 2021 Utah TC-40 Instructions Prepayment Requirements for Filing Extension You must prepay by the original due date: • 90 percent of your 2021 tax due (TC-40, line 27 plus line 30); • 100 percent of your 2020 tax liability (2020 TC-40, line 27 plus line 30); or • 90 percent of your 2021 tax due (TC-40, line 27 plus line 30) if you did not have a Utah tax liability in 2020 or if this is your fi rst year fi ling. You may prepay through withholding (W-2, TC-675R, 1099-R, etc.), payments applied from previous year refunds, credits and credit carryovers, or payments made by the tax due date using form TC-546, Individual Income Tax Prepayment Coupon, or at tap.utah.gov. Interest is assessed on unpaid tax from the original fi ling due date until the tax is paid in full. Penalties may also apply. How to File File your Utah taxes at tap.utah.gov. If fi ling on paper, mail your return to the address on page 1. What to Attach and What to Keep Attach Send the following with your Utah return (also keep a copy with your tax records): • Utah Schedules

TC-40 page 3, TC-40A, TC-40B, TC-40S, and TC-40W (all that apply). • Other Adjustments

An explanation for any equitable adjustment entered on TC-40A, Part 2, code 79. • Other Forms

Attach form TC-131 if claiming a refund for a deceased taxpayer. Also attach TC-40LIS if you are a building project owner of a low-income housing unit. Also attach federal form 8379 if you are claiming relief as an injured spouse (see page 5). • Tax Due

Pay any return amount due at tap.utah.gov. If paying by check or money order, include form TC-547, Individual Income Tax Return Payment Coupon (see the last page of these instructions). FYI: Withholding Forms You must enter withholding tax information on form TC-40W. Attach TC-40W to your return. Keep Do not send forms W-2, 1099-R, 1099-MISC, Utah Schedule K-1 or TC-675R with your return. If you do not complete and submit form TC-40W with your return, processing will be de- layed and we may reject your withholding credit. Do not send a copy of your federal return, credit schedules (other than Utah schedules TC-40A, TC-40B, TC-40S and/or TC-40W), worksheets, or other documentation with your Utah return. Recordkeeping Keep copies of any receipts, tax forms, worksheets and other documentation to support any income, deduction, exemption and credit you have reported. We may ask you to provide this information later to support entries on your Utah return. Rounding Off to Whole Dollars Round off cents to the nearest whole dollar. Round down if under 50 cents; round up if 50 cents and above. Do not enter cents on the return. Utah Domicile (UC §59-10-136) Test 1 You are domiciled in Utah if: 1. You or your spouse claimed a child tax credit (IRC §24) for a dependent on your federal tax return, and the dependent is enrolled in a Utah public K-12 school. This does not apply if you are the dependent’s noncustodial parent and are divorced from, or were never married to, the custodial parent. 2. You or your spouse is enrolled as a resident student in a Utah state institution of higher education. Test 2 There is a rebuttable presumption you are domiciled in Utah (i.e., you are domiciled in Utah unless you can prove otherwise) if you or your spouse: 1. claims a residential exemption for a primary residence under UC §59-2, Property Tax Act, 2. voted in Utah during the taxable year and were not regis- tered to vote in another state during that time, or 3. fi le a Utah income tax return as a full-year or part-year resident. Test 3 Even if you do not meet any of the conditions above, you are still domiciled in Utah if: 1. either you or your spouse has a permanent home in Utah to which either of you intend to return after being absent; and 2. you or your spouse has voluntarily settled in Utah, not for a special or temporary purpose, but with the intent of making a permanent home. Under Test 3, whether you have a permanent home in Utah is based on a preponderance of the evidence (i.e., the evi- dence you have a permanent home is more convincing than any evidence you do not), taking into consideration all of the following facts and circumstances: • You or your spouse has a Utah driver’s license. • You or your spouse claims a federal tax credit (IRC §24) for a dependent who is enrolled as a resident student in a Utah state institution of higher education. • The nature and quality of the living accommodations you or your spouse has in Utah compared to another state.

4 2021 Utah TC-40 Instructions • You have a spouse or dependent in Utah for whom you or your spouse claims a federal tax credit under IRC §24. • The physical location where you or your spouse earns income. • The state of registration of a vehicle owned or leased by you or your spouse. • You or your spouse has a membership in a church, club or similar organization in Utah. • You or your spouse lists a Utah address on mail, a telephone listing, a listing in an offi cial government publication, other correspondence, or similar item. • You or your spouse lists a Utah address on a federal or state tax return. • You or your spouse claims Utah residency on a document (other than a Utah income tax return) fi led with or provided to a court or other government entity. • You or your spouse fails to obtain a permit or license nor- mally required of a resident in the state where you claim to have domicile. • You are the noncustodial parent of a dependent enrolled in a Utah public K-12 school for which you claimed a child tax credit (IRC §24) on your federal tax return, and you are divorced from the custodial parent. • You maintain a place of abode in Utah and spent 183 or more days of the taxable year in Utah. • You or your spouse did not vote in Utah during the taxable year but voted in Utah in any of the three prior years and was not registered to vote in another state during those three years. No Utah Domicile You do not have Utah domicile if you are absent from Utah for at least 761 consecutive days and during this time you or your spouse: 1. do not return to Utah for more than 30 days in a calendar year, 2. do not claim a child tax credit under IRC §24 on your federal tax return for a dependent who is enrolled in a Utah public K-12 school (unless you are a noncustodial parent of the dependent and are divorced from the custodial parent), 3. are not enrolled in a Utah state institution of higher educa- tion as a resident student, 4. do not claim the residential exemption for property tax on your primary residence in Utah, or 5. do not claim Utah as your tax home for federal tax purposes. An absence from the state begins on the later of the date you or your spouse leaves Utah and ends on the day you or your spouse returns to and stays in Utah for more than 30 days in a calendar year. If you do not have Utah domicile, you may choose to have Utah domicile by fi ling a Utah resident income tax return. Spouses If your spouse has Utah domicile under Test 1 (above), you also have Utah domicile. If your spouse has Utah domicile under Test 2 or 3, you also have Utah domicile unless you can establish by a preponderance of the evidence (i.e., the evidence for your claim is more convincing than any evidence against it) that during the taxable year and the three prior years you did not: 1. own property in Utah, 2. spend more than 30 days in a calendar year in Utah, 3. receive earned income for services performed in Utah, 4. vote in Utah, or 5. have a Utah driver’s license. You are not considered to have a spouse with Utah domicile if: 1. you and your spouse are legally separated or divorced, or 2. you and your spouse both claimed married fi ling separately on your federal individual income tax returns for the taxable year. You must fi le a Utah income tax return (or amended return) and pay any penalty and interest that apply if you did not fi le a Utah return based upon your belief that you did not meet the domicile criteria. " Resident" Defi ned A resident is a person who is domiciled in Utah for any period of time during the taxable year, but only for the duration of that period. "Nonresident" Defi ned A nonresident is a person who is not a resident. " Part-Year Resident" Defi ned A part-year resident is a person who is a resident for part of the year and a nonresident for part of the year. All income received during the period of residency is taxable in Utah, regardless of where that income is earned, unless specifi cally exempted. Income from Utah sources is taxable in Utah during the period of nonresidency. Military Special domicile rules apply to service members and their spouses. See Pub 57, Military Personnel Instructions. Native Americans Native Americans who earn income in Utah must fi le a Utah tax return. Certain income earned by Utah Native Americans may be exempt from Utah income tax. See page 16 to see if you qualify. Students All Utah residency rules and fi ling requirements apply to students, including Utah residents going to school in another state and non-residents attending a Utah school. Income from Other States Utah residents who earn income in other states must pay Utah tax on that income. You may claim a credit for income tax paid to another state if the other state also taxes the same income. See Credit for Income Tax Paid to Another State in Schedule A instructions.

5 2021 Utah TC-40 Instructions Income from Other Countries Utah residents who live and work abroad must pay Utah tax on income earned in other countries if the income is included in federal adjusted gross income on the federal return. There is no Utah credit for taxes paid to another country. See Federal Tax Credits, below. Foreign Nationals & Expatriates A foreign national or expatriate who meets Utah domicile and residency requirements is considered a Utah resident for tax purposes. See Utah Domicile, above. You must pay tax on income earned from Utah sources if that income is included in your adjusted gross income on your federal return. Injured Spouse If your spouse had outstanding Utah tax liabilities before your marriage, any refund on a joint Utah return may be used to pay that liability. You may be able to claim part or all of a refund under the injured spouse provisions. If another state, a federal agency or another entity claimed your refund to pay a debt owed to them, contact them directly. Attach a copy of federal form 8379, Injured Spouse Allocation, to the front of your joint Utah return if claiming injured spouse provisions and a joint refund is expected to be applied (offset) to a past-due Utah tax obligation of the other spouse. See more information at tax.utah.gov/extension/innocent. Innocent Spouse If your spouse did not report income or claimed false deduc- tions or credits and you did not receive any benefi t, you may be entitled to relief from your tax liability. See more information at tax.utah.gov/extension/innocent. Fiscal Year Filers You can be a Utah fi scal year fi ler only if you are a federal fi scal year fi ler. Utah follows the same rules and guidelines for fi scal year fi lers as the IRS. See IRS Publications 17, 505 and 538. Use the tax forms for the year in which your fi scal year begins. Prepare your federal tax return before your Utah return. Special Utah Rules • Enter your fi scal year end date on TC-40, page 3, Part 2. • Calculate your Utah taxpayer tax credit using the quali- fi ed dependents and standard or itemized deductions from your fi scal year federal return. Use the credit phase-out amount shown on the Utah return for the year in which your fi scal year began. • Calculate non-refundable Utah credits using amounts and facts that apply to your fi scal year. For example, to claim a credit for a contribution to a my529 plan, use the amount contributed during your fi scal year, but the maximum you may take is the maximum allowed for the calendar year in which your fi scal year began. • Report Utah use tax for purchases during your fi scal year, using the rate chart for the calendar year in which your fi scal year began. • Calculate credits for withholding tax, pass-through entity withholding tax and mineral production withholding tax based on forms W-2 and 1099 for the year in which your fi scal year began. Amended Return To amend a previously-fi led return, use the tax forms and instructions for the year you are amending. Get prior year forms and instructions at tax.utah.gov/forms. Note: You cannot use TAP to fi le amended returns. Amend your return if you fi nd an error on your Utah or federal return, or if your federal return is audited or adjusted by the IRS in a way that affects your Utah return. You must amend your Utah return within 90 days of the IRS’s fi nal determination. See Deadlines to Claim a Refund or Credit, below. How to Amend a 2021 Return A. On the top of TC-40, page 1, on the “Amended Return" line, enter the code number from the following list that best describes your Reason for Amending: Reason-for-Amending Codes (enter on return) 1 You fi led an amended federal return with the IRS. Attach a copy of your amended federal return, form 1040X. (If amending for a net operating loss, do not use code 1, use code 4 - see below.) 2 You made an error on your Utah return. Attach an explanation of the error. 3 Your federal return was changed by an IRS audit or adjustment and it affects your Utah return. Attach a copy of the IRS adjustment. 4 You had a net operating loss. Utah treats net oper- ating losses the same as the federal return. If any part of your amended return is from a net operating loss carryback, use code 4 and complete a Utah return for each year you are amending. Attach a copy of your amended federal return, form 1040X or 1045. Your documentation must clearly show the year you experienced the loss. 5 Other. Attach an explanation to your return. B. Enter the corrected fi gures on the return and/or schedules. C. Enter all other amounts as shown on your original return. If you received a refund on your original return, enter the amount of the previous refund on line 29 of your 2021 amended return. If you paid with the original return or made subsequent tax payments before fi ling the amended return, enter the total previous payments on line 37 of your 2021 amended return. Contributions on line 28 and my529 deposits from TC-40 page 3, Part 5 cannot be changed after the original return is fi led. D. Submit the amended return with all schedules, including copies of those schedules that did not change from the original fi ling. E. Do not submit a copy of your original return with your amended return.

6 2021 Utah TC-40 Instructions Federal Tax Credits Federal income tax credits do not have an effect on Utah income tax. See UC §59-10-110. There are some situations on the federal return that let you take a tax credit instead of excluding income from adjusted gross income or taking an itemized deduction. For example: • Foreign tax credit -OR- Foreign earned income exclusion • Lifetime learning credit -OR- Tuition deductions Be aware: In these cases, if you choose to take a credit on your federal return instead of using an exclusion or deduction, you lose the tax benefi t on your Utah return. Do not adjust your federal adjusted gross income or itemized deductions on your Utah return in an effort to gain the tax advantage — report your adjusted gross income and itemized deductions exactly as they appear on your federal return. Utah Losses and Loss Carries You must treat federal net operating losses on your Utah return in the same manner as you do on your federal return. Nonresidents and part-year residents with a Utah loss but no federal net operating loss can apportion their Utah tax for the loss year to zero on Schedule TC-40B, but may not carry the remaining loss forward or back to other years. Deadlines to Claim a Refund or Credit (UC §§59-1-1410 and 59-10-529) To qualify for a refund or credit, you must fi le a return within: • three years from the original return due date (plus exten- sions), or • two years from the payment date. For amended returns, you must fi le a claim for refund or credit within: • two years after you had to fi le an amended Utah return based on changes to your federal return made by the IRS, or • three years from the original due date (plus extensions) of the return of a loss year to report a net operating loss carryback. TC-40 - Line-by-Line Instructions TC-40, Page 1 NOTE: Enter your Social Security number, phone number, and ZIP+4 as straight numbers, without brackets or hyphens/ dashes. Amended Return To amend a previously-fi led return, see the instructions on page 5. Enter the "reason-for-amending" code in the fi eld at the top of the return. Name, Address, Social Security Number, Residency Your name and Social Security number must match your Social Security card. If fi ling married jointly or separately, also enter your spouse’s name and Social Security number. Social Security Number You must provide your Social Security number on your return. All information on the return is protected from unauthorized disclosure by federal and state law. If you do not have a Social Security number, enter the Individual Taxpayer Identifi cation Number (ITIN) issued by the IRS. If you do not have a Social Security number or an ITIN, apply for one through the IRS, pay any tax due by the return due date, and fi le a return once you have received your number. Residency Report whether you are a full-year Utah resident by marking Y (yes) for resident or N (no) for non-resident or part-year resident on the line to the right of your last name. If you or your spouse answer “N,” complete and attach Schedule B, Non or Part-year Resident Schedule. See "Resident" Defi ned on page 4. Foreign Address If your address is in a foreign country, enter the mailing ad- dress where indicated. Enter the foreign city, state/province and postal code in the City fi eld. Abbreviate if necessary. Leave the State and Zip Code fi elds blank. Enter only the foreign country name in the "Foreign Country" fi eld.

7 2021 Utah TC-40 Instructions Deceased Taxpayer If you are fi ling for a taxpayer who has died, enter the deceased person's name and Social Security number and your mailing address and telephone number. Complete TC-40, page 3, Part 1 if the taxpayer or spouse died in 2021 or 2022. Line 1. Filing Status If you fi led federal return: • 1040 or 1040-SR, enter the code that matches the fi ling status from your federal return. • 1040NR, enter “1” (Single), regardless of your marital status. • 1040NR -AND- you are a qualifying widow(er) who marked box 6 on your federal return, enter “5” (Qualifying Widow(er). Use one of these codes for your fi ling status: 1 – Single 2 – Married fi ling jointly 3 – Married fi ling separately 4 – Head of household 5 – Qualifying widow(er) 9 – Special Instructions for Couples (see Special Instructions for Married Couples on page 29) Line 2. Qualifying Dependents Qualifying dependents are those you were allowed to claim for a tax credit in box 4 of federal form 1040 or 1040-SR (IRC §24). 2a. Enter on line 2a the number of qualifying dependents age 16 or younger on Dec. 31, 2021. 2b. Enter on line 2b the number of other persons not included in 2a for whom you were able to claim a dependent tax credit. You may not claim yourself or your spouse as other dependents. 2c. Add lines 2a and 2b. Line 3. Election Campaign Fund

(UC §59-10-1311) If your Utah income tax liability on line 27 plus line 30 is $2 or more ($4 if married fi ling jointly), you may contribute $2 to the campaign fund for any of the qualifi ed parties listed below. If this is a joint return, your spouse may also contribute $2 to the party of his or her choice. This contribution will not reduce your refund or increase the tax you owe. Political Party Codes: C = Constitution M = Independent American D = Democratic R = Republican L = Libertarian U = United Utah Enter N if you do not want to make a contribution. Line 4. Federal Adjusted Gross Income Enter your federal adjusted gross income (FAGI) from line 11 of your federal return (1040, 1040-SR, 1040NR). Nonresidents and part-year residents: Enter the full amount of your federal adjusted gross income from your federal return (as noted above), not just your Utah income. Line 5. Additions to Income Enter the total from TC-40A, Part 1. Complete TC-40A, Part 1 if you have any of the following additions to income: • Lump sum distribution • Medical care savings account (MSA) addback • my529 addback • Child's income excluded from parent's return • Municipal bond interest • Untaxed income of a resident trust • Untaxed income of a nonresident trust • Payroll Protection Program grant or loan addback • Equitable adjustments Line 6. Total Income Add line 4 and line 5. Line 7. State Tax Refund Included on Federal Return

(UC §59-10-114(2)(c)) If you itemized your deductions on your 2020 federal form 1040 or 1040-SR, enter the amount reported on your 2021 federal form 1040, Schedule 1, line 1. Otherwise, leave this line blank. Line 8. Subtractions from Income Enter the total from TC-40A, Part 2. Complete TC-40A, Part 2 if you have any of the following subtractions from income: • Interest from Utah municipal bonds and U. S. Government obligations • Native American income • Railroad retirement income • Equitable adjustments • Nonresident active duty military pay • State tax refund distributed to benefi ciary of trust • Nonresident military spouse income • FDIC Premiums • Qualifi ed Retirement Plan Distributions • COVID-19 Utah Grant Funds Included in AGI Line 9. Utah Taxable Income (Loss) Subtract the total of lines 7 and 8 from line 6. Line 10. Utah Tax Calculation Multiply line 9 by 4.95 percent (.0495). If the result is zero or less, enter "0." Line 11. Utah Personal Exemption

(UC §59-10-1018(1)(g)) The Utah personal exemption is $1,750 per dependent you were allowed to claim on your federal return for the federal tax credit (IRC §24). Multiply the amount on line c in box 2 by $1,750.

8 2021 Utah TC-40 Instructions Line 12. Federal Standard or Itemized Deductions Enter the amount of your federal standard or itemized deduction. Get this amount from line 12a of your federal return (1040, 1040-SR, 1040NR). Line 13. Total Exemptions and Standard/ Itemized Deductions Add line 11 and line 12. Line 14. State Income Tax Included in Itemized Deductions on Federal Schedule A

If you claimed the standard deduction on your federal return, leave this line blank. If you took state and local income tax as an itemized deduc- tion on your federal return, enter that amount on line 14, up to $10,000. Do not include any sales tax that you itemized. Line 15. Total Exemptions and Federal Deductions Subtract line 14 from line 13. Line 16. Initial Credit before Phase-out Multiply line 15 by 6 percent (.06). Line 17. Base Phase-out Amount Enter the following base phase-out amount determined by your fi ling status shown on line 1. Filing Status Base Amount Single $15,095 Married fi ling jointly $30,190 Married fi ling separately $15,095 Head of household $22,643 Qualifying widow(er) $30,190 Line 18. Income Subject to Phase-out Subtract line 17 from line 9. If the result is zero or less, enter "0". Line 19. Phase-out Amount Multiply line 18 by 1.3 percent (.013). This is the credit phase- out amount. Line 20. Taxpayer Tax Credit Subtract the phase-out amount on line 19 from the initial credit on line 16. If the result is zero or less, enter "0". Line 21. Qualifi ed Exempt Taxpayers If your federal adjusted gross income is less than or equal to your federal standard deduction, you are exempt from Utah income tax. For this purpose, the federal standard deduction does not include the extra deductions for age or blindness. Complete the worksheet to see if you qualify. Qualifi ed Exempt Taxpayer Worksheet (Line 21) 1. Enter the federal adjusted gross income from line 11 of your federal return 1 _________ (1040, 1040-SR, 1040NR) 2. Enter your standard deduction. 2 _________ Note: If your standard deduction was limited, enter the amount allowed on your federal return. Federal 1040NR fi lers enter "0". Otherwise, see the following for your fi ling status: a. Single: Enter $12,550 b. Head of Household: Enter $18,800 c. Married fi ling joint: Enter $25,100 d. Married fi ling separate: If your spouse did not itemize, enter $12,550. If your spouse itemized, enter "0" e. Qualifying widow(er): Enter $25,100 3. Subtract line 2 from line 1. If the amount is less than zero, enter "0". 3 _________ If the amount on line 3 of this worksheet is more than zero, leave the box on TC-40, line 21 blank and go to line 22. If the amount on line 3 of this worksheet is zero, you are exempt from Utah income tax. Enter "X" in the box on TC-40, line 21 and enter "0" on line 22. Then complete the rest of the return. Line 22. Utah Income Tax Subtract the taxpayer tax credit on line 20 from the tax calculated on line 10. If the result is zero or less, enter "0". If you qualifi ed as exempt from Utah tax (see worksheet for line 21) and checked the box on line 21, enter "0".

9 2021 Utah TC-40 Instructions TC-40, Page 2 Line 23. Tax from Page 1 Enter the Utah income tax from line 22 (page 1). Line 24. Apportionable Nonrefundable Credits Enter the total from TC-40A, Part 3. Complete TC-40A, Part 3 if you can claim any of these credits: • Capital Gain Transactions Credit • Retirement Credit • my529 Credit • Health Benefi t Plan Credit • Gold and Silver Coin Sale Credit • Social Security Benefi ts Credit • Military Retirement Credit

Apportionable nonrefundable credits can reduce your income tax to zero, but cannot result in a refund. See instructions for TC-40A, Part 3 on page 17. Line 25. Enter Tax Full-year residents: Subtract line 24 from line 23 and enter the result. Do not enter an amount less than zero. Complete the rest of the return. Nonresidents and part-year residents: Subtract line 24 from line 23 and enter the result on TC-40B, Non or Part-year Resident Schedule, line 40. Do not enter an amount less than zero. Complete TC-40B and enter the tax from TC-40B, line 41 on TC-40, line 25. Complete the rest of the return. See instructions for TC-40B on page 25. Line 26. Nonapportionable Nonrefundable Credits Enter the total from TC-40A, Part 4. Complete TC-40A, Part 4 to claim any of these credits: • At-Home Parent Credit • Qualifi ed Sheltered Workshop Cash Contribution Credit • Carryforward of Clean Fuel Vehicle Credit • Historic Preservation Credit • Low-Income Housing Credit • Credit for Increasing Research Activities in Utah • Carryforward of Credit for Machinery and Equipment Used to Conduct Research • Credit for Income Tax Paid to Another State • Live Organ Donation Expenses Credit • Renewable Residential Energy Systems Credit • Combat Related Death Credit • Veteran Employment Credit • Employing Persons Who are Homeless Credit • Achieving a Better Life Experience (ABLE) Program Credit • Military Survivor Benefi ts Credit • Special Needs Opportunity Scholarship Program Credit

Nonapportionable nonrefundable credits can reduce your income tax to zero, but cannot result in a refund. See instructions for TC-40A, Part 4, on page 20. Line 27. Subtract Line 26 from Line 25 If the total credits on line 26 is more than or equal to the tax on line 25, enter "0". Line 28. Voluntary Contributions Enter the total of your voluntary contributions from TC-40, Part 4. The contributions will add to your tax due or reduce your refund. Once made, you cannot change a contribution on an amended return. Line 29. Amended Return Only - Previous Refund This line is only for an amended return. Enter the total of all refunds, credits, and offsets of state income tax received for the tax year being amended. Do not include refund interest. Line 30. Recapture of Low-Income Housing Credit If you claimed the Utah low-income housing credit in a previous year and then disposed of the building or an ownership interest, or if the qualifi ed basis of the building has decreased, you may have to recapture the credit. See form TC-40LIC for instructions. Line 31. Utah Use Tax Use tax is a tax on goods and taxable services purchased for use, storage or other consumption in Utah during the taxable year and applies only if sales tax was not paid at the time of purchase. If you purchased an item from an out-of-state seller (including Internet, catalog, radio and TV purchases) and the seller did not collect sales tax on that purchase, you must pay the use tax directly to the Tax Commission. If you have a Utah sales tax license/account, include the use tax on your sales tax return. If you do not have a Utah sales tax license/ account, report the use tax on line 31 of TC-40. You may take a credit for sales or use tax paid to another state (but not a foreign country). The credit may not be greater than the Utah use tax you owe. If you paid sales tax to more than one state, complete the Use Tax Worksheet below for each state. Add lines 8 on all worksheets, and enter the total on line 31. Sales and use tax rates vary throughout Utah. Use the Use Tax Rate Chart below to get the rate for the location where the merchandise was delivered, stored, used, or consumed. Use the county tax rate if the city is not listed. The tax on grocery food is 3 percent. Grocery food is food sold for ingestion or chewing by humans and consumed for taste or nutrition. Grocery food does not include alcoholic beverages or tobacco. See Pub 25, Sales and Use Tax, for more information.

10 2021 Utah TC-40 Instructions Line 32. Total Tax, Use Tax and Additions to Tax Add lines 27 through 31. Line 33. Utah Income Tax Withheld Enter the total from form TC-40W, Part 1. Complete TC-40W, Part 1, listing each W-2 and 1099 with Utah withholding tax. If you have more than four withholding forms, use additional TC-40Ws. See instructions for TC-40W on page 27. Keep withholding forms with your records. Do not attach them to your return. Processing will be delayed and we may reject your withholding credit if you do not complete form TC-40W, Part 1 with all required information. Line 34. Credit for Utah Income Tax Prepaid Prepayments include payments made with form TC-546, In- dividual Income Tax Prepayment Coupon, and any amount of the previous year’s refund applied to your current tax liability. Line 35. Pass-through Entity Withholding Tax Credit

(UC §59-10-1103) Enter the total from TC-40W, Part 3. Complete TC-40W, Part 3 if you are claiming credit for any Utah income tax withheld or paid on your behalf by a pass- through entity (partnership, LLC, LLP, S corporation or trust) to which you belong. Keep Utah Schedule K-1 and all other related documents with your records. Do not attach them to your Utah return. Processing will be delayed, and we may reject your withholding credit if you do not complete TC-40W, Part 3 with all required information. See instructions for TC-40W, Part 3 on page 28. Line 36. Mineral Production Withholding Tax Credit

(UC §59-6-102(3)) Enter the total of Utah mineral production withholding tax from TC-675R or Utah Schedule K-1. Complete TC-40W, Part 2 if you are claiming credit for Utah mineral production withholding tax. The mineral production company on form TC-675R must provide the following information to you: 1. the company's federal employer identifi cation number (EIN), 2. the company's Utah mineral production withholding account number, and 3. your share of the mineral production withholding tax. Keep all TC-675Rs and Utah Schedule K-1(s) with your records. Do not attach them to your Utah return. Processing will be delayed, and we may reject your mineral production withholding credit if you do not complete TC-40W, Part 2 with all required information. See instructions for TC-40W, Part 2 on page 28. Line 37. Amended Return Only - Previous Payment Use this line only for an amended return. Enter the total tax paid with the original return plus any later tax payments for the tax year being amended. Do not include on this line any penalty, interest or fees paid on the previous return. .0635 Beaver County .0735 Beaver City .0610 Box Elder County .0665 Brigham City, Perry, Willard .0640 Mantua .0710 Snowville .0670 Cache County .0695 Cache Valley Transit, Hyde Park, Lewiston, Millville .0700 Hyrum, Logan, Nibley, N. Logan, Providence, Rich- mond, River Heights, Smithfi eld .0635 Carbon County .0645 Helper .0675 Price .0665 Wellington .0735 Daggett County .0845 Dutch John .0715 Davis County .0725 Bountiful, Centerville, Clearfi eld, Farming- ton, Layton, N. Salt Lake, Syracuse, W. Bountiful, Woods Cross .0635 Duchesne County .0645 Duchesne City .0675 Roosevelt .0635 Emery County .0825 Green River .0710 Garfi eld County .0810 Boulder, Panguitch, Tropic .0830 Bryce Canyon .0820 Escalante .0685 Grand County .0885 Moab .0610 Iron County .0810 Brian Head .0620 Cedar City .0610 Juab County .0650 Nephi .0635 Santaquin South .0710 Kane County .0820 Kanab .0810 Orderville .0635 Millard County .0645 Fillmore .0620 Morgan County .0645 Morgan City .0610 Piute County .0635 Rich County .0795 Garden City .0725 Salt Lake County .0875 Alta .0835 Brighton .0745 Murray, South Salt Lake .0775 Salt Lake City .0635 San Juan County .0675 Blanding, Monticello .0745 Bluff .0635 Sanpete County .0645 Centerfi eld, Mayfi eld .0675 Ephraim, Fairview, Gunnison .0665 Mt. Pleasant .0635 Sevier County .0645 Aurora, Redmond .0675 Richfi eld, Salina .0715 Summit County .0905 Mil. Rec. Park City, Park City .0745 Snyderville Basin Transit .0660 Tooele County .0690 Erda, Grantsville, Lakepoint, Lincoln, Stansbury Park .0700 Tooele City .0645 Uintah County .0695 Naples, Vernal .0715 Utah County .0725 American Fork, Cedar Hills, Lindon, Orem, Payson, Pleasant Grove, Provo, Santa- quin, Spanish Fork, Vineyard .0610 Wasatch County .0640 Heber .0720 Independence .0750 Midway .0800 Park City East .0645 Washington County .0675 Hurricane, Ivins, La

Verkin, St. George,

Santa Clara, Washing- ton City .0805 Springdale .0745 Virgin .0610 Wayne County .0725 Weber County .0745 Falcon Hill Riverdale, Riverdale Use Tax Rate Chart (Effective Dec. 31, 2021) Use Tax Worksheet 1. Amount of purchases (except grocery food) subject to use tax 1 _________ 2. Use tax rate

(decimal from Use Tax Rate Chart) 2 . __ __ __ __ 3. Multiply line 1 by line 2 3 _________ 4. Amount of grocery food purchases

subject to use tax 4 _________ 5. Multiply line 4 by 3% (.03) 5 _________ 6. Add line 3 and line 5 6 _________ 7. Credit for sales tax paid to another state

on use tax purchases 7 _________ 8. Use tax due (subtract line 7 from line 6) 8 _________ (If less than zero, enter "0.")

11 2021 Utah TC-40 Instructions Line 38. Refundable Credits Enter the total from TC-40A, Part 5. Complete TC-40A, Part 5 to claim any of the following credits: • Renewable Commercial Energy Systems Credit • Special Needs Adoption Credit • Agricultural Off-highway Gas/Undyed Diesel Credit • Farm Operation Hand Tools Credit See instructions for TC-40A, Part 5, on page 24. Line 39. Total Withholding and Refundable Credits Add lines 33 through 38. Line 40. Tax Due If line 32 is more than line 39, subtract line 39 from line 32. This is the tax you owe. Line 41. Penalty and Interest If you are fi ling your return or paying any tax late, you may owe penalties and interest. Use the Penalty and Interest Calculator at tap.utah.gov to calculate your penalty and interest, or follow the instructions in Pub 58, Utah Interest and Penalties (tax.utah.gov/forms). We will send you a bill if you do not pay the penalties and interest with your return or if the penalty and/or interest is calculated incorrectly. Penalties You may have to pay a penalty for not fi ling your return by the due date, not paying tax due on time, not pre-paying enough on an extension return, and not fi ling information returns or supporting schedules (UC §59-1-401). The penalties are a percentage of the unpaid tax, based on the number of days late. The penalty for underpaying an extension prepayment is 2 percent of the unpaid tax per month of the extension period. If the return is not fi led by the extension due date, failure to fi le and pay penalties will apply as if the extension had not been granted. There is no late fi ling penalty (including on an amended return) if you have no tax due on the return. Interest Interest is in addition to penalties due. Calculate interest from the due date (April 18, 2022) to the date paid. The 2022 inter- est rate is 2 percent. Line 42. Total Due - Pay This Amount Add any penalty and interest you owe on line 41 to the tax on line 40. Pay this amount at tap.utah.gov or pay with your return and include a TC-547 coupon with your payment. Payment Options You may pay your tax online with your credit card or with an electronic check (ACH debit). Online payments may include a service fee. Follow the instructions at tap.utah.gov. You may also mail your check or money order payable to the "Utah State Tax Commission" with your return. Write your daytime phone number and "2021 TC-40" on your check. Do not staple your check to your return. Remove any check stub before sending. Do not mail cash with your return. The Tax Commission is not liable for cash lost in the mail. Include the TC-547 coupon with your payment. Mail your payment, coupon and TC-40 return to the Utah State Tax Commission, 210 N 1950 W, Salt Lake City, UT 84134-0266. If fi ling a paper return, allow at least 90 days for your return to be processed. Payment Agreement Request

A payment agreement plan cannot be set up until after the return due date and when we've processed your return. If you cannot pay the full amount you owe, you can request a payment plan. Go to tap.utah.gov and click "Request Waiver, Payment Plan or e-Reminder." You may also call the Tax Commission at 801-297-7703 or 1-800-662-4335 ext. 7703. If we accept your plan request we will send you an email stat- ing the terms and conditions of the agreement. Even if we accept your request for a payment plan, we will continue to assess penalties and interest on any amount not paid by the return due date and we may still fi le a tax lien to secure the debt. You may make payments prior to approval of the payment plan or prior to receiving a billing notice. Line 43. Refund If line 39 is more than line 32, subtract line 32 from line 39. This is your refund. Note: Your refund may be applied to any outstanding federal or state debt owed. Mail your Utah refund TC-40 return to the Utah State Tax Commission, 210 N 1950 W, Salt Lake City, UT 84134-0260. Check your Utah refund status at tap.utah.gov. Line 44. Voluntary Subtractions from Refund If you want to deposit all or part of your refund into a my529 account(s), or if you want to apply all or part of your refund as a prepayment of your 2022 Utah income tax liability, complete TC-40 page 3, Part 5. Enter the total from Part 5 on line 44. The amount on line 44 cannot be greater than the amount on line 43. Line 45. Direct Deposit of Refund If you want your refund (or remaining refund) deposited directly into your checking or savings account, enter your bank or credit union’s routing number and your account number. Do not include hyphens, spaces or special symbols. See the Direct Deposit Example (below) to fi nd the routing and account numbers on your check. Your fi nancial institution can also provide this information. If we cannot direct deposit your refund we will mail you a refund check to the address on your return. Completing the Return Signature You must sign your return. If fi ling a joint return, both you and your spouse must sign. Not signing the return will delay your refund.

12 2021 Utah TC-40 Instructions Signature for Deceased If your spouse died in 2021 or 2022 before fi ling your return and you are fi ling a joint return, write “DECEASED” in the signature block for your spouse. See more on page 13. If you are not a surviving spouse and are claiming a refund for the deceased taxpayer, sign the return and attach form TC-131. Third Party Designee If you want a friend, family member or other person to discuss your return with the Tax Commission, enter their name and phone number in the Third Party Designee area (page 2 of your return). Also, enter a number (up to fi ve digits) as a personal identifi cation number (PIN). If you want the paid preparer who signed your return as the third party designee, enter "Preparer" in the designee's name area. If you fi ll in the Third Party Designee area, you (and your spouse if fi ling a joint return) authorize the Tax Commission to call the designee with questions that may arise while processing your return. You also authorize the designee to: 1. give the Tax Commission any missing information from your return; 2. call the Tax Commission for information about the process- ing of your return or the status of your refund or payment(s); 3. receive copies of notices or transcripts related to your return, upon request; and 4. respond to certain Tax Commission notices about math errors, offsets and return preparation. You are not authorizing the designee to receive any refund, bind you to anything (including any additional tax liability), or otherwise represent you before the Tax Commission. The authorization automatically ends on the due date for fi ling your next year's tax return (without regard to extensions). If you want to change the designee's authorization, complete and submit TC-737, Power of Attorney and Declaration of Representative (tax.utah.gov/forms). If you want to revoke the authorization before it ends, submit your request in writing to the Utah State Tax Commission, attention Taxpayer Services, 210 N 1950 W, SLC, UT 84134. Paid Preparer Requirements A paid preparer must enter his or her name, address, and PTIN in the section below the taxpayer's signature. Preparer Electronic Filing Requirements (UC §59-10-514.1) If a preparer (or two or more preparers affi liated together in the same establishment) prepared over 100 returns in a prior calendar year, the preparer(s) must submit all of their Utah individual income tax returns electronically. Exceptions apply for taxpayers who choose not to fi le electronically and for un- due hardship on the preparer in conforming to this provision (see form TC-831). Preparer Penalties (UC §59-1-401(11)-(12)) The person who prepares, presents, procures, advises, aids, assists, or counsels another on a return, affi davit, claim, or similar document administered by the Tax Commission, and who knows or has reason to believe it may understate a tax, fee or charge, is subject to both a civil penalty ($500 per document) and criminal penalties (second degree felony with a fi ne from $1,500 to $25,000). Tax Due If you owe tax and do not pay electronically, submit form TC-547 and your check or money order with your return. See form TC-547 on the last page of these instructions. FYI: IRS All information on your return is compared to infor- mation fi led with the IRS. JOHN J.TAXPAYER MARY S.TAXPAYER 900 N 500 W My Town, UT 84000 JOHN J.TAXPAYER MARY S.TAXPAYER 900 N 500 W My Town, UT 84000 1234 PAY TO THE ORDER OF PAY TO THE ORDER OF FOR MY TOWN BANK My Town, UT 84000 MY TOWN BANK My Town, UT 84000 DOLLARS $ Routing number Routing number Account number Account number Do not include the check number Do not include the check number 250250025 0 00009876543 1 234 2 X 9 5 8 0 0 0 0 7 2 6 0 5 5 0 0 4 0 3 2 5 Routing number Account number Enter "X" for bank account type Savings Checking Direct Deposit Example for Line 45

13 2021 Utah TC-40 Instructions TC-40, Page 3 Submit TC-40, page 3 ONLY if you have entered information on the form. Do NOT submit TC-40, page 3 if it is blank.   Part 1 – Deceased Taxpayer Information A return must be fi led for a deceased person who would have been required to fi le an income tax return. The personal rep- resentative, executor, administrator, legal representative, or surviving spouse must sign and fi le the fi nal return and any other returns still due. If you are fi ling the deceased taxpayer’s return as single, mar- ried separate, head of household, or qualifying widow(er), and they died in 2021 or 2022 before fi ling the tax return, enter the taxpayer’s date of death (mm/dd/yy) on the fi rst line of TC-40, page 3, Part 1. If you are the surviving spouse fi ling a joint return with the taxpayer who died in 2021 or 2022 before fi ling the tax return, enter the deceased taxpayer’s date of death (mm/dd/yy) on TC-40, page 3, Part 1: 1. Line 1 if the deceased person was the primary taxpayer shown on TC-40, page 1; or 2. Line 2 if the deceased person was the spouse shown on TC-40, page 1. Write “DECEASED” in the signature block on TC-40, page 2 for the deceased taxpayer and sign the return. If you are not a surviving spouse and are claiming a refund for the deceased taxpayer, enter an "X" on TC-40 page 3, Part 1. Sign the return and attach form TC-131, Statement of Person Claiming Refund Due a Deceased Taxpayer.  Part 2 – Fiscal Year End Date Leave this fi eld blank if you are a calendar year fi ler (your tax year ends on December 31). If you fi le your return on a fi scal year basis (a 12-month period ending on the last day of any month except December), enter your fi scal year-end date (two-digit month and two-digit year). See Fiscal Year Filers on page 5.  Part 3 – Federal Form 8886 If you fi led federal form 8886, Reportable Transaction Disclosure Statement, with the IRS, enter an "X" in Part 3.  Part 4 – Voluntary Contributions You may contribute to any of the following approved causes. Contributions will add to your tax due or reduce your refund. Once made, you cannot change a contribution on an amended return. Leave the entire Part 4 blank if you are not contributing to any of the accounts. Write the code and amount of each contribution on the lines in Part 4. Add your contributions and enter the total on TC-40, line 28. Codes for Contributions 02 Pamela Atkinson Homeless Account 03 Kurt Oscarson Children's Organ Transplant Account 05 School District and Nonprofi t School Dist. Foundation 15 Clean Air Fund 16 Governor's Suicide Prevention Fund See below for an explanation of each contribution. (02) Pamela Atkinson Homeless Account

(UC §59-10-1306) Contributions help fund services and programs to help Utahns become self-suffi cient. For more information, contact: Housing and Community Development Division Department of Workforce Services 1385 S State Street Salt Lake City, UT 84115 801-468-0148 https://jobs.utah.gov/htf/index.html (03) Kurt Oscarson Children’s Organ Transplant Account

(UC §59-10-1308) Contributions provide fi nancial help to families of children needing an organ transplant. For more information, contact: Representative for the Department of Health 288 N 1460 W PO Box 144610 Salt Lake City, UT 84114-4610 801-538-6003 (05) School District and Nonprofi t School District Foundation

(UC §59-10-1307) Contributions help fund private, nonprofi t school district foundations that promote the following: partnership activities between schools and communities; charitable giving activities to specifi c educational programs; and opportunities for scientifi c, educational, literary, and improvement objectives. Your contribution goes to the school district if there is no nonprofi t foundation. Enter a code for the school district/ foundation (from the list below) in the SCHOOL DIST. CODE box to the right of the amount. School District Codes for "SCHOOL DIST. CODE" box 01 Alpine 11 Grand 22 N. Sanpete 33 S. Summit 02 Beaver 12 Granite 23 N. Summit 34 Tintic 03 Box Elder 13 Iron 24 Ogden 35 Tooele 04 Cache 14 Jordan 25 Park City 36 Uintah 42 Canyons 15 Juab 26 Piute 41 Utah Assistive 05 Carbon 16 Kane 27 Provo

Technology 06 Daggett 17 Logan 28 Rich 37 Wasatch 07 Davis 18 Millard 29 Salt Lake 38 Washington 08 Duchesne 19 Morgan 30 San Juan 39 Wayne 09 Emery 20 Murray 31 Sevier 40 Weber 10 Garfi eld 21 Nebo 32 S. Sanpete

14 2021 Utah TC-40 Instructions (15) Clean Air Fund

(UC §59-10-1319) Contributions are disbursed to the Utah Division of Air Qual- ity to fund: 1. grants to individuals or organizations in Utah for activities to improve Utah air quality; or 2. public educational programs about the importance of air quality for the health, well-being and livelihood of Utah residents. For more information, contact: Utah Division of Air Quality Department of Environmental Quality PO Box 144820 Salt Lake City, UT 84114-4820 801-536-4019 (16) Governor’s Suicide Prevention Fund

(UC §59-10-1320) Contributions fund mental health crisis response improve- ments, suicide risk factor reductions and protection factors associated with suicide reduction. For more information, contact: Utah Department of Human Services Division of Substance Abuse & Mental Health 195 N 1950 W Salt Lake City, UT 84116 801-538-4171  Part 5 – Voluntary Subtractions from Refund 1. my529 (UC §59-10-1313) You may contribute all or part of your refund to your Utah my529 individual account(s) by entering the amount you want deposited. The deposit will be sent to my529 with your name, address and Social Security number as identifi cation. my529 will deposit your refund into your my529 account(s). If you have multiple my529 individual accounts under your Social Security number, your refund will be divided equally among all your individual accounts. Both Social Security numbers from a joint return will be matched to existing my529 individual accounts for dividing the refund. If you do not have a my529 individual account, my529 will send you information to open an account. If you do not open an account within the designated time frame, your refund will be returned to you by my529 without interest or earnings. Note: Your refund will not be contributed to your my529 individual account until your return has completed process- ing, which may take up to 90 days. Any outstanding federal or state debt you owe may be subtracted from your refund before it is contributed to your my529 individual account(s). The refund will be treated as a current year contribution in the year contributed. For more information about my529 accounts, call 1-800-418-2551, or visit my529.org. 2. Refund Applied To 2022 Taxes You may apply all or part of your refund as a prepayment for your 2022 Utah income tax liability. Enter the amount of refund you want applied to your 2022 tax on this line. If you change your mind, you must mail a written request to: Technical Research Unit Utah State Tax Commission 210 N 1950 W Salt Lake City, UT 84134-7000 Total Add the two amounts and enter the total here and on TC-40, page 2, line 44. Note: This amount may not be greater than the amount on line 43. We will refund any amount left over, unless you have other outstanding government obligations.  Part 6 – Direct Deposit to Foreign Account Enter "X" if you requested direct deposit on TC-40, page 2, and you want your direct deposit to go to an account outside of the United States or its territories. We cannot transfer funds outside of the United States, so if you check this box Utah will send you your refund as a check.  Part 7 – Property Owner’s Residential Exemption Termination Declaration You must notify the county when you have a primary residential property on which you have claimed the homeowner’s exemp- tion and to which you are no longer entitled. You must also report on your Utah income tax return that you no longer qualify for the homeowner’s exemption on your primary residence. Note: Do not complete Part 7 if you change your primary residence and were entitled to claim the homeowner’s ex- emption on your former residence and are entitled to claim the homeowner’s exemption on your new residence. If you are unsure about your homeowner’s exemption qualifi cation, contact the county assessor’s offi ce. Enter "X" in Part 7 if you no longer are entitled to the home- owner’s exemption, and enter the code from the chart below for the county in which the property is located. County Codes 01 Beaver 11 Iron 21 Sevier 02 Box Elder 12 Juab 22 Summit 03 Cache 13 Kane 23 Tooele 04 Carbon 14 Millard 24 Uintah 05 Daggett 15 Morgan 25 Utah 06 Davis 16 Piute 26 Wasatch 07 Duchesne 17 Rich 27 Washington 08 Emery 18 Salt Lake 28 Wayne 09 Garfi eld 19 San Juan 29 Weber 10 Grand 20 Sanpete Mailing Your Return Mail your return and any payment to the address shown at the bottom of TC-40, page 3.

15 2021 Utah TC-40 Instructions Use TC-40A to enter fi ve categories of items affecting your Utah individual income tax return:  Part 1 - Additions to Income (added to federal income)  Part 2 - Subtractions from Income (subtracted from federal income)  Part 3 - Apportionable Nonrefundable Credits (apportioned for non or part-year residents)  Part 4 - Nonapportionable Nonrefundable Credits  Part 5 - Refundable Credits  Part 1 – Additions to Income Enter the following additions to income that apply. Attach TC-40A to your Utah return. Write the code and amount of each addition to income in Part 1. Total the amounts and carry the total to TC-40, line 5. Codes for Additions to Income, TC-40A, Part 1 51 Lump Sum Distribution 53 Medical Care Savings Account (MSA) Addback 54 my529 Addback 56 Child's Income Excluded from Parent's Return 57 Municipal Bond Interest 60 Untaxed Income of a Resident Trust 61 Untaxed Income of a Nonresident Trust 68 Payroll Protection Program Grant or Loan Addback 69 Equitable Adjustments Each addition to income is explained below. (51) Lump Sum Distribution

(UC §59-10-114(1)(a))

This addition to income only applies if you fi led form 4972 with your federal return. If you received a lump sum distribution and fi led federal form 4972, enter the total of the amounts shown on Part II, line 6 and on Part III, line 10. Keep a copy of form 4972 and any 1099-R forms showing the distribution with your records. Shared Distributions: If you shared a lump sum distribution with others, multiply the amount on line 10 of federal form 4972 by the distribution percentage shown in box 9a on your form 1099-R, then add the amount from form 4972, Part II, line 6. (53) Medical Care Savings Account (MSA) Addback

(UC §59-10-114(1)(c)) If you are an account holder who contributes to an MSA, the account administrator will send you form TC-675M, Statement of Withholding for Utah Medical Savings Account. Enter the sum from TC-675M, lines 8 and 9, only up to the amount deducted or used in calculating the MSA credit on your cur- rent or previously fi led Utah tax return. Keep form TC-675M with your records. (54) my529 Addback

(UC §59-10-114(1)(d)) If you withdrew an amount from a Utah my529 account but did not use it for qualifi ed education expenses, and the withdrawal did not meet an exception under IRC §529(c) or §530(d), enter that amount to the extent the amount was deducted or used in calculating the my529 credit on your current or a previously fi led Utah tax return. If you are a my529 account owner, you will receive form TC-675H, my529 Tax Statement for Contribu- tions, Withdrawals, and Transfers from my529. Keep this form with your records. If you have any questions about my529 accounts, call my529 at 1-800-418-2551, or visit my529.org. (56) Child's Income Excluded from Parent's Return

(UC §59-10-114(1)(b)) If you are a parent who reported a child's interest and divi- dends on your federal return, you must add any child's income excluded from your income to your Utah return. Use the fol- lowing worksheet to calculate the addback: Worksheet 1. Enter the lesser of federal form 8814,

line 4 or line 5

1 _________ 2. Federal amount not taxed 2 $1,100 3. Subtract line 2 from line 1. If less than zero,

enter "0." This is the addition to Utah income. 3 _________ If you reported income for more than one child, complete the calculation above separately for each child using their respective federal form 8814. Total the amounts from line 3 above for each child and enter the amount on TC-40A, Part 1, using code 56. (57) Municipal Bond Interest

(UC §59-10-114(1)(e)) Enter interest from certain bonds, notes and other evidences of indebtedness issued by non-federal government entities out- side Utah (municipal bonds) acquired after Jan. 1, 2003, if the interest is not included in your federal adjusted gross income. Do not enter interest earned on non-Utah municipal bonds if the issuer does not impose an income tax on bonds issued by Utah, or the issuing state does not impose an income tax. (60) Untaxed Income of a Resident Trust

(UC §59-10-114(1)(f)) Enter any distribution received by a Utah resident benefi ciary of a resident trust if the income was taxed at the trust level for federal tax purposes, but not taxed at the trust level for Utah tax purposes. (61) Untaxed Income of a Nonresident Trust

(UC §59-10-114(1)(g)) Enter any distribution received by a Utah resident benefi ciary of a nonresident trust of undistributed distributable net income realized by the trust on or after Jan. 1, 2004, if the income was taxed at the trust level for federal tax purposes but not taxed at the trust level by any state. Undistributed distributable net income is considered to be distributed from the most recently accumulated undistributed distributable net income. TC-40A - Supplemental Schedule Instructions

16 2021 Utah TC-40 Instructions (68) Payroll Protection Program Grant or Loan Addback

(UC §59-10-103(1)(a)(ii)) If you received a COVID-19 Payroll Protection Program (PPP) grant or loan, enter any amount that: 1. was forgiven during the 2021 tax year, 2. is exempt from federal income tax, and 3. you used for expenses that you deducted on your federal tax return. If you own an interest in an LLC, partnership, S-corporation or trust that received a PPP grant or loan meeting these re- quirements, include your distributed share on this line. (See the "Other Income" line of Utah Schedule K-1 received from the LLC, partnership, S-corporation or trust.) (69) Equitable Adjustments

(UC §59-10-115(2)) Enter any qualifi ed equitable adjustment needed to prevent receiving a double tax benefi t.  Part 2 – Subtractions from Income Enter the following subtractions from income that apply. Attach TC-40A to your Utah return. Write the code and amount of each subtraction from income in Part 2. Total the amounts and carry the total to TC-40, line 8. Codes for Subtractions from Income, TC-40A, Part 2 71 Interest from Utah Municipal Bonds and U. S. Gov- ernment Obligations 77 Native American Income 78 Railroad Retirement Income 79 Equitable Adjustments 82 Nonresident Active Duty Military Pay 85 State Tax Refund Distributed to Benefi ciary of Trust 88 Nonresident Military Spouse Income 89 FDIC Premiums 90 Qualifi ed Retirement Plan Distributions SA COVID-19 Utah Grant Funds Included in AGI Each subtraction from income is explained below. (71) Interest from Utah Municipal Bonds and U. S. Government Obligations

(UC §59-10-114(2)(a) and (f)) Utah Municipal Bonds Interest earned on Utah municipal bonds is exempt from Utah income tax. • Municipal bond interest is usually excluded from federal adjusted gross income. In these cases, do not subtract municipal bond interest. • Some municipal bond interest is included in federal ad- justed gross income, (e.g., Build America Bonds, etc.). In these cases, deduct Utah municipal bond interest from Utah taxable income. Enter the non-taxable subtraction on TC-40A, Part 2, using code 71. Keep all records and documentation to support this subtraction. U.S. Government Obligations Interest earned on U.S. Government obligations is exempt from Utah income tax. These obligations include: • Treasury bills • Treasury notes • E, EE, H, HH, and I bonds The following income is NOT exempt from Utah income tax: • Interest or dividends from Federal National Mortgage Association (FNMA) and Government National Mortgage Association (GNMA). • Interest on IRS or other federal agency refunds. The following conditions determine if the instrument qualifi es as a U.S. Government obligation (see U.S. Supreme Court decision, Smith vs. Davis, 323 U.S. 111 (1944)). The instru- ment must: 1. be a written document, 2. bear interest, 3. contain a binding promise by the U. S. Government to pay a specifi c sum on a specifi c date, and 4. have congressional authorization to pledge the full faith and credit of the United States in support of the promise to pay. You may only deduct interest or dividend income from U. S. Government obligations included in your federal adjusted gross income. Before entering an amount, subtract any re- lated interest expense on money borrowed to purchase the obligation or security. See Pub 33, Interest from U.S. Government Obligations, at tax.utah.gov/forms. Keep all records, forms and worksheets to support this subtraction. (77) Native American Income

(UC §59-10-114(2)(b) and (e)) Some income of Utah Native Americans is exempt from Utah income tax. To qualify, you must: 1. be an enrolled member of a Native American tribe in Utah, 2. live on your tribe’s reservation, and 3. earn the income on your tribe’s reservation (for active duty military income, see Pub 57). Also, enrolled members of the Ute tribe who work on the Uintah and Ouray Reservation and live on land removed from that reservation under Hagen vs. Utah (510 U.S. 399 (1994)) are exempt from Utah income tax on income earned on the reservation. Enter the exempt income included in your federal total income on TC-40A, Part 2, using code 77. Enter your enrollment/cen- sus number and your Nation/Tribe Code from the following list: Nation/Tribe Code 1 Confederated Tribes of the Goshute Reservation 2 Navajo Nation Reservation 3 Paiute Indian Tribe of Utah 4 Skull Valley Band of Goshute Indians 5 Ute Indian Tribe 6 Other tribe Keep all records and documents to support this subtraction.

17 2021 Utah TC-40 Instructions (78) Railroad Retirement Income

(UC §59-10-114(2)(d)) Federal law does not permit states to tax railroad retirement, disability income, unemployment income, and sickness benefi ts received from the Railroad Retirement Board and reported on form RRB-1099. Railroad retirement pensions are deductible only if taxed on the federal return. If you received pension payments, disability income or unemployment payments under the Railroad Re- tirement Act and report all or part of the amount received as income on federal form 1040 or 1040-SR, lines 5b and/or 6b, you may deduct that amount from Utah income. If amounts from sources other than railroad retirement are included on these lines on your federal return, only deduct the amount of railroad retirement reported on these lines. (79) Equitable Adjustments

(UC §59-10-115(2)) Enter any qualifi ed equitable adjustment needed to prevent paying double tax. Attach an explanation.

Do not use this subtraction to deduct the income of a nonresident spouse. File TC-40B, Non or Part-year Resident Schedule. See TC-40B instructions on page 25. (82) Nonresident Active Duty Military Pay

(50 USC §4001) Nonresident service members do not pay Utah income tax on active duty military pay. Deduct the amount of active duty military pay included in your federal adjusted gross income on TC-40A, Part 2, using code 82. See instructions for TC-40B and Pub 57, Military Personnel Instructions. (85) State Tax Refund Distributed to Benefi ciary of Trust

(UC §59-10-114(2)(c)) Enter any state tax refund distributed to you by a resident trust if the refund was used to compute federal income of the resident trust for the year. (88) Nonresident Military Spouse Income

(50 USC §4001) All income of a service member’s nonresident spouse is exempt from Utah tax ONLY IF: 1. the spouse and the service member are residents of the same state outside Utah, 2. the service member is in Utah under military orders, and 3. the spouse is in Utah solely to be with the service member. Enter the total income of the nonresident spouse on TC-40A, Part 2, using code 88. When completing TC-40B, deduct only the Utah income of the nonresident spouse in Column A, line 31. See Pub 57, Military Personnel Instructions. (89) FDIC Premiums

(UC §59-10-114(2)(i)) You may subtract from income FDIC premiums that were not allowed as a deduction on your federal return under IRC 162(r). (90) Qualifi ed Retirement Plan Distributions

(UC §59-10-114.1) Enter the amount of any distribution from a qualifi ed IRC Section 401(a) retirement plan that is included in your federal adjusted gross income if, in the year it was paid into the plan, the amount was: 1. not included in your federal adjusted gross income; and 2. taxed by another state, the District of Columbia, the United States or a U.S. possession. (SA) COVID-19 Utah Grant Funds Included in AGI

(UC §59-10-114(2)(j)) Enter the amount of any federally-funded COVID-19 grant funds or forgiven loans received from Utah or a local Utah government that are included in adjusted income on this return.  Part 3 – Apportionable Nonrefundable Credits Apportionable nonrefundable credits can reduce your income tax to zero, but any credit greater than the tax will not be refunded. Enter the following apportionable nonrefundable credits (cred- its that must be apportioned for nonresidents and part-year residents) that apply. Attach TC-40A to your Utah return. Write the code and amount of each apportionable nonrefund- able credit in Part 3. Add the amounts and carry the total to TC-40, line 24. Codes for Apportionable Nonrefundable Credits, TC-40A Part 3 04 Capital Gain Transactions Credit 18 Retirement Credit 20 my529 Credit 23 Health Benefi t Plan Credit 26 Gold and Silver Coin Sale Credit AH Social Security Benefi ts Credit AJ Military Retirement Credit Keep all related documents with your records. You may have to provide this information later to prove a credit claimed on your return. Each apportionable nonrefundable credit is explained below. (04) Capital Gain Transactions Credit

(UC §59-10-1022) You may claim a credit for the short-term and long-term capital gain on a transaction if: 1. the transaction occurs on or after Jan. 1, 2008; 2. at least 70 percent of the gross proceeds of the transaction are used to buy stock in a qualifi ed Utah small business corporation within 12 months from when the capital gain transaction occurred; and 3. you did not have an ownership interest in the qualifi ed Utah small business corporation at the time of investment. Calculation of Capital Gain Transactions Credit 1. Eligible capital gain 1 _________ 2. Multiply line 1 by 4.95% (.0495). This is your credit. 2 _________

Enter this amount on TC-40A, Part 3, using code 04.

18 2021 Utah TC-40 Instructions There is no form for this credit. Keep all documents with your records. Note: You may not carry forward or back any credit that is more than your tax liability. ( 18) Retirement Credit

(UC §59-10-1019) If you (and/or your spouse, if fi ling jointly) were born on or before Dec. 31, 1952, you may take a retirement credit of up to $450. Complete the Retirement Credit Worksheet, below, to calculate the credit. You may not claim this credit if you (or your spouse, if fi ling jointly) claim either the Social Security Benefi ts Credit (code AH) or the Military Retirement Credit (code AJ).

Because the maximum amount of this credit is $450 per individual, you (and/or your spouse) may qualify for a larger credit by taking the Social Security Benefi ts Credit (code AH) or the Military Retirement Credit (code (AJ). See below. Retirement Credit Worksheet 1. If only you or only your spouse is taking this credit, enter 450. If both you and your spouse are taking this credit, enter 900. 1 _________ 2. Enter the amount from TC-40, line 6 (Total income)

2 _________ 3. Enter municipal bond interest from TC-40, Schedule A, Part 1, code 57 3 _________ 4. Line 2 minus line 3 4 _________ 5. Enter tax exempt interest from federal form1040 or 1040-SR, line 2a 5 _________ 6. Modifi ed Adjusted Gross Income 6 _________ Add lines 4 and 5 7. Enter:

7 _________ a. Married fi ling separately: $16,000 b. Married fi ling federal return 1040NR: $16,000 c. Married fi ling joint: $32,000 d. Single: $25,000 e. Qualifi ed widow(er) or head of household: $32,000 8. Line 6 minus line 7 (not less than zero) 8 _________ 9. Multiply line 8 by 0.025 9 _________ 10. Retirement Credit 10 _________ Subtract line 9 from line 1 (not less than zero).

If you (and/or your spouse) claim this credit, enter the total amount on TC-40A, Part 3, using code 18. Also enter your (and/or your spouse’s) birthdate(s). Note: You may not carry forward or back any retirement credit that is more than your tax liability. (20) my529 Credit

(UC §59-10-1017) If a qualifi ed contribution was made to your Utah my529 ac- count, you may claim a nonrefundable credit. To qualify, the contribution must be made during the taxable year and must not have been deducted on your federal return. If you are a my529 account owner, you will receive form TC-675H, my529 Tax Statement for Contributions, Withdraw- als, and Transfers, from my529. If your fi ling status is single, head of household, married fi ling separate or qualifying wid- ower, enter on TC-40A, Part 3, the amount from TC-675H, box 1A. If your fi ling status is married fi ling joint, enter the amount from TC-675H, box 1B. Use code 20. If you are a grantor trust and you receive more than one TC-675H for the same benefi ciary, contact my529 for instruc- tions to correctly calculate the credit. Keep form TC-675H with your records to provide the Tax Com- mission upon request. If you have any questions about my529 accounts, call my529 at 1-800-418-2551, or visit my529.org. Note: You may not carry forward or back any credit that is more than your tax liability. (23) Health Benefi t Plan Credit

(UC §59-10-1023)

Amounts not included in your federal taxable income and amounts used to claim a federal credit cannot be used for this credit. You may claim this credit if you purchased your own health insurance and were not eligible to participate in a health benefi t plan maintained and funded through an employer or former employer. You do not qualify for this credit if you (or your spouse, if fi ling a joint return) had the option to get health insurance through an employer or former employer, even if you chose not to use the employer’s plan. Defi nition A health benefi t plan is a policy, contract or agreement offered by a carrier to pay for or reimburse health care costs. Health benefi t plans do not include: • accident and disability income insurance; • liability and supplemental liability insurance; • workers compensation insurance; • automobile medical insurance; • credit-only insurance; • on-site medical coverage; • insurance where health care is not the main benefi t; • separate dental, vision, hearing, long-term care or home health plans; • insurance for a specifi c illness or disease; • fi xed indemnity insurance; • Medicare supplemental insurance; • self-insurance; or • other similar coverage.

19 2021 Utah TC-40 Instructions Excluded Amounts You must exclude the following amounts when calculating the credit: • Amounts used to calculate a federal Health Coverage Tax Credit (HCTC) for Trade Adjustment Assistance (TAA) recipients, alternate TAA recipients or Pension Benefi t Guaranty Corporation (PBGC) pension recipients (IRC Section 35). • Payments into or for an Archer Medical Savings Account (MSA), Health Savings Account (HSA), Health Flexible Spending Accounts (FSA) or Health Reimbursement Ar- rangement (HRA) (IRC Section 106). • Pre-tax employer contributions to cafeteria or employer plans covering employees who may choose among two or more cash and qualifi ed benefi ts (IRC Section 125). • Trade or business expenses for self-employed persons up to 100 percent of premiums paid but not more than your net business income (under IRC Section 162). • Amounts deducted on federal Schedule A (IRC section 213). • Amounts paid on your behalf by a third party, such as government subsidies through Medicaid. • Payments for Medicare supplemental plans (Medigap). • Fees or co-pays for Children’s Health Insurance Program (CHIP) and Primary Care Network (PCN) programs run by the Utah Department of Health, or similar programs run by other states. Included Amounts You may include the following amounts when calculating the credit: • Payments for a health benefi t plan through an Affordable Care Act (ACA) marketplace. You may also include any extra amounts you had to pay for the plan on your federal income tax return, but you must subtract any amounts refunded to you on your federal tax return. • Medicare Plan A premiums, if you are required to pay them (most people are not). • Medicare Plan B premiums, even if the payments are deducted from your social security benefi ts. • Payments for healthcare plans offered by private insurance carriers approved by Medicare (Medicare Plan C, Medicare Advantage). • Payments for Medicare Plan D (drug) plans offered by private insurance carriers and approved by Medicare. • Payments for a health benefi t plan connected to Medicaid. Do not include amounts paid by Medicaid. • Payments through COBRA for a former employer’s insur- ance plan. Credit Calculation Use the worksheet below to calculate the credit. There is no form for this credit. Keep all related documents with your records. Calculation of Health Benefi t Plan Credit 1. Amount paid for health benefi t plan in 2021 1 _________ 2. Enter your excess advance premium tax

credit repayment from federal form 1040, 2 _________ *

Schedule 2, line 2 3. Add line 1 and line 2 3 _________ 4. Enter your net premium tax credit from

federal form 1040, Schedule 3, line 9 4 _________ * 5. Subtract line 4 from line 3 5 _________ 6. Excluded amount (see instructions, above) 6 _________ 7. Subtract line 6 from line 5

(if less than zero, enter “0”) 7 _________ 8. Multiply line 7 by 4.95% (.0495) 8 _________ 9. Enter maximum credit allowed per return: 9 _________

$300 for single taxpayer with no dependents

$600 for married fi ling jointly with no dependents

$900 for all taxpayers with dependents 10. Enter the lesser of line 8 or line 9.

This is your credit. 10 _________

Enter this amount on TC-40A, Part 3, using code 23. *Enter an amount on line 2 or line 4 only if you claimed the Health Benefi t Credit on your 2020 Utah return. Note: You may not carry forward or back any credit that is more than your tax liability (26) Gold and Silver Coin Sale Credit

(UC §59-10-1028) Capital gains recognized on the sale or exchange of gold and silver coins issued by the United States government and reported on a federal individual income tax return are eligible for an apportionable nonrefundable credit against Utah tax. You may also include any gold or silver coin or bullion, other than that issued by the United States, if a court of competent jurisdiction issues a fi nal, unappealable judgment or order determining that Utah may recognize the gold or silver coin or bullion as legal tender in the state, or Congress enacts legislation expressly providing that such coin or bullion is legal tender. To qualify for the credit, all of the following conditions must be met: 1. The capital gain transaction must be for the sale or exchange of gold or silver coin issued by the federal government for another form of legal tender, 2. the capital gain transaction must result in a short-term or long-term capital gain (defi ned in IRC §1222) that is re- ported on Schedule D of your federal individual or fi duciary return, 3. any eligible capital gain must fi rst be offset by any capital loss recognized for the year for federal purposes from the sale of gold and/or silver coin, and 4. the transaction must be made during the taxable year. For more information, see UC Title 59, Chapter 1, Part 15, Specie Legal Tender Act.

20 2021 Utah TC-40 Instructions Calculation of Gold and Silver Coin Sale Credit 1. Capital gains on all sales and exchanges of gold and silver coins 1 _________ 2. Capital losses on all sales and exchanges of gold and silver coins 2 _________ 3. Subtract line 2 from line 1 (if a loss, STOP, there is no credit) 3 _________ 4. Amount from form 1040, Schedule D, line 16 (if a loss, STOP, there is no credit) 4 _________ 5. Enter the lesser of line 3 or line 4 5 _________ 6. Credit percentage - 4.95% 6 .0495 7. Credit - multiply line 5 by line 6 7 _________

Enter this amount on TC-40A, Part 3, using code 26. Note: You may not carry forward or back any credit that is more than your tax liability There is no form for this credit. Keep all related documents with your records. (AH) Social Security Benefi ts Credit

(UC §59-10-1042) You may qualify for this credit if you (or your spouse, if fi ling jointly) received taxable Social Security retirement, disability or survivor benefi ts. Complete the Social Security Credit Work- sheet, below, to calculate this credit. You may only claim this credit for Social Security benefi ts included in adjusted gross income on this return. You may not claim this credit if you (or your spouse, if fi ling jointly) claim the Retirement Credit (code 18). Social Security Credit Worksheet 1. For yourself (and/or your spouse), enter the amount from federal return 1040 or 1040-SR, line 6b; or 1040NR, Schedule NEC, line 8.

1 _________ 2. Enter the amount from TC-40, line 6 (Total income)

2 _________ 3. Enter municipal bond interest from TC-40, Schedule A, Part 1, code 57 3 _________ 4. Line 2 minus line 3 4 _________ 5. Enter tax exempt interest from federal form1040 or 1040-SR, line 2a 5 _________ 6. Modifi ed Adjusted Gross Income 6 _________ Add lines 4 and 5 7. Multiply line 1 by 0.0495 7 _________ 8. Enter:

8 _________ a. Married fi ling separately: $25,000 b. Married fi ling federal return 1040NR: $25,000 c. Married fi ling joint: $50,000 d. Single: $30,000 e. Qualifi ed widow(er) or head of household: $50,000 9. Line 6 minus line 8 (not less than zero) 9 _________ 10. Multiply line 9 by 0.025 10 _________ 11. Social Security Benefi ts Credit 11 _________ Line 7 minus line 10 (not less than zero)

If claiming this credit, enter the total amount on TC-40A, Part 3, using code AH. Note: You may not carry forward or back any credit that is more than your tax liability. (AJ) Military Retirement Credit

(UC §59-10-1043) You may qualify for this credit if you (or your spouse, if fi ling jointly) received taxable military retirement pay. Military retire- ment pay means retirement pay related to service in the armed forces, including retirement pay received by a survivor of a deceased service member. It does not include Social Security income, 401(k) or IRA distributions, or other sources of income. You may only claim this credit for military retirement income included in adjusted gross income reported on this return. Complete the Military Retirement Credit Worksheet, below, to calculate this credit. You may not claim this credit if you (or your spouse, if fi ling jointly) claim the Retirement Credit (code 18).

Do not take this credit if you receive survivor benefi ts for a service member who died while on active duty or while in training; instead, take the Military Survivor Benefi ts Credit (code AA). See page 24. Military Retirement Credit Worksheet Complete one worksheet for each person taking this credit. 1. Enter the amount of taxable military retirement pay on DFAS 1099-R 1 _________ 2. Military Retirement Credit 2 _________ Multiply line 1 by 0.0495

If claiming this credit, add the amount on line 2 of all worksheets and enter the total amount on TC-40A, Part 3, using code AJ. Note: You may not carry forward or back any credit that is more than your tax liability.   Part 4 – Nonapportionable Nonrefundable Credits Nonapportionable nonrefundable credits can reduce your income tax to zero, but any credit greater than your tax liability will not be refunded. Enter the following nonapportionable nonrefundable credits that apply. Attach TC-40A to your Utah return. Write the code and amount of each nonapportionable nonrefundable credit in Part 4. Total the amounts and carry the total to TC-40, line 26.

21 2021 Utah TC-40 Instructions Codes for Nonapportionable Nonrefundable Credits, TC-40A Part 4 01 At-Home Parent Credit 02 Qualifi ed Sheltered Workshop Cash Contribution Credit 05 Carryforward of Clean Fuel Vehicle Credit 06 Historic Preservation Credit 08 Low-Income Housing Credit 12 Credit for Increasing Research Activities in Utah 13 Carryforward of Credit for Machinery and Equip- ment Used to Conduct Research 17 Credit for Income Tax Paid to Another State 19 Live Organ Donation Expenses Credit 21 Renewable Residential Energy Systems Credit 25 Combat Related Death Credit 27 Veteran Employment Credit 28 Employing Persons Who are Homeless Credit 63 Achieving a Better Life Experience (ABLE) Program Credit AA Military Survivor Benefi ts Credit AG Special Needs Opportunity Scholarship Program Credit Keep all related documents, including credit forms, with your records. You may have to provide this information later to verify a credit claimed on your return. Each nonapportionable nonrefundable credit is explained below. (01) At-Home Parent Credit

(UC §59-10-1005) An at-home parent may claim a nonrefundable credit of $100 for each child 12 months old or younger on the last day of 2021. An at-home parent includes the: • biological mother or father, • stepmother or stepfather, • adoptive parents, • foster parents, • legal guardian, and • persons housing a child placed by a child-placing agency for legal adoption. To qualify for the credit, all of the following conditions must be met: 1. The child must be 12 months or younger on the last day of 2021; 2. the at-home parent must provide full-time care in their residence; 3. the child must be claimed as a dependent on the at-home parent's return; 4. the total of the at-home parent’s wages, tips and compen- sation listed on federal W-2 forms and the gross income on federal Schedule C, Profi t or Loss from Business, line 7, must be $3,000 or less for the taxable year; and 5. the federal adjusted gross income (TC-40, line 4) must be $50,000 or less. Note: You may not carry forward or back any credit that is more than your tax liability There is no form for this credit. Keep all related documents with your records. (02) Qualifi ed Sheltered Workshop Cash Contribution Credit

(UC §59-10-1004)

Charitable contributions claimed on the federal Schedule A cannot be claimed as a credit here. Cash contributions made during the taxable year to a qualifi ed Utah nonprofi t rehabilitation sheltered workshop facility for persons with disabilities are eligible for the credit. Check with the workshop to make sure they have a current Day Training Provider License or Day Support Provider Certifi cate issued by the Department of Human Services. The credit is the lesser of $200 or 50 percent of the total cash contributions. There is no form for this credit. Keep all related documents with your records.

You must enter the name of the qualifi ed workshop on TC-40A, Part 4 to claim the credit. Note: You may not carry forward or back any credit that is more than your tax liability For more information contact: Division of Services for People with Disabilities 195 N 1950 W Salt Lake City, UT 84116 1-844-275-3773 dspd.utah.gov (05) Carryforward of Clean Fuel Vehicle Credit

(UC §59-10-1009) The clean fuel vehicle credit is no longer available. The fi ve- year carryforward remains for credit earned before 2017. If you have unused credit from a year prior to 2017, you may carry it forward for up to fi ve years through tax year 2021 or until the credit is used up (whichever comes fi rst). The carryforward must not be more than your tax liability in the year you claim it. (06) Historic Preservation Credit

(UC §59-10-1006) The credit is for costs to restore any residential certifi ed historic building. Complete form TC-40H, Historic Preservation Tax Credit, with the State Historic Preservation Offi ce certifi cation, verifying the credit is approved. Do not send form TC-40H with your return. Keep the form and all related documents with your records to provide the Tax Commission upon request. Note: You may carry forward for the next fi ve years any credit that is more than your tax liability For more information contact: Utah Division of State History 3760 S Highland Drive Salt Lake City, UT 84106 801-245-7277 history.utah.gov/shpo/fi nancial-incentives/

22 2021 Utah TC-40 Instructions (08) Low-Income Housing Credit

(UC §59-10-1010) This credit is determined by the Utah Housing Corporation for owners of a low-income housing project who also received part of the federal low-income housing credit. When this credit ap- plies, the project owner will provide you with form TC-40TCAC (issued by the Utah Housing Corporation). If you share in this credit, get form TC-40TCAC, Utah Low- Income Housing Tax Credit Allocation Certifi cation, and com- plete form TC-40LI, Summary of Utah Low-Income Housing Tax Credit. Do not send these forms with your return. Keep the forms and all related documents with your records. The building project owner must also complete and attach to his/her return form TC-40LIS, Utah Credit Share Summary of Low-Income Housing Project. Note: You may carry back three years or forward for the next fi ve years any credit that is more than your tax liability. If you are carrying this credit forward or back, also complete form TC-40LIC, Utah Low-Income Housing Tax Credit Carryback and/or Carryforward. For more information contact: Utah Housing Corporation 2479 S Lake Park Blvd. West Valley City, UT 84120 801-902-8200 utahhousingcorp.org (12) Credit for Increasing Research Activities in Utah

(UC §59-10-1012) The credit is: 1. 5 percent of your qualifi ed expenses for increasing research activities in Utah above a base amount, 2. 5 percent of certain payments made to a qualifi ed orga- nization increasing basic research in Utah above a base amount, and 3. 7.5 percent of your qualifi ed research expenses in Utah for the current taxable year. Note: You may carry forward for the next 14 years any credit for 1 or 2 (above) that is more than your tax liability. You may not carry forward any credit for 3 (above). There is no form for this credit. Keep all related documents with your records. (13) Carryforward of Credit for Machinery and Equipment Used to Conduct Research

(UC §59-10-1013) The credit expired for taxable years beginning after 2010. If you claimed a credit on your return for machinery and/or equipment used to conduct research for a year after 1998 and prior to 2011, and the credit was more than your tax liability for the year, you may carry over the excess credit to the next 14 years and use it to offset tax until used up. If you are using any remaining credit in this year, enter that carryover amount on TC-40A, Part 4, using code 13. (17) Credit for Income Tax Paid to Another State

(UC §59-10-1003) If you are a Utah resident or part-year resident with income that is taxed by Utah and another state(s), the District of Columbia, or a possession of the United States, you may be entitled to a credit for income tax paid to the other state(s). Nonresidents do not qualify for this credit. You can only take this credit for individual income tax (you cannot take it for sales tax or local taxes). Complete Schedule B to see if your income was taxed by both states. Complete and attach form TC-40S, Credit for Income Tax Paid to Another State. If there are two or more states, calculate each state separately. Carry the sum of the credits from TC- 40S, line 7 to TC-40A, Part 4, using code 17. Do not use the state income tax withheld from form W-2 as the tax paid to the other state. You must complete and fi le the other state's return to determine the tax amount paid. You may have to provide additional information later to verify this credit. Part-year residents rarely qualify for this credit. If you are domiciled in Utah for part of the year and domiciled in another state for part of the year, you may only claim credit on the portion of income: 1. taxable in Utah, 2. taxed also by the other state(s), and 3. included in "Column A - Utah" income on form TC-40B. Part-year residents must prorate and enter the tax paid to the other state(s) on TC-40S, line 6. The credit only applies to tax paid on the part of your income (TC-40, line 1) taxed by both states. Note: You may not carry forward or back any credit that is more than your tax liability. Keep a signed copy of the other state's return and all related documents with your records. FYI: Common Credit 17 Errors • Claiming the withholding amount on a W-2 as taxes paid to another state. • Claiming credit for taxes other than income tax. • Claiming the entire amount of tax paid to another state. • Part-year residents not prorating correctly on TC-40S. (19) Live Organ Donation Expenses Credit

(UC §59-10-1015) You may claim a credit up to $10,000 of qualifi ed costs incurred for donating human bone marrow, or any part of an intestine, kidney, liver, lung, or pancreas for transplanting in another person. Qualifi ed expenses include travel, lodging or a "lost wage" if the expense was not reimbursed, and the organ was donated by you, your spouse, or a dependent. Note: You may carry forward for the next fi ve years any credit that is more than your tax liability. Complete form TC-40T, Live Organ Donation Expenses Credit. Do not send form TC-40T with your return. Keep the form and related documents with your records to provide the Tax Commission upon request.

23 2021 Utah TC-40 Instructions (21) Renewable Residential Energy Systems Credit

(UC §59-10-1014) This credit is for reasonable costs, including installation, of a residential energy system that supplies energy to a Utah residential unit. Additional residential energy systems or parts may be claimed in following years as long as the total amount claimed does not exceed certain limits. Contact the Gover- nor’s Offi ce of Energy Development for more information. If the residence is sold to a non-business entity before claiming the credit, you may irrevocably transfer the right to the credit to the new owner. The principal portion of the system's lease payments may qualify for the credit if the lessor irrevocably transfers the credit rights to the new owner. Get form TC-40E, Renewable Residential and Commercial Energy Systems Tax Credits, from the Governor's Offi ce of Energy Development with their certifi cation stamp, verifying the credit is approved and showing the amount of the approved credit. Do not send form TC-40E with your return. Keep the form and all related documents with your records to provide the Tax Commission upon request. Note: You may carry forward for the next four years any credit that is more than your tax liability. For more information contact: Governor's Offi ce of Energy Development (OED) PO Box 144845 Salt Lake City, UT 84114 801-538-8732 or 801-538-8702 energy.utah.gov/tax-credits/ renewable-energy-systems-tax-credit (25) Combat Related Death Credit

(UC §59-10-1027) If you are fi ling a return on behalf of a military service mem- ber who died as a result of military service in a combat zone, you may claim a nonrefundable credit equal to the amount of your tax liability on the return attributable to the deceased service member. To qualify for the credit, all of the following conditions must be met: 1. The military service member must have been in an active or reserve component of the United States Army, Navy, Air Force, Marine Corps, Coast Guard or Space Force; 2. The combat related death must have occurred on or after Jan. 1, 2010; 3. The death must have occurred while the military service member was serving in a combat zone, or be the result of a wound, disease, or injury incurred while serving in a combat zone; and 4. The service must have been on or after the date declared by the President of the United States by Executive Order as a combat zone, and on or before such designation is terminated by the President. If the return is being fi led by a single person (or married fi ling separately), the credit is equal to your tax liability shown on line 22. Enter this amount on TC-40A, Part 4, using code 25 If the return is being fi led as married fi ling jointly (deceased service member and spouse), use the following calculation to determine the allowable credit. Calculation of Combat Related Death Credit for Joint Return 1. Adjusted gross income on joint federal return 1 _________ 2. Federal adjusted gross income of deceased

military member

2 _________ 3. Allocated percentage - divide line 2 by line 1 3 _________ 4. Amount of tax liability from TC-40, line 22 4 _________ 5. Combat Related Death Credit –

multiply line 3 by line 4. 5 _________

Enter this amount on TC-40A, Part 4, using code 25. Note: You may use a different method of allocating your tax liability if that method more accurately refl ects the deceased service member's tax liability. (27) Veteran Employment Credit

(UC §59-10-1031) A nonrefundable credit is available to taxpayers who hire a qualifi ed, recently deployed veteran. A qualifi ed, recently deployed veteran is a person who was mobilized to active federal military service in an active or reserve component of the United States Armed Forces, and received an honorable or general discharge within the two- year period before the employment begins. To qualify for the credit, the qualifi ed veteran must meet all of the following conditions: 1. received an honorable or general discharge within the two-year period before the employment begins; 2. was collecting or was eligible to collect unemployment benefi ts, or has exhausted their unemployment benefi ts within the last two years, under UC Title 35A, Chapter 4, Part 4, Benefi ts and Eligibility; and 3. work for the taxpayer for at least 35 hours per week for not less than 45 of the 52 weeks following the veteran’s employment start date. The credit is claimed beginning in the year the 45 consecutive weeks in paragraph 3 above are met. Calculate the credit as follows: First Year Credit (count all months in the year the 45-week requirement is met): 1. Number of months or partial months the veteran was employed in the fi rst year 1 _________ 2. Monthly credit allowable in fi rst year 2 200 3. First year credit – multiply line 1 by line 2 (maximum $2,400) 3 _________ Second Year Credit: 4. Number of months or partial months the veteran was employed in the 2nd year 4 _________ 5. Monthly credit allowable in second year 5 400 6. Second year credit – multiply line 4 by line 5 (maximum ($4,800) 6 _________

24 2021 Utah TC-40 Instructions We will not refund any credit greater than your tax due, but you may carry it forward to offset tax for up to fi ve years. If taking this credit, you must keep the following documentation and make it available to the Tax Commission upon request: 1. the veteran’s name, last known address, and taxpayer identifi cation or Social Security number; 2. the start date of employment; 3. documentation establishing that the veteran was employed 45 out of the 52 weeks after the date of employment; 4. documentation from the veteran’s military service unit showing that the veteran was recently deployed; and 5. a signed statement from the Department of Workforce Services that the veteran was collecting, was eligible to collect, or exhausted their unemployment benefi ts within the last two years. (28) Employing Persons Who Are Homeless Credit

(UC §59-10-1032) You may claim a credit for hiring a homeless person if you receive a credit certifi cate from the Department of Workforce Services. Do not send the certifi cate with your return. Keep the certifi cate and all related documents with your records. Note: You may carry forward for the next fi ve years any credit that is more than your tax liability. For more information contact: Department of Workforce Services 140 E 300 S PO Box 142503 Salt Lake City, UT 84111-2503 385-272-7798 jobs.utah.gov/employer/business/htc.html (63) Achieving a Better Life Experience (ABLE) Program Credit

(UC §59-10-1035) You may claim a credit for 4.95 percent of the total qualifi ed contributions you made to a Utah resident's Achieving a Better Life Experience Program account. You must make the contributions during the taxable year and have an itemized statement from the qualifi ed ABLE program. You may not claim a credit for an amount of a contribution that is returned to you or an amount already deducted on your federal income tax return. Credit calculation Contributions _______ x .0495 = Credit _________ Note: You may not carry forward or back any credit that is more than your tax liability. For more information, contact: Department of Workforce Services 140 E 300 S PO Box 45249 Salt Lake City, UT 84145-0249 801-526-9675 jobs.utah.gov (AA) Military Survivor Benefi ts Credit

(UC §59-10-1036) If you are a surviving spouse or dependent child (10 U.S.C. Sec 1447) of a deceased military member, you may claim a credit for 4.95 percent of the survivor benefi ts you received during the year. Survivor benefi ts are benefi ts paid due to: 1. the death of a member of the armed forces or reserve while on active duty, or 2. the death of a member of the reserve that results from a service-connected cause while performing inactive duty training.

Do not take this credit if the deceased service member was retired from the armed forces; instead, take the Military Retirement Credit (code AJ). See page 20. Credit calculation Survivor benefi ts _______ x .0495 = Credit _________ Note: You may not carry forward or back any credit that is more than your tax liability. (AG) Special Needs Opportunity Scholarship Program Credit

(UC §59-10-1041) You may claim a credit for a donation made to the Special Needs Opportunity Scholarship Program. You will receive a tax credit certifi cate from the program, listing the amount of the credit. You may not claim this credit if you claimed the donation as an itemized deduction on your federal return. Do not send the certifi cate with your return. Keep the certifi cate and all related documents with your records. Note: You may carry forward for the next three years any credit that is more than your tax liability. For more information, contact: info@childrensfi rsteducationfund.org 385-204-5331   Part 5 – Refundable Credits Enter the following refundable credits that apply. Attach TC-40A to your Utah return. Write the code and amount of each refundable credit in Part 5. Total the amounts and carry the total to TC-40, line 38. Codes for Refundable Credits, TC-40A Part 5 39 Renewable Commercial Energy Systems Credit 41 Special Needs Adoption Credit 47 Agricultural Off-highway Gas/Undyed Diesel Credit 48 Farm Operation Hand Tools Credit Keep all related documents, including credit forms, with your records. You may have to provide this information later to verify a credit claimed on your return. Each refundable credit is explained below.

25 2021 Utah TC-40 Instructions (39) Renewable Commercial Energy Systems Credit

(UC §59-10-1106) Get form TC-40E, Renewable Residential and Commercial Energy Systems Tax Credits, from the Governor's Offi ce of Energy Development with their certifi cation stamp. Do not send this form with your return. Keep the form and all related documents with your records to provide the Tax Commission upon request. For more information contact: Governor's Offi ce of Energy Development (OED) PO Box 144845 Salt Lake City, UT 84114 801-538-8732 or 801-538-8702 energy.utah.gov/tax-credits/ renewable-energy-systems-tax-credit (41) Special Needs Adoption Credit

(UC §59-10-1104) You may claim a refundable credit of $1,000 for a special needs child you adopt for whom the adoption order was issued by a court of competent jurisdiction in Utah or another state, or a foreign country. You must be a resident of the State of Utah on the date the order is issued. If the adoption is made by a foreign country, the adoption must be registered in accordance with UC §78B-6-142. To claim this credit, the child must meet one of the following conditions: 1. be fi ve years of age or older; 2. be under the age of 18 with a physical, emotional, or mental disability; or 3. be part of a sibling group (two or more persons) placed together for adoption. The credit may not exceed $1,000 per taxable year, regardless of the number of qualifying special needs children adopted during the year. If the adoption order is issued by a court in Utah or another state, the credit may only be claimed the year the adoption order becomes fi nal. If the adoption order is issued by a for- eign country, the credit may only be claimed the year a court of competent jurisdiction in Utah orders the state registrar to fi le the adoption order issued by the foreign country. There is no form for this credit. Keep all related documents with your records to provide the Tax Commission upon request. (47) Agricultural Off-highway Gas/Undyed Diesel Credit

(UC §59-13-202) You may claim a credit of 31.4 cents per gallon for motor fuel and undyed diesel fuel bought in Utah during 2021 and used to operate stationary farm engines and self-propelled farm machinery used solely for commercial non-highway agricul- tural use if the fuel was taxed at the time it was bought. This does not include golf courses, horse racing, boat operations, highway seeding, vehicles registered for highway use, hobbies, personal farming and other non-agricultural use. Credit calculation Gallons _______ x .314 = Credit _________ There is no form for this credit. Keep all related documents with your records to provide the Tax Commission upon request. (48) Farm Operation Hand Tools Credit

(UC §59-10-1105) This credit is for sales and use tax paid on hand tools pur- chased and used or consumed primarily and directly in a farm- ing operation in Utah. The credit only applies if the purchase price of a tool is more than $250. There is no form for this credit. Keep all related documents with your records to provide the Tax Commission upon request. TC-40B - Non or Part-year Resident Schedule Use TC-40B to calculate the Utah tax for a nonresident or a part-year resident. Residency Status 1. If you are a part-year resident, enter the date you estab- lished residency in Utah and the date the residency ended. Enter dates in the format mm/dd/yy. 2. If you (and your spouse) are a nonresident, enter the two-character home state postal abbreviation. If you are a resident of a foreign country (a foreign national or citizen), enter "NA" in the home state abbreviation fi eld. 3. If you are a Utah resident and your spouse is a nonresident, enter your spouse’s two-character home state postal ab- breviation. If your spouse is a resident of a foreign country (a foreign national or citizen), enter "NA" in the home state abbreviation fi eld.

26 2021 Utah TC-40 Instructions Column B: Enter the state tax refund included on line 1 of federal form 1040, Schedule 1. Line 33 Column A: Enter only the subtractions from income attribut- able to Utah and shown on TC-40A, Part 2. Include in Column A an equitable adjustment shown on TC-40A, Part 2, only to the extent the equitable adjustment relates to subtractions from income from Utah sources. Column B: Enter the total subtractions from income shown on TC-40A, Part 2. Line 34 - RESERVED Line 35 - RESERVED Line 36 If you adjusted your income on federal form 1040, Schedule 1, line 26, enter the description on line 36 blank line and the adjustment amount in Column B. In Column A, enter the amount of the adjustment that is from Utah income. Line 37 Enter the total of lines 19 through 36. Note: Do not report nonresident active duty military pay included in federal income in the Utah portion of income on line 1. Include a nonresident military spouse's Utah portion of income on lines 1 through 17, whichever applies, and also include the deduction claimed on TC-40A, Part 2 for this in- come (code 88) on line 33. Line 38 Subtract line 37 from line 18 for both columns A and B and enter the result. Note: The amount on line 38 in column B must equal the Utah taxable income shown on TC-40, line 9. Line 39 Divide the total on line 38 Column A by the total on line 38 Column B, and enter the result on line 39. Round to four decimal places. Do not enter a decimal greater than 1.0000, and do not enter a negative number. (If the amount in column A or column B is zero, enter 0.0000 on line 39.) Line 40 Subtract TC-40, line 24 from TC-40, line 23. This is your net tax. Line 41 Multiply line 40 by the decimal on line 39. This is your Utah tax. Carry this amount to TC-40, line 25. Follow these steps to calculate your Utah tax: 1. Complete form TC-40 through line 24. 2. Complete form TC-40B, Non or Part-Year Resident Sched- ule (see line-by-line instructions, below). 3. Complete the rest of form TC-40, beginning with line 25. Attach form TC-40B to your Utah return. Do not attach a copy of your federal return. Keep a copy with your records. Line-by-Line Instructions Note: Column A is for Utah income and adjustments. Column B is for total income and adjustments. Lines 1 - 14 Column A: Enter all income (loss) earned or received from Utah sources while not a Utah resident, plus all income (loss) earned or received from all sources while a Utah resident (even if not from a Utah source) included in income on the federal return. Column B: Enter the total income (loss) from all sources as reported on your federal return. Line 15 Column A: Enter only the additions to income attributable to Utah and shown on TC-40A, Part 1. In the case of an addition to income attributable to a Medical Savings Account addback or a my529 addback, only include the addition in the Utah column to the extent it was previously subtracted from Utah taxable income. Include in Column A an equitable adjustment shown on TC-40A, Part 1, only to the extent the equitable adjustment relates to additions to income from Utah sources. Column B: Enter the total additions to income shown on TC-40A, Part 1. Line 16 - RESERVED Line 17 - RESERVED Line 18 Enter the total of lines 1 through 17. Lines 19 - 29 Column A: Enter adjustments applicable to Utah income, including moving expenses for members of the armed forces when moving into Utah (line 22). Column B: Enter adjustments claimed on your federal return. Line 30 - RESERVED Line 31 - RESERVED Line 32 Column A: Enter a subtraction for a state tax refund included on line 1 of federal form 1040, Schedule 1, only to the extent the refund subtracted is related to Utah tax.

27 2021 Utah TC-40 Instructions You must claim Utah withholding tax credits by complet- ing form TC-40W and attaching it to your return. Do not send W-2s, 1099s, TC-675Rs, and Utah Schedule K-1 with your return. Keep all these forms with your tax records — we may ask you to provide the documents at a later time. Processing may be delayed or your withholding tax credits may be disallowed if you do not complete TC-40W as explained below and submit it with your return.  TC-40W, Part 1 Report Utah withholding tax from the following forms: • Federal form W-2, Wage and Tax Statement • Federal form 1099 (with Utah withholding), including 1099-R, 1099-MISC, 1099-G, etc. To claim credit for Utah withholding tax, complete TC-40W, page 1. Enter the following information: Line 1 - Enter the employer/payer federal EIN (W-2 box "b," or 1099). Line 2 - Enter the employer/payer Utah withholding account number (W-2 box 15, or 1099). FYI: Withholding Account Number The Utah withholding account number is a 14-char- acter number. The fi rst eleven characters are numeric and the last three are "WTH." Do not enter hyphens. Example: 12345678901WTH. If form W-2 or 1099 does not include this number, contact the employer or payer to get the correct num- ber to enter on TC-40W, Part 1. Failure to include this number on TC-40W may cause your withholding to be disallowed and delay any refund. Line 3 - Enter the employer/payer name and address (W-2 box "c," or 1099). Line 4 - Enter an "X" if the income and withholding tax are from a form 1099. Line 5 - Enter the Social Security number (shown on the W-2 box "a," or 1099). Line 6 - Enter your Utah wages or income being reported (or your spouse’s, if fi ling jointly) (W-2 box 16, or 1099). Line 7 - Enter your Utah withholding tax (or your spouse’s, if fi ling jointly) (W-2 box 17, or 1099). Note: If there is no Utah employer identifi cation number on a form W-2 box 15, 1099-R box 13, 1099-MISC box 17, or any other 1099 form, your refund may be reduced or your tax due increased. Contact the employer or payer of the income to get the Utah ID number. Add the amounts of Utah withholding tax from all lines 7 and enter the total at the bottom of TC-40W, page 1 and on form TC-40, page 2, line 33. TC-40W - Utah Withholding Tax Schedule 22222 a Employee’s social security number OMB No. 1545-0008 b Employer identification number (EIN) c Employer’s name, address, and ZIP code d Control number e Employee’s first name and initial Last name Suff. f Employee’s address and ZIP code 1 Wages, tips, other compensation 3 Social security wages 5 Medicare wages and tips 7 Social security tips 9 11 Nonqualified plans 13 Statutory employee Retirement plan Third-party sick pay 14 Other 15 State Employer’s state ID number 16 State wages, tips, etc. 17 State income tax 18 Local wages, tips, etc. 19 Form W-2 Wage and Tax Statement 2020

567-89-0123

87-1234567

32,519.85

ABC ENTERPRISE INC

32,519.85

9876 MAIN ST

32,519.85

SALT LAKE CITY UT 84101

WILLIAM J SMITH

456 TIMBER DR

MURRAY UT 84150 UT 12345678002WTH 32,519.85 767.99 W-2 Example Utah TC-40W Example

567-89-0123

SMITH

87-1234567

12345678002WTH

ABC ENTERPRISE INC

9876 MAIN ST

SALT LAKE CITY UT 84101

567-89-0123

32,520

768 Line Explanations IMPOR 1 Employer/payer ID number from W-2 box “b” or 1099 Do no 2 Utah withholding ID number from W-2 box “15” or 1099 W-2 o (14 characters, ending in WTH, no hyphens) on the 3 Employer/payer name and address from W-2 box “c” or 1099 4 Enter “X” if reporting Utah withholding from form 1099 Use ad 5 Employee’s Social Security number from W-2 box “a” or 1099 1099s 6 Utah wages or income from W-2 box “16” or 1099 7 Utah withholding tax from W-2 box “17” or 1099 Enter enter p First W-2 or 1099 Secon 1 1 2 (14 characters, no hyphens) 2 3 3 4 4 5 5 6 6 7 7 Third W-2 or 1099 Fourth 1 1 USTC ORIGINAL FORM L 40009 Part 1 - Utah Withholding Tax Schedule SSN Last name 0 0. 0 0.

28 2021 Utah TC-40 Instructions  TC-40W, Part 2 To claim credit for Utah mineral production withholding tax, en- ter the following information. If from form TC-675R, enter lines 1, 2, 3 and 5; if from Utah Schedule K-1, enter lines 4 and 5. Line 1 - Enter the mineral producer's federal EIN (TC-675R box 2). Line 2 - Enter the mineral producer's name (TC-675R box 1). Line 3 - Enter the mineral producer's Utah withholding account number (TC-675R box 3). FYI: Mineral Withholding Account Number The Utah mineral withholding account number is a 14-character number. The fi rst eleven characters are numeric and the last three are "WMP." Do not enter hyphens. Example: 12345678901WMP. If form TC-675R does not include this number, contact the payer to get the correct number to enter on TC- 40W, Part 2. Failure to include this number on TC-40W may cause your withholding to be disallowed and delay any refund. Line 4 - If the mineral withholding tax distribution was received from a pass-through entity (partnership, LLC, LLP, S corporation or trust), enter the pass-through entity's federal EIN. If you receive a TC-675R directly from the mineral producer, leave this line blank. Line 5 - Enter your mineral production withholding tax (TC-675R box 6) or your share of mineral production withholding tax reported on Utah Schedule K-1 by a pass-through entity. Add the amounts of mineral production withholding tax from all lines 5 and enter the total on form TC-40, page 2, line 36. Do not send TC-675R(s) with your return. Keep them in your fi les. Processing may be delayed or the withholding tax credit disallowed if you do not complete TC-40W with all required information.   TC-40W, Part 3 To claim credit for Utah withholding tax paid on your behalf by a pass-through entity (partnership, LLC, LLP, S corporation or trust), enter the following information from Utah Schedule K-1: Line 1 - Enter the pass-through entity's federal EIN (Schedule K-1 box A). Line 2 - Enter the pass-through entity's name (Schedule K-1 box B). Line 3 - Enter the Utah withholding tax withheld or paid on your behalf by the pass-through entity. Add the amounts of pass-through entity Utah withholding tax from all lines 3 and enter the total on form TC-40, page 2, line 35. Do not send Utah Schedule(s) K-1 with your return. Keep them in your fi les. Processing may be delayed or the withholding tax credit disallowed if you do not complete TC-40W with all required information. 2. Producer’s federal EIN 3. Producer’s Utah account number 4. Recipient’s federal EIN (or SSN if an individual) 5. Utah mineral production gross payment to recipient 8. Recipient's name, address, city, state, ZIP code 9. Recipient entity type (check one) C - Corporation S - S Corporation P - Partnership L - Limited Liability Company O - Limited Liability Partnership Statement of Utah Tax Withheld on Mineral Production TC-675R 20__ __ I - Individual T , - Trust Estate or Fiduciary For tax year: 1. Producer’s name, address, city, state and ZIP code Rev. 6/13 6. Utah tax withheld on mineral production 7. Utah mineral production gross payment subject to withholding not ABC MINING COMPANY

PO BOX 4941

PRICE UT 84501

2 0

84-1909732

12345678002WMP

545-18-6791

24,615.18

1,230.76

.00

545-18-6791

WINTER

84-1909732

ABC MINING COMPANY

12345678002WMP

545-18-6791

1,231 Part 2 -Utah Mineral Production Withholding Tax - TC-675R 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. Line Explanations 1 Producer’s EIN from box “2” of TC-675R 4 Pass-through entity EIN if credit from partnership or S corporation 2 Producer’s name from box “1” of TC-675R

(enter EIN from Utah Schedule K-1) 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

(14 characters, ending in WMP, no hyphens)

from Utah Schedule K-1. First TC-675R or Utah Schedule K-1

Second TC-675R or Utah Schedule K-1 1

1 2

2 3

(14 characters, no hyphens) 3

(14 characters, no hyphens) 4

4 5

5 Third TC-675R or Utah Schedule K-1

Fourth TC-675R or Utah Schedule K-1 USTC ORIGINAL FORM 40010 Mineral Production and Pass-through Withholding TC-40W Pg. 2 SSN Last name 2020 TC-675R Example

29 2021 Utah TC-40 Instructions Special Instructions for Married Couples A married couple who fi les a joint federal return may fi le separate Utah returns ONLY IF: • one spouse is a full-year Utah resident, AND • the other spouse is a full-year nonresident.

If either spouse is a part-year resident, you cannot use Special Instructions for Married Couples and your fi ling status must match your federal return. To fi le this way, use Special Instructions for Couples, below. You may also use Special Instructions if the spouse of a Utah resident is a nonresident military service member. See Pub 57, Military Personnel Instructions. Special Instructions for Couples 1. Complete a federal return “as if” you were fi ling separately. DO NOT fi le the “as if” return with the IRS. Use this return ONLY to complete these special instructions. 2. Determine your allocation percentage:

A. Adjusted gross income on your married fi ling joint federal return ___________

B. Utah resident spouse’s federal adjusted gross income only

___________

- For a full-year Utah resident, federal “as if” adjusted gross income.

- For a nonresident who has Utah income and must fi le a Utah return, federal adjusted gross income. C. Allocation percentage ___________

- Divide line B by line A and carry to four decimal places. 3. Follow the line-by-line instructions in this book to complete Utah form TC-40, with the following exceptions:

Box 1 Filing Status – Enter a “9.” This code is not shown on the return but is valid for this special calculation.

Line 4 Federal Adjusted Gross Income – Enter the federal “as if” adjusted gross income from line 2B, above.

Line 5 Additions to Income – Multiply each addition to income by the allocation percentage, above. Enter the additions on TC-40A, Part 1, and carry the total to TC- 40, line 5.

Line 7 State tax refund included on federal return – Multiply any state income tax refund on federal form 1040, Schedule 1, line 1 by the allocation percentage, above.

Line 8 Subtractions from Income – Except for codes 82 and 88, multiply each subtraction from income by the allocation percentage, above. Enter the subtractions on TC-40A, Part 2, and carry the total to line 8.

If fi ling for the service member:

a. Subtract the total military pay earned while not a Utah resident that was included in federal adjusted gross income on TC-40A, Part 2, using code 82.

b. Code 88 is not allowed.

Line 11 Utah personal exemption – Multiply the number of qualifying dependents from line 2c by the allocation percentage, above. Then multiply the result by $1,750.

Line 12 Federal standard or itemized deductions – Multiply the deduction claimed on your married fi ling joint federal income tax return by the allocation percentage, above. 4. Complete Utah form TC-40B using the amounts from your “as if” married fi ling separate federal return. 5. Complete the rest of the Utah return. 6. If fi ling a paper return, attach a copy of both your married fi ling joint federal return and your “as if” married fi ling separate federal return. You do not need to include federal 1040 schedules and supporting documents.

30 2021 Utah TC-40 Instructions Utah State Tax Commission Individual Income Tax Return Coupon TC-547 Rev. 12/11 Individual Income Tax Return Payment Coupon Rev. 12/11 TC-547 Make check or money order payable to the Utah State Tax Commission. Do not send cash. Do not staple check to coupon. Detach check stub. Mail to: Utah State Tax Commission, 210 N 1950 W, SLC UT 84134-0266 Tax year ending USTC Use Only ) ) 4

   SEPARATE AND RETURN ONLY THE BOTTOM COUPON WITH PAYMENT. KEEP TOP PORTION FOR YOUR RECORDS. Payment amount enclosed 00 $ Use of Payment Coupon If you have a tax due balance on your Utah individual income tax return and you have previously filed your return (either electronically or by paper) without a payment, include the payment coupon below with your check or money order to insure proper credit to your account. Do not mail another copy of your income tax return with this payment. Sending a duplicate of your return may delay posting of the payment. If you are sending a payment with your paper Utah individual income tax return, include the payment coupon below with your check or money order, to insure proper credit to your account. Do not use this return payment coupon to prepay future individual income taxes. Use form TC-546. Electronic Payment You may pay your tax online at tap.utah.gov. How to Prepare the Payment Make your check or money order payable to the Utah State Tax Commission. Do not send cash. The Tax Commission does not assume liability for loss of cash placed in the mail. Print your name and address, daytime telephone number and the year the payment is for on your check or money order. Sending Payment Coupon If sending this payment coupon separate from your individual income tax return, do NOT mail another copy of your return with this payment. Complete and detach the payment coupon below. Do not attach (staple, paper clip, etc.) the check or money order to the payment coupon. Send the payment coupon and payment to:

Utah State Tax Commission

210 N 1950 W

Salt Lake City, UT 84134-0266 Primary taxpayer name Social Security no. Secondary taxpayer name Social Security no. Address City State ZIP code