Source: https://www.taxformfinder.org/connecticut/form-ct-12-717a
Timestamp: 2019-02-21 08:53:57
Document Index: 163701225

Matched Legal Cases: ['§12', '§12', '§12', '§12', '§12', '§12', '§12', '§12', '§12']

Connecticut Form CT-12-717A (Change of Resident Status - Special Accruals Connecticut Surety Bond Form) - 2018 Connecticut TaxFormFinder
Connecticut Form CT-12-717A
Connecticut Change of Resident Status - Special Accruals Connecticut Surety Bond Form
Form CT-12-717A PDF
2017 Form CT-12-717A 2016 Form CT-12-717A 2015 Form CT-12-717A 2014 Form CT-12-717A 2013 Form CT-12-717A 2012 Form CT-12-717A 2011 Form CT-12-717A
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CT-12-717A,  Change of Resident Status - Special Accruals Connecticut Surety Bond Form
Connecticut Surety Bond Form
Complete this agreement and forward it by registered mail to: Department of Revenue Services, Attention: Director, Operations
Division, 450 Columbus Blvd, Hartford CT 06103-1837. If filing a joint return, include both names. Enter your Social Security
Number(s) above.
Know all persons by these presents, that I (we)
as principal, and the
a corporation organized under the laws of the State of ___________________________ and duly authorized to transact business
in the State of Connecticut, having an office and usual place of business at _________________________________________________
as Surety, are held and firmly bound unto the People of the State of Connecticut and the Connecticut Department of Revenue
Services, the sum of ___________________________________________ lawful money of the United States of America, for the payment
whereof we bind ourselves, our successors, and assigns, jointly and severally, firmly by these presents.
Whereas, the principal on ___________________ (date) changed resident status, for purposes of the Connecticut income
tax administered by the Commissioner of Revenue Services,
and is required under Conn. Gen. Stat. §§12-700(c)(2) and 12-717(c)(1) to determine Connecticut source income for the taxable
year ___________________ and under Conn. Gen. Stat §12-700 to file a return(s) as a part-year resident individual(s) for the
year ___________________ and
Whereas, due to such change of residence, certain additional amounts were includable under Conn. Gen. Stat.
§§12-700(c)(2) and 12-717(c)(1) in computing Connecticut adjusted gross income of the principal on the accrual basis for the
taxable period immediately prior to the change of residence, and
Whereas, the principal desires not to report on such principal’s return for the taxable period immediately prior to the change
of residence the amounts referred to in the preceding paragraph which would otherwise be includable under Conn. Gen. Stat.
§§12-700(c)(2) and 12-717(c)(1), and
Whereas, the principal elects to defer Connecticut income tax under Conn. Gen. Stat. §12-717(c)(4) and expressly agrees
to file the Connecticut nonresident income tax return or returns required by Conn. Gen. Stat. §12-717(c)(4) and to include thereon
the amounts so accruable under Conn. Gen. Stat. §12-717 in computing Connecticut adjusted gross income and Connecticut
source income and consents to personal jurisdiction in Connecticut for Connecticut income tax purposes, which election and
agreement shall be binding on the principal’s heirs, representatives, assigns, successors, executors, and administrators, and
Whereas, the tax for the taxable period prior to the change of residence would have been increased by the amount of
if the election had not been made, and
Whereas, Conn. Gen. Stat. §12-717 requires a taxpayer to file a bond to secure future payments of tax calculated on the
amount of deferred income as if no change of residence occurred thereunder;
Now, therefore, the condition of this bond is such that if the principal shall pay the full amount of tax, and any penalties and
interest thereon, deferred for the taxable year _____________ by reason of the election under Conn. Gen. Stat. §12-717(c)(4) or
shall report for the applicable taxable years all items of income, gain, loss, or deduction which were accruable for the taxable
period immediately prior to such principal’s change of residence and which would otherwise have been required to be included
in the principal’s return for such period, then this obligation is to be void; otherwise, it shall be irrevocable and remain in full force
and effect. The obligations of the principal and surety under this bond may not be changed or terminated orally.
In witness whereof, said principal and surety have signed and sealed this instrument this
Note: Add acknowledgments
by both principal and surety,
financial statement of surety, etc.
Principal (Spouse)
Extracted from PDF file 2017-connecticut-form-ct-12-717a.pdf, last modified March 2017
More about the Connecticut Form CT-12-717A Individual Income Tax
We last updated the Change of Resident Status - Special Accruals Connecticut Surety Bond Form in January 2018, and the latest form we have available is for tax year 2017. This means that we don't yet have the updated form for the current tax year. Please check this page regularly, as we will post the updated form as soon as it is released by the Connecticut Department of Revenue Services. You can print other Connecticut tax forms here.
TaxFormFinder has an additional 85 Connecticut income tax forms that you may need, plus all federal income tax forms. These related forms may also be needed with the Connecticut Form CT-12-717A.
Form CT-12-717B Change of Resident Status - Special Accruals Other Acceptable Security Form
Connecticut usually releases forms for the current tax year between January and April. We last updated Connecticut Form CT-12-717A from the Department of Revenue Services in January 2018.
Original Form PDF is http://www.ct.gov/drs/lib/drs/forms/1-2017/income/ct-12-717a.pdf
Historical Past-Year Versions of Connecticut Form CT-12-717A
We have a total of seven past-year versions of Form CT-12-717A in the TaxFormFinder archives, including for the previous tax year. Download past year versions of this tax form as PDFs here:
2017 Form CT-12-717A
CT-12-717A, Change of Resident Status - Special Accruals Connecticut Surety Bond Form
2016 Form CT-12-717A
Form CT 12-717A, Change of Resident Status - Special Accruals Connecticut Surety Bond Form
2015 Form CT-12-717A
2014 Form CT-12-717A
2013 Form CT-12-717A
2012 Form CT-12-717A
2011 Form CT-12-717A
Source: http://www.taxformfinder.org/connecticut/form-ct-12-717a