1040 U.S.

Individual Income Tax Return 2019

Form Department of the Treasury—Internal Revenue Service (99)
OMB No. 1545-0074 IRS Use Only—Do not write or staple in this space.

Filing Status Single Married filing jointly Married filing separately (MFS) Head of household (HOH) Qualifying widow(er) (QW)
Check only If you checked the MFS box, enter the name of spouse. If you checked the HOH or QW box, enter the child’s name if the qualifying person is
one box.
a child but not your dependent. a
Your first name and middle initial Last name Your social security number
larissa duarte 685-42-6438
If joint return, spouse’s first name and middle initial Last name Spouse’s social security number
francisco soares 044-84-9195
Home address (number and street). If you have a P.O. box, see instructions. Apt. no. Presidential Election Campaign
Check here if you, or your spouse if filing
206 Steep Hill Rd
jointly, want $3 to go to this fund.
City, town or post office, state, and ZIP code. If you have a foreign address, also complete spaces below (see instructions). Checking a box below will not change your
Weston CT 06883-1927 tax or refund. You Spouse
Foreign country name Foreign province/state/county Foreign postal code If more than four dependents,
see instructions and  here a

Standard Someone can claim: You as a dependent Your spouse as a dependent

Deduction Spouse itemizes on a separate return or you were a dual-status alien

Age/Blindness You: Were born before January 2, 1955 Are blind Spouse: Was born before January 2, 1955 Is blind
Dependents (see instructions): (2) Social security number (3) Relationship to you (4)  if qualifies for (see instructions):
(1) First name Last name Child tax credit Credit for other dependents

1 Wages, salaries, tips, etc. Attach Form(s) W-2 . . . . . . . . . . . . . . . . . . 1 49,367.

2a Tax-exempt interest . . . . 2a b Taxable interest. Attach Sch. B if required 2b
3a Qualified dividends . . . . 3a b Ordinary dividends. Attach Sch. B if required 3b
Standard
Deduction for— 4a IRA distributions . . . . . 4a b Taxable amount . . . . . . 4b
• Single or Married
filing separately,
c Pensions and annuities . . . 4c d Taxable amount . . . . . . 4d
$12,200 5a Social security benefits . . . 5a b Taxable amount . . . . . . 5b
• Married filing
6 Capital gain or (loss). Attach Schedule D if required. If not required, check here . . . . . . . a 6
jointly or Qualifying
widow(er), 7a Other income from Schedule 1, line 9 . . . . . . . . . . . . . . . . . . . . 7a 0.
$24,400
• Head of b Add lines 1, 2b, 3b, 4b, 4d, 5b, 6, and 7a. This is your total income . . . . . . . . . . . a 7b 49,367.
household,
$18,350
8a Adjustments to income from Schedule 1, line 22 . . . . . . . . . . . . . . . . . 8a
• If you checked b Subtract line 8a from line 7b. This is your adjusted gross income . . . . . . . . . . . a 8b 49,367.
any box under
Standard 9 Standard deduction or itemized deductions (from Schedule A) . . . . . 9 24,400.
Deduction, 10 Qualified business income deduction. Attach Form 8995 or Form 8995-A . . . 10
see instructions.
11a Add lines 9 and 10 . . . . . . . . . . . . . . . . . . . . . . . . . 11a 24,400.
b Taxable income. Subtract line 11a from line 8b. If zero or less, enter -0- . . . . . . . . . . . 11b 24,967.
For Disclosure, Privacy Act, and Paperwork Reduction Act Notice, see separate instructions. Form 1040 (2019)
 Form 1040 (2019) Page 2
12a Tax (see inst.) Check if any from Form(s): 1 8814 2 4972 3 12a 2,609.
b Add Schedule 2, line 3, and line 12a and enter the total . . . . . . . . . . . . . . a 12b 2,609.
13a Child tax credit or credit for other dependents . . . . . . . . . . 13a
b Add Schedule 3, line 7, and line 13a and enter the total . . . . . . . . . . . . . . a 13b
14 Subtract line 13b from line 12b. If zero or less, enter -0- . . . . . . . . . . . . . . . 14 2,609.
15 Other taxes, including self-employment tax, from Schedule 2, line 10 . . . . . . . . . . . . 15 0.
16 Add lines 14 and 15. This is your total tax . . . . . . . . . . . . . . . . . . a 16 2,609.
17 Federal income tax withheld from Forms W-2 and 1099 . . . . . . . . . . . . . . . 17 4,173.
• If you have a
18 Other payments and refundable credits:
qualifying child, a Earned income credit (EIC) . . . . . . . . . . . . No
. . . 18a
attach Sch. EIC.
• If you have b Additional child tax credit. Attach Schedule 8812 . . . . . . . . . 18b
nontaxable c American opportunity credit from Form 8863, line 8 . . . . . . . . 18c
combat pay, see
instructions. d Schedule 3, line 14 . . . . . . . . . . . . . . . . . 18d
e Add lines 18a through 18d. These are your total other payments and refundable credits . . . . . a 18e
19 Add lines 17 and 18e. These are your total payments . . . . . . . . . . . . . . . a 19 4,173.
Refund 20 If line 19 is more than line 16, subtract line 16 from line 19. This is the amount you overpaid . . . . . . 20 1,564.
21a Amount of line 20 you want refunded to you. If Form 8888 is attached, check here . . . . . . a 21a 1,564.
Direct deposit? a b Routing number 0 2 1 1 0 1 1 0 8 a c Type: Checking Savings
See instructions.
a d Account number 8 9 9 9 3 0 8 2 5 0
22 Amount of line 20 you want applied to your 2020 estimated tax . . . . a 22
Amount 23 Amount you owe. Subtract line 19 from line 16. For details on how to pay, see instructions . . . . . a 23
You Owe 24 Estimated tax penalty (see instructions) . . . . . . . . . . . a 24
Third Party Do you want to allow another person (other than your paid preparer) to discuss this return with the IRS? See instructions. Yes. Complete below.
Designee No
(Other than Designee’s Phone Personal identification
paid preparer) name a no. a number (PIN) a

Sign Under penalties of perjury, I declare that I have examined this return and accompanying schedules and statements, and to the best of my knowledge and belief, they are true,
correct, and complete. Declaration of preparer (other than taxpayer) is based on all information of which preparer has any knowledge.
Here Your signature Date Your occupation If the IRS sent you an Identity
Protection PIN, enter it here
F

Joint return? Nanny (see inst.)

See instructions. Spouse’s signature. If a joint return, both must sign. Date Spouse’s occupation If the IRS sent your spouse an
Keep a copy for Identity Protection PIN, enter it here
your records. (see inst.)
Construction Worker
Phone no. Email address
Preparer’s name Preparer’s signature Date PTIN Check if:
Paid 3rd Party Designee
Preparer Self-employed
Firm’s name a Self-Prepared Phone no.
Use Only
Firm’s address a Firm’s EIN a

Go to www.irs.gov/Form1040 for instructions and the latest information. BAA REV 02/23/20 Intuit.cg.cfp.sp Form 1040 (2019)
larissa duarte & francisco REV 02/07/20 Intuit.cg.cfp.sp

Do not send this sheet with your return.

&KHFNOLVWIRU¿OLQJ\RXU&RQQHFWLFXWLQFRPHWD[UHWXUQ
 %HVXUHWKDW3DJHRI\RXUUHWXUQLVQRWSULQWHGRQWKHEDFNRIWKLVVKHHW
 9HULI\WKDWWKHDGGUHVVOLQHVRQWKHUHWXUQDUHFRUUHFWDQGSURSHUDEEUHYLDWLRQVDUHXVHG
 ,IWKH(PSOR\HURU3D\HU¶V)HGHUDO,'LVQRWOLVWHGRQ3DJH/LQHVDWKURXJKH&ROXPQ$all withholding claimed
ZLOOEHGLVDOORZHGDQG\RXUUHWXUQZLOOQRWEHVXFFHVVIXOO\SURFHVVHG
 'RQRWDWWHPSWWRUHPRYHRUPRGLI\WKHVROLGER[HVWKDWSULQWRXWRQ\RXUUHWXUQ$OWHULQJWDUJHWPDUNVPD\D൵HFWWKH
processing of your return.
 'RQRWVHQG³'UDIW´RU³8QDSSURYHG´YHUVLRQVRI\RXUUHWXUQ7KLVZLOOGHOD\RUVWRSWKHSURFHVVLQJRI\RXUUHWXUQ
 'RQRWPDNHPDQXDOKDQGZULWWHQRUW\SHGFRUUHFWLRQVWR\RXUUHWXUQWKLVLVDPDFKLQHUHDGDEOHUHWXUQ&KDQJHVPD\RQO\
EHPDGHE\UHHQWHULQJLQIRUPDWLRQLQ\RXUVRIWZDUHDQGUHSULQWLQJWKHUHWXUQ
 'RQRWXVHWKLVUHWXUQWRFKDQJHRUDPHQGSUHYLRXVO\¿OHGUHWXUQV<RXPXVWXVH)RUP&7;WRFKDQJHRUDPHQGD
SUHYLRXVO\¿OHG&RQQHFWLFXWLQFRPHWD[UHWXUQ)LOH)RUP&7;HOHFWURQLFDOO\DWwww.ct.gov/TSC using the Taxpayer
6HUYLFH&HQWHU
8. Do not attach or send copies of forms W-2 or 1099.
9. Send allFRPSOHWHGSDJHVRI&76FKHGXOH&7(,7&6FKHGXOH&7&+(76XSSOHPHQWDO6FKHGXOH
&7:+6FKHGXOH&7,7&UHGLW6FKHGXOH&73(DQG)RUP&76HQGall four pages of your completed return,
ERWKSDJHVRI\RXUFRPSOHWHG&7(,7&VFKHGXOHWKHFRPSOHWHG6FKHGXOH&7&+(7DQGDQ\RWKHUVXSSRUWLQJVFKHGXOHV
 0DNHFKHFNSD\DEOHWR&RPPLVVLRQHURI5HYHQXH6HUYLFHV
 7RHQVXUHSURSHUSRVWLQJZULWH\RXU661VRSWLRQDODQG³)RUP&7´RQ\RXUFKHFN
12. To mail your return, use the following addresses:
For all tax returns with payment:
Department of Revenue Services
   32%R[
   +DUWIRUG&7
For refunds and tax returns without payment:
Department of Revenue Services
   32%R[
   +DUWIRUG&7
 9HULI\WKDWDOO¿HOGVSULQWFRPSOHWHO\DQGDQ\SUHSDUHULQIRUPDWLRQLV¿OOHGRXWDQGOHJLEOHEHIRUH¿OLQJWKLVUHWXUQ,I\RX
¿QGDQ\HUURUVGRQRWPDNHPDQXDOFKDQJHV5HHQWHULQIRUPDWLRQLQ\RXUVRIWZDUHDQGUHSULQWWKHUHWXUQ
 ,I\RXZLVKWRGLUHFWO\GHSRVLWDUHIXQGLQWRDFKHFNLQJRUVDYLQJVEDQNDFFRXQWFRQ¿UPWKDW/LQHVDWKURXJKGKDYH
EHHQFRPSOHWHG<RXmustHQWHUEDQNLQIRUPDWLRQRQERWKWKHIHGHUDODQG&RQQHFWLFXWUHWXUQVIRUHDFKWREHFRUUHFWO\
deposited.
 :KHQPDNLQJSD\PHQWXVLQJ)RUP&79DO NOTDWWDFKFRSLHVRI\RXUSUHYLRXVO\¿OHG)RUP&7
 REV 02/07/20 INTUIT.CG.CFP.SP

10401219V011555 Form CT-1040 - 2019

Connecticut Resident Income Tax Return
(Rev. 12/19)
Page 1 of 4

Other tax year, beginning: and ending:

N S Y FJ N MFS N HOH N QW

685 - 42 - 6438 044 - 84 - 9195

LARISSA DUARTE N Dec.

FRANCISCO SOARES N Dec.

206 STEEP HILL RD N CT-8379 N CT-2210

N CT-1040 CRC

WESTON CT 06883 - 1927 y

1. Federal adjusted gross income (from federal Form 1040, Line 8b or federal Form 1040-SR, Line 8b) 1. 49367
2. Additions to federal adjusted gross income (from Schedule 1, Line 38) 2. 0
3. Add Line 1 and Line 2 3. 49367
4. Subtractions from federal adjusted gross income (from Schedule 1, Line 50) 4. 0
5. Connecticut adjusted gross income: Line 4 subtracted from Line 3. 5. 49367
6. Income tax 6. 823
7. Credit for income taxes paid to qualifying jurisdictions (from Schedule 2, Line 59) 7. 0
8. Line 7 subtracted from Line 6. If Line 7 is greater than Line 6, “0” is entered. 8. 823
à 9. Connecticut alternative minimum tax (from Form CT-6251) 9. 0
10. Add Line 8 and Line 9. 10. 823
11. Credit for property taxes paid on your primary residence, motor vehicle, or both (from Schedule 3, Line 68) 11. 0
Do not send W-2 or 1099 forms.
Clip check here. Do not staple.

12. Line 11 subtracted from Line 10. If less than zero, “0” is entered. 12. 823
13. Total allowable credits (from Schedule CT-IT Credit, Part 1, Line 11) 13. 0
14. Connecticut income tax: Line 13 subtracted from Line 12. If less than zero, “0” is entered. 14. 823
15. Individual use tax (from Schedule 4, Line 69). If no tax is due, “0” is entered. 15. 0
16. Total tax: Add Line 14 and Line 15. 16. 823

10401219V011555
 REV 02/07/20 INTUIT.CG.CFP.SP

Form CT-1040, Page 2 of 4

10401219V021555 y 685426438
17. Amount from Line 16 17. 823
Forms W-2, W-2G, and 1099 Information
Col. A - Employer or Payer’s Fed. ID # Col. B - CT Wages, Tips, etc. Col. C - CT Income Tax Withheld

18a. 82 - 1668850 y 28768 333

18b. 06 - 0967800 y 16414 1147
18c. 06 - 1367424 y 4185 120
18d. - y 0 0
18e. - y 0 0
18f. Additional Connecticut withholding (from Supplemental Schedule CT-1040WH, Line 3) 18f. 0
18. Total Connecticut income tax withheld: Amounts in Column C. 18. 1600
19. All 2019 estimated tax payments and any overpayments applied from a prior year 19. 0
20. Payments made with Form CT-1040 EXT 20. 0
20a. Earned income tax credit (from Schedule CT-EITC, Line 16). 20a. 0
20b. Claim of right credit (from Form CT-1040 CRC, Line 6). 20b. 0
20c. Pass-through entity tax credit: (from Schedule CT-PE, Line 1). Schedule must be attached. 20c. 0
21. Total payments and refundable credits: Add Lines 18, 19, 20, 20a, 20b and 20c. 21. 1600
22. Overpayment: If Line 21 is more than Line 17, Line 17 subtracted from Line 21. 22. 777

23. Amount of Line 22 you want applied to your 2020 estimated tax 23. 0
24. Amount of Line 22 you want applied as a CHET contribution (from Schedule CT-CHET, Line 4) 24. 0
24a. Total contributions of refund to designated charities (from Schedule 5, Line 70) 24a. 0
25. Refund: Lines 23, 24, and 24a subtracted from Line 22.  777
If you have not elected to direct deposit, a refund check will be issued and processing may be delayed.
25a. Acct. type Y Ck. N Sv. 25b. Rout. # 021101108 25c. Acct. # 8999308250
25d. Refund going to a bank account outside the U.S. 25d. N
26. Tax due: If Line 17 is more than Line 21, Line 21 subtracted from Line 17. 26. 0
27. If late: Penalty entered. Line 26 multiplied by 10% (.10). 27. 0
28. If late: Interest entered.
Line 26 multiplied by number of months or fraction of a month late, then by 1% (.01). 28. 0
29. Interest on underpayment of estimated tax (from Form CT-2210) 29. 0
30. Total amount due: Add Lines 26 through 29. 30. 0.00
Declaration: I declare under penalty of law that I have examined this return and all accompanying schedules and statements,
including reporting and payment of any use tax due, and, to the best of my knowledge and belief, it is true, complete, and
FRUUHFW,XQGHUVWDQGWKHSHQDOW\IRUZLOOIXOO\GHOLYHULQJDIDOVHUHWXUQRUGRFXPHQWWR'56LVD¿QHRIQRWPRUHWKDQRU
LPSULVRQPHQWIRUQRWPRUHWKDQ¿YH\HDUVRUERWK7KHGHFODUDWLRQRIDSDLGSUHSDUHURWKHUWKDQWKHWD[SD\HULVEDVHGRQDOO
information of which the preparer has any knowledge.
Your signature Date Home/cell telephone number

y y 2035239774
Keep a copy for your records.

Spouse’s signature (if joint return) Date Daytime telephone number

y y y
Sign Here

3DLGSUHSDUHU¶VVLJQDWXUH 'DWH 7HOHSKRQHQXPEHU 3DLG3UHSDUHU¶V37,1

y SELF-PREPARED y y
3DLGSUHSDUHU¶VQDPH   )(,1

Firm’s name, address and ZIP code Self-employed

y - N
Third Party Designee - Complete the following to authorize DRS to contact another person about this return.
'HVLJQHH¶VQDPH 7HOHSKRQHQXPEHU 3HUVRQDOLGHQWL¿FDWLRQQXPEHU3,1

y y y

10401219V021555
 REV 02/07/20 INTUIT.CG.CFP.SP

Form CT-1040, Page 3 of 4

10401219V031555 y 685426438

6FKHGXOH0RGL¿FDWLRQVWR)HGHUDO$GMXVWHG*URVV,QFRPH
31. Interest on state and local government obligations other than Connecticut 31. 0
32. Mutual fund exempt-interest dividends from non-Connecticut state or municipal government
obligations 32. 0
7D[DEOHDPRXQWRIOXPSVXPGLVWULEXWLRQVIURPTXDOL¿HGSODQVQRWLQFOXGHGLQIHGHUDODGMXVWHG
gross income 33. 0
%HQH¿FLDU\¶VVKDUHRI&RQQHFWLFXW¿GXFLDU\DGMXVWPHQW(QWHUHGRQO\LIJUHDWHUWKDQ]HUR  0
35. Loss on sale of Connecticut state and local government bonds 35. 0
36. Section 168(k) federal bonus depreciation deduction allowed for property placed in service during this year. 36. 0
36a. 80% of Section 179 federal deduction. 36a. 0
37. Other - specify y 37. 0
38. Total additions: Add Lines 31 through 37. 38. 0
39. Interest on U.S. government obligations 39. 0
40. Exempt dividends from certain qualifying mutual funds derived from U.S. government obligations 40. 0
6RFLDO6HFXULW\EHQH¿WDGMXVWPHQWIURP6RFLDO6HFXULW\%HQH¿W$GMXVWPHQW:RUNVKHHW  0
42. Refunds of state and local income taxes 42. 0
7LHUDQG7LHUUDLOURDGUHWLUHPHQWEHQH¿WVDQGVXSSOHPHQWDODQQXLWLHV  0
44. Military retirement pay 44. 0
45. 25% of Connecticut teacher’s retirement pay 45. 0
%HQH¿FLDU\¶VVKDUHRI&RQQHFWLFXW¿GXFLDU\DGMXVWPHQW(QWHUHGRQO\LIOHVVWKDQ]HUR  0
47. Gain on sale of Connecticut state and local government bonds 47. 0
48. CHET contributions made in 2019 or
an excess carried forward from a prior year Acct. #: 48. 0
48a. 25% of Section 168(k) federal bonus depreciation deduction added back in preceding two years. 48a. 0
48b. 14% of pension or annuity income. 48b. 0
49. Other - specify y 49. 0
50. Total subtractions: Add Lines 39 through 49. 50. 0
Schedule 2 - Credit for Income Taxes Paid to Qualifying Jurisdictions
0RGL¿HG&RQQHFWLFXWDGMXVWHGJURVVLQFRPH   0
Col. A Col. B

52. Qualifying jurisdiction’s name and two-letter code 52.

1RQ&RQQHFWLFXWLQFRPHLQFOXGHGRQ/LQHDQGUHSRUWHGRQD
qualifying jurisdiction’s income tax return (from Schedule 2 worksheet) 53. 0 0
54. Line 53 divided by Line 51 54. 0.0000 0.0000
55. Income tax liability: Line 11 subtracted from Line 6. 55. 0 0
56. Line 54 multiplied by Line 55 56. 0 0
57. Income tax paid to a qualifying jurisdiction 57. 0 0
58. Lesser of Line 56 or Line 57 58. 0 0
59. Total credit: Add Line 58, all columns. 59. 0

10401219V031555
 REV 02/07/20 INTUIT.CG.CFP.SP

Form CT-1040, Page 4 of 4

10401219V041555 y 685426438
Schedule 3 - Property Tax Credit

N 65 years or older N One or more dependents on federal return

Qualifying Property Primary Residence Auto 1 Auto 2

1DPHRI&RQQHFWLFXW7D[7RZQRU'LVWULFW y y y
Description of Property y y y
Date(s) Paid y y y
y y y
Amount Paid 60. 0 61. 0 62. 0
63. Total property tax paid: Add Lines 60, 61, and 62. 63. 0
64. Maximum property tax credit allowed 64. y 0
65. Lesser of Line 63 or Line 64. 65. y 0
66. Property tax credit limitation decimal amount: If zero, the amount from Line 65 is entered on Line 68. 66. y 0.00
67. Line 65 multiplied by Line 66. 67. y 0
68. Line 67 subtracted from Line 65. 68. 0
Schedule 4 - Individual Use Tax
69a. Use tax at 1% (from Connecticut Individual Use Tax Worksheet, Section A, Column 7) 69a. 0
69b. Use tax at 6.35% (from Connecticut Individual Use Tax Worksheet, Section B, Column 7) 69b. 0
69c. Use tax at 7.75% (from Connecticut Individual Use Tax Worksheet, Section C, Column 7) 69c. 0
69d. Use tax at 2.99% (from Connecticut Individual Use Tax Worksheet, Section D, Column 7) 69d. 0

69. Individual use tax: Add Lines 69a, 69b, 69c, and 69d. 69. y 0
6FKHGXOH&RQWULEXWLRQVWR'HVLJQDWHG&KDULWLHV
70a. AR 70a. 0
70b. OT 70b. 0
70c. ES/W 70c. 0
70d. BCR 70d. 0
H616 H 0
70f. MR 70f. 0
70g. CBS 70g. 0
70h. MHCIA 70h. 0
70. Total Contributions: Add Lines 70a through 70h. 70. 0
Taxpayer email

10401219V041555