Utah Fiduciary Supplemental Schedule

Fiduciary Supplemental Schedule
2023 Utah TC-41 Fiduciary Income Tax Return
Clear form

2023

Utah State Tax Commission

41301

Utah Fiduciary Income Tax Return

9998
For calendar year 2023 or fiscal year ending (mm/yy)

TC-41
/

US
STC ORIGINAL FORM

Amended Return - enter code (1-5) •

“X” if federal form 8886 filed

•

Name of estate or trust
EIN or SSN
Name of fiduciary
Fiduciary address

“X” if this is an SSN:

City

State

Zip + 4

Foreign country (if not U.S.)

1 Type of return - enter code
•

2 Status code

3 “X” if this estate or trust

A = Bankruptcy estate Ch. 7

E = Decedent’s estate

S = Simple trust

B = Bankruptcy estate Ch. 11

F = Qualified funeral trust (QFT)

T = ESBT

has any

C = Complex trust

G = Grantor type trust

N = Nonresident

D = Qualified disability trust

H = Charitable trust

P = Part-year resident

R = Resident

•

nonresident

•

beneficiaries

4

Federal total income from federal form 1041 line 9 or 1041-QFT line 5

• 4

.00

5

Additions to income from TC-41A, Part 1 (only include amounts taxed at the trust level)

• 5

.00

6

Total adjusted income - add line 4 and line 5

6

.00

7

Fiduciary fees for administering estate or trust and deducted on federal return (1041, line 12)

• 7

.00

8

Income distribution deduction (1041, line 18)

• 8

.00

9

Estate tax deduction, including certain generation-skipping transfer taxes (1041, line 19)

• 9

.00

10 Exemption (1041, line 21)

• 10

.00

11 State tax refund included in federal total income

• 11

.00

12 Subtractions from income from TC-41A, Part 2. Only include amounts that apply to income taxed at trust level.

• 12

.00

13

.00

14 Utah taxable income/loss - subtract line 13 from line 6

• 14

.00

15 Utah tax - multiply line 14 by 4.65% (.0465) (not less than zero)

• 15

.00

13 Total deductions - add lines 7 through 12

16 Allowable deductions for estate or trust credit (from worksheet)

• 16

.00

17 Initial credit before phase-out - multiply line 16 by 6% (.06)

• 17

.00

18 Base phase-out amount

18

19 Income subject to phase-out - subtract line 18 from line 14 (not less than zero)

19

.00

• 20

.00

20 Phase-out amount - multiply line 19 by 1.3% (.013)
21 Estate or trust tax credit - subtract line 20 from line 17 (not less than zero)
22 Utah income tax - subtract line 21 from line 15 (not less than zero)
Enter amount from line 22 on page 2, line 23

12,000

• 21

.00

22

.00

41302

Utah Fiduciary Income Tax Return (continued)
EIN or SSN

TC-41
2023

Estate/trust name

Pg. 2

USTC ORIGINAL FORM

23 Enter tax from line 22

• 23

.00

24 Apportionable nonrefundable credits from TC-41A, Part 3 (attach TC-41A, page 1)

• 24

.00

25

.00

26 Full-year resident estate or trust - enter tax from line 25 above
Non or part-year resident estate or trust - enter tax from TC-41B, line 21
Bankruptcy estate, see instructions and complete TC-41C

• 26

.00

27 Nonapportionable nonrefundable credits from TC-41A, Part 4 (attach TC-41A, page 1)

• 27

.00

28

.00

29 AMENDED RETURN ONLY - previous refund

• 29

.00

30 Utah use tax

• 30

.00

31 Total pass-through withholding tax - enter the total amount from Schedule N, column K
Note: This amount must be paid by the due date of the return, without extensions

• 31

.00

32

.00

33 Utah tax withheld shown on TC-41W, Part 1 (attach TC-41W, page 1)

• 33

.00

34 Credit for Utah fiduciary tax prepaid from TC-548 and 2021 refund applied to 2023

• 34

.00

35 AMENDED RETURN ONLY - previous payments

• 35

.00

36 Nonapportionable refundable credits from TC-41A, Part 5 (attach TC-41A, page 2)

• 36

.00

37 Apportionable refundable credits from TC-41A, Part 6 (attach TC-41A, page 2)

• 37

.00

38

.00

• 39

.00

40

.00

41 PAY THIS AMOUNT - add line 39 and line 40

• 41

.00

42 REFUND - subtract line 32 from line 38 (not less than zero)

• 42

.00

43 Enter the amount of refund from line 42 you want applied to your 2024 fiduciary tax

• 43

.00

25 Subtract line 24 from line 23 (not less than zero)
Non or Part-year resident estate or trust - complete TC-41B before continuing on line 26

28 Subtract line 27 from line 26 (not less than zero)

32 Total tax, additions and use tax - add lines 28 through 31

38 Total withholding and refundable credits - add lines 33 through 37
39 TAX DUE - subtract line 38 from line 32 (not less than zero)
40 Penalty and interest (see instructions)

Under penalties of perjury, I declare to the best of my knowledge and belief,
this return and accompanying schedules are true, correct and complete.
SIGN Signature of fiduciary or officer representing estate or trust

Date

•

EIN/SSN of fiduciary

HERE
Preparer’s signature
Paid
Preparer’s
Section

“X” if USTC may discuss
this return with preparer below:

Date

Preparer’s telephone number

Preparer’s PTIN
•

Firm’s name and address

Preparer’s EIN
•

41303

Fiduciary Supplemental Schedule
EIN or SSN

TC-41A
2023

Estate/trust name

Pg. 1

USTC ORIGINAL FORM

Part 1 - Additions to Income (enter the code and amount of each addition to income)
See instructions for codes.

Code

Amount

•

.00

•

.00

•

.00

•

.00
.00

Total additions to income (add all additions to income and enter total here and on TC-41, line 5)
Part 2 - Subtractions from Income (enter the code and amount of each subtraction from income)
See instructions for codes.
If using subtraction 77 (Native American Income), enter your enrollment
number and tribal code:
Tribe
Enrollment Number
Code
•

Code

Amount

•

.00

•

.00

•

.00

•

.00
.00

Total subtractions from income (add all subtractions from income and enter total here and on TC-41, line 12)

Part 3 - Apportionable Nonrefundable Credits (enter the code and amount of each credit)
See instructions for codes.

Code

.00

•

.00

•

.00

•

.00

a. Total apportionable nonrefundable credits
b. Less apportionable nonrefundable credit distributed to beneficiaries on Schedule K-1
c. Total apportionable nonrefundable credits claimed by fiduciary
(subtract line b from line a and enter this amount on TC-41, page 2, line 24)
Part 4 - Nonapportionable Nonrefundable Credits (enter the code and amount of each credit)
See instructions for codes.
If using credit 02 (Qualified Sheltered Workshop),
enter the sheltered workshop’s name:

a. Total nonapportionable nonrefundable credits
b. Less nonapportionable nonrefundable credit distributed to beneficiaries on Schedule K-1
c. Total nonapportionable nonrefundable credits claimed by fiduciary
(subtract line b from line a and enter this amount on TC-41, page 2, line 27)
Submit page ONLY if data entered.
Attach completed schedule to your Utah Fiduciary Tax Return.

Amount

•

.00

a.

.00

• b. 91

.00

c.
Code

Amount

•

.00

•

.00

•

.00

•

.00
a.

• b. 92
c.

.00
.00
.00

41304

Fiduciary Supplemental Schedule (continued)
EIN or SSN

TC-41A
2023

Estate/trust name

Pg. 2

USTC ORIGINAL FORM

Part 5 - Nonapportionable Refundable Credits (write the code and amount of each credit)
See instructions for codes.

Code

.00

•

.00

•

.00

•

.00

a. Total nonapportionable refundable credits
b. Less nonapportionable refundable credit distributed to beneficiaries on Schedule K-1
c. Total nonapportionable refundable credits claimed by fiduciary or trust
(subtract line b from line a and enter this amount on TC-41, line 36)
Part 6 - Apportionable Refundable Credits (write the code and amount of each credit)
See instructions for codes.

a. Total apportionable refundable credits
b. Less apportionable refundable credit distributed to beneficiaries on Schedule K-1

.00

a.

.00

• b. 93

.00

c.
Code

Amount

•

.00

•

.00

•

.00

•

.00
a.

• b. 94

c. Subtract line b from line a

c.

d. If you are a nonresident or a part-year resident, enter the apportionment fraction from TC-41C, line 59.
If you are a full-year Utah resident, enter “1”.
e. Total apportionable refundable credits claimed by fiduciary or trust
(multiply line c by line d and enter this amount on TC-41, line 37)

d.

Submit page ONLY if data entered.
Attach completed schedule to your Utah Fiduciary Tax Return.

Amount

•

e.

.00
.00
.00

.00

41305

Non and Part-year Resident Estate or Trust Schedule
EIN or SSN

TC-41B
2023

Estate/trust name

USTC ORIGINAL FORM

Residency Status:
•

Nonresident. Home state abbreviation:

•

Part-year resident from:

/

/

mm/dd/yy

Income

Column A - Utah

to

/

/

mm/dd/yy

Column B - Total

1
2
3
4
5
6
7
8
9

Interest income (1041 line 1)
Total ordinary dividends (1041 line 2a)
Business income or loss (1041 line 3)
Capital gain or loss (1041 line 4)
Rental, royalties, partnerships, other estates and trusts, etc. (1041 line 5)
Farm income or loss (1041 line 6)
Ordinary gain or loss (1041 line 7)
Other income (1041 line 8)
Additions to income from TC-41A, Part 1 (Utah portion only in Utah column)

.00
.00
.00
.00
.00
.00
.00
.00
.00

.00
.00
.00
.00
.00
.00
.00
.00
.00

10

Total income/loss - add lines 1 through 9 for both columns A and B

.00

.00

Deductions

Column A - Utah

Column B - Total

11
12
13
14
15
16

Fiduciary fees for administrating trust and deducted on federal return (1041 line 12)
Income distribution deduction (1041 line 18)
Estate tax deduction, including certain generation-skipping taxes (1041 line 19)
Exemption (1041 line 21)
State tax refund included in federal income
Subtractions from income from TC-41A, Part 2 (Utah portion only in Utah column)

.00
.00
.00
.00
.00
.00

.00
.00
.00
.00
.00
.00

17

Total deductions - add lines 11 through 16 for both columns A and B

.00

.00

18

Subtract line 17 from line 10 for both columns A and B
Line 18, column B must equal TC-41, line 14

.00 •

.00

•

Non or Part-year Resident Estate or Trust Tax
19
20

Divide line 18 column A by line 18 column B (to 4 decimal places)
Do not enter a number greater than 1.0000 or less than 0.0000
Enter tax amount from TC-41, line 25

21

Multiply line 20 by the decimal on line 19. This is your Utah tax. Enter on TC-41, page 2, line 26

Submit page ONLY if data entered.
Attach completed schedule to your Utah Fiduciary Tax return.

19
20

.00

• 21

.00

41306

Bankruptcy Estate Schedule
EIN or SSN

TC-41C
2023

Estate/trust name

Pg. 1

USTC ORIGINAL FORM

Trustee (or debtor-in-possession)

Trustee SSN

1

Federal total income (see instructions)

• 1

.00

2

Federal adjustments from federal form 1040, Schedule 1, line 26

• 2

.00

3

Federal adjusted gross income (subtract line 2 from line 1)

3

.00

4

Additions to income (enter code and amount below and total on line 4 (see codes in TC-40 instructions)
Code
Amount
Code
Amount

4

.00

5

.00

• 6

.00

7

.00

• 4a

.00 • 4b

.00

• 4c

.00 • 4d

.00

5

Add lines 3 and 4

6

State tax refund included on federal form 1040, Schedule 1, line 1

7

Subtractions from income (enter code and amount below and total on line 7 (see codes in TC-40 instructions)
Code
Amount
Code
Amount
• 7a

.00 • 7b

.00

• 7c

.00 • 7d

.00

8

Utah taxable income/loss - subtract the total of lines 6 and 7 from line 5

• 8

.00

9

Utah tax - multiply line 8 by 4.65% (.0465) (not less than zero)

• 9

.00

19 Taxpayer tax credit - subtract line 18 from line 15 (not less than zero)

• 19

.00

20 Utah income tax - Subtract line 19 from line 9 (not less than zero)
Enter the tax from line 20 on TC-41, page 1, line 22
Note: Non or part-year resident bankruptcy estate must also complete TC-41C, page 2

• 20

.00

10 Personal exemption (zero in 2023)

10

11 Enter greater of $13,850 or federal itemized deductions

• 11

.00

12

.00

• 13

.00

14

.00

• 15

.00

12 Add line 10 and line 11
13 State income tax deducted on federal Schedule A, line 5a
14 Subtract line 13 from line 12
15 Initial credit before phase-out - multiply line 14 by 6% (.06)

0

16 Base phase-out amount

16

17 Phase-out income - subtract line 16 from line 8 (not less than zero)

17

.00

• 18

.00

18 Phase-out amount - multiply line 17 by 1.3% (.013)

16,742

Submit this page ONLY if data entered.
Attach completed schedule to your Utah Fiduciary Tax Return.

41307

Bankruptcy Estate Schedule
Non or Part-year Resident (continued)
EIN or SSN

TC-41C
2023

Pg. 2

Estate/trust name

USTC ORIGINAL FORM

Residency Status:

•

Nonresident: Home state abbreviation:

•

Part-year resident from:

/

/

mm/dd/yy

Income
21 Wages, salaries, tips, etc. (1040 line 1z)
22 Taxable interest income (1040 line 2b)
23 Ordinary dividends (1040 line 3b)
24 IRAs, pensions and annuities - taxable amount (1040 lines 4b and 5b)
25 Social Security benefits - taxable amount (1040 line 6b)
26 Taxable refunds/credits/offsets of state/local income tax (1040, Schedule 1, line 1)
27 Alimony received (1040, Schedule 1, line 2a)
28 Business income or loss (1040, Schedule 1, line 3)
29 Capital gain or loss (1040, line 7)
30 Other gains or losses (1040, Schedule 1, line 4)
31 Rental real estate, royalties, partnerships, S corps, trusts, etc. (1040, Schd 1, line 5)
32 Farm income or loss (1040, Schedule 1, line 6)
33 Unemployment compensation (1040, Schedule 1, line 7)
34 Other income (1040, Schedule 1, line 9)
35 Additions to income from TC-40A, Part 1 (Utah portion only in Utah column)
36 Reserved
37 Reserved
38 Total income/loss - add lines 21 through 37 for both columns A and B

Column A - Utah

Adjustments
39 Educator expenses (1040, Schedule 1, line 11)
40 Certain business expenses (1040, Schedule 1, line 12)
41 Health savings account deduction (1040, Schedule 1, line 13)
42 Moving expenses (1040, Schedule 1, line 14) - col. A only expenses moving into Utah
43 Deductible part of self-employment tax (1040, Schedule 1, line 15)
44 Self-employed SEP, SIMPLE and qualified plans (1040, Schedule 1, line 16)
45 Self-employed health insurance deduction (1040, Schedule 1, line 17)
46 Penalty on early withdrawal of savings (1040, Schedule 1, line 18)
47 Alimony paid (1040, Schedule 1, line 19a)
48 IRA deduction (1040, Schedule 1, line 20)
49 Student loan interest deduction (1040, Schedule 1, line 21)
50 Reserved
51 Reserved
52 State tax refund included on federal form 1040, Schedule 1, line 1
53 Subtractions from income from TC-40A, Part 2 (Utah portion only in Utah column)
54 Reserved
55 Reserved
56 (see instructions):
57 Total adjustments - add lines 39 through 56 for both columns A and B

Column A - Utah

58

Subtract line 57 from line 38 for both columns A and B
Line 58, column B must equal TC-41C, page 1, line 8

to

/

Column B - Total

.00
.00
.00
.00
.00
.00
.00
.00
.00
.00
.00
.00
.00
.00
.00
.00
.00
.00

.00
.00
.00
.00
.00
.00
.00
.00
.00
.00
.00
.00
.00
.00
.00
.00
.00
.00
Column B - Total

.00
.00
.00
.00
.00
.00
.00
.00
.00
.00
.00
.00
.00
.00
.00
.00
.00
.00
.00

•

/

mm/dd/yy

.00

.00
.00
.00
.00
.00
.00
.00
.00
.00
.00
.00
.00
.00
.00
.00
.00
.00
.00
.00

•

.00

Non or Part-year Resident Bankruptcy Estate Tax
59 Divide line 58 column A by line 58 column B (to 4 decimal places, not more than 1.0000 or less than 0.0000)

59

60

Enter tax amount from TC-41, line 25

60

.00

61

UTAH TAX - Multiply line 60 by the decimal on line 59. Enter on TC-41, line 26
Submit this page ONLY if data entered.
Attach completed schedule to your Utah Fiduciary Tax Return.

• 61

.00

41308

Schedule K - Beneficiaries’ Share of Income, Deductions and Credits
EIN or SSN

TC-41K
2023

Estate/trust name

USTC ORIGINAL FORM

Ź Number of Schedules K-1 attached to this return:

•

Deductions and Other Information

Income/Loss

Federal Amount

Utah Amount

1a
1b
1c
2

U.S. government interest income
Municipal bond interest income
Other interest income
Ordinary dividends

.00
.00
.00
.00

.00
.00
.00
.00

3
4

Net short-term capital gain
Net long-term capital gain

.00
.00

.00
.00

5
6

Other portfolio and nonbusiness income
Ordinary business income

.00
.00

.00
.00

7
8

Net rental real estate income
Other rental income

.00
.00

.00
.00

9

Directly apportioned deductions (describe)

.00
.00
.00
.00

.00
.00
.00
.00

.00

.00

.00
.00
.00
.00

.00
.00
.00
.00

.00
.00
.00
.00

.00
.00
.00
.00

10 Estate tax deduction
11 Final year deductions (describe)

12 Other information

13 Utah nonrefundable credits - enter the name of the Utah credit

Code

Credit Amount

Utah Credits

.00
.00
.00
.00
14 Utah refundable credits - enter the name of the Utah credit

Code

Credit Amount

•

.00

•

.00

•

.00

•

.00

15 Total Utah tax withheld on behalf of all beneficiaries from Schedule N, column K
Attach completed schedule to your Utah Fiduciary Tax return.

.00

41309

Schedule K-1 - Beneficiary’s Share of Income, Deductions and Credits
EIN or SSN

Estate/trust name

TC-41K-1
2023

USTC ORIGINAL FORM

Estate or Trust Information
A Estate or trust EIN or SSN:
B Estate or trust name

Beneficiary’s Share of Utah Income, Deductions and Credits
1a
Utah U.S. government interest income
1b
Utah taxable municipal bond interest income
1c
Utah other interest income
2
Utah ordinary dividends

.00
.00
.00
.00

3
4

Utah net short-term capital gain
Utah net long-term capital gain

.00
.00

5
6

Utah portfolio and nonbusiness income
Utah ordinary business income

.00
.00

7
8

Utah net rental real estate income
Utah other rental income

.00
.00

9

Utah directly apportioned deductions (describe)

Fiduciary Information
C Fiduciary name, address, city, state, and ZIP code

.00
.00
.00
.00

Beneficiary Information
D Beneficiary’s EIN or SSN
E Beneficiary’s name, address, city, state, and ZIP code
10
11

F

Estate tax deduction
Final year Utah deductions (describe)

.00
.00
.00
.00

Beneficiary’s phone number

G Percent of Utah income distributed to
the beneficiary
H Dependent Beneficiary - enter “X”
“Statement of Dependent Beneficiary Income” on file with trustee
(See Schedule N instructions for definition of dependent beneficiary.)
Other Information

.00

12

Other Utah information

.00
.00
.00
.00
13

Utah nonrefundable credits distributed to beneficiary
Name of credit
Code
Amount

.00
.00
.00
.00
14

Utah refundable credits distributed to beneficiary
Name of Credit
Code
Amount

.00
.00
.00
.00

Tax Commission Use Only:

15

Utah tax withheld on behalf of beneficiary
“X” if withholding waiver applied for

.00

41310

Schedule N - Pass-through Entity Withholding Tax
EIN or SSN

TC-41N
2023

Estate/trust name

An estate or trust with nonresident individual beneficiaries, resident/nonresident business beneficiaries, or resident/nonresident trust or estate
beneficiaries must complete the information below to report the Utah income and to calculate the Utah withholding tax for these beneficiaries.

.
WITHHOLDING WAIVER CLAIMED under §59-10-1403.2(5): If beneficiaries will pay the Utah tax on their own returns:
•
Enter "1" to claim a waiver for ALL beneficiaries (enter "X" in column B and "0" in column F for all beneficiaries)
Enter "2" to claim a waiver for SOME beneficiaries (enter "X" in column B and "0" in column F for those beneficiaries claimed)
See Schedule N instructions for liability responsibilities when claiming a waiver.
A Name of beneficiary
F Income/loss
G 4.65% of income - H Mineral production K
B Withholding waiver for this beneficiary
attributable to Utah
F times .0465
withholding credit
(enter “X” in column B and “0” in column F)
(not less than zero) I
Tax paid by PTE
C “X” if Dependent Beneficiary
J Upper-tier passD SSN or EIN of Beneficiary
E Beneficiary’s % of income
through withholding

#1 A

F

.00 G

.00 H

.00 K

• B

•C

I

.00

• D

E

J

.00

#2 A

F

.00 G

.00 H

.00 K

• B

•C

I

.00

• D

E

J

.00

#3 A

F

.00 G

.00 H

.00 K

• B

•C

I

.00

• D

E

J

.00

#4 A

F

.00 G

.00 H

.00 K

• B

•C

I

.00

• D

E

J

.00

#5 A

F

.00 G

.00 H

.00 K

• B

•C

I

.00

• D

E

J

.00

#6 A

F

.00 G

.00 H

.00 K

• B

•C

I

.00

• D

E

J

.00

#7 A

F

.00 G

.00 H

.00 K

• B

•C

I

.00

• D

E

J

.00

Report the beneficiary’s pass-through withholding
tax from column K on Schedule K-1, line 15

Total Utah withholding tax to be paid by this fiduciary:
Enter on TC-41, line 31 and on Sch. K, line 15.

Withholding tax
to be paid by
this fiduciary G less H, I and J
(not less than 0)

.00

.00

.00

.00

.00

.00

.00

.00

41311

Credit for Income Tax Paid to Another State
EIN or SSN

TC-41S
2023

Estate/trust name

NOTE: Part-year resident estates/trusts rarely qualify for this credit. Nonresident estates/trusts do not qualify for this credit. See instructions.
FIRST STATE
.00
1 Enter only taxable income taxed by both Utah and state of:
1
Utah taxable income from TC-41 line 14, or TC-41C line 8, if applicable

3

Divide line 1 by line 2; round to 4 decimal places. Do not enter a number greater than 1.0000.

4

Utah fiduciary tax from TC-41, line 22. Part-year residents, see instructions.

4

.00

5

Credit limitation - multiply line 4 by decimal on line 3

5

.00

6

Actual fiduciary tax paid to state shown on line 1
Part-year residents must prorate tax paid to other state. Credit only applies
to the portion of actual taxes paid to the other state on income shown on line 1.

6

.00

7

Credit for tax paid another state - lesser of line 5 or line 6

SECOND STATE
1 Enter only taxable income taxed by both Utah and state of:

2

.00

2

3

7

1

.00

2

.00

2

Utah taxable income from TC-41 line 14, or TC-41C line 8, if applicable

3

Divide line 1 by line 2; round to 4 decimal places. Do not enter a number greater than 1.0000.

4

Utah fiduciary tax from TC-41, line 22. Part-year residents, see instructions.

4

.00

5

Credit limitation - multiply line 4 by decimal on line 3

5

.00

6

Actual fiduciary tax paid to state shown on line 1
Part-year residents must prorate tax paid to other state. Credit only applies
to the portion of actual taxes paid to the other state on income shown on line 1.

6

.00

7

Credit for tax paid another state - lesser of line 5 or line 6

THIRD STATE
1 Enter only taxable income taxed by both Utah and state of:

3

7

1

.00

2

.00

2

Utah taxable income from TC-41 line 14, or TC-41C line 8, if applicable

3

Divide line 1 by line 2; round to 4 decimal places. Do not enter a number greater than 1.0000.

4

Utah fiduciary tax from TC-41, line 22. Part-year residents, see instructions.

4

.00

5

Credit limitation - multiply line 4 by decimal on line 3

5

.00

6

Actual fiduciary tax paid to state shown on line 1
Part-year residents must prorate tax paid to other state. Credit only applies
to the portion of actual taxes paid to the other state on income shown on line 1.

6

.00

7

Credit for tax paid another state - lesser of line 5 or line 6

Use additional forms TC-41S if claiming credits for more than three states.
Enter the total of all amounts shown line 7 above on TC-41A, Part 4, using code 17.
Submit page ONLY if data entered.
Attach completed schedule to your Utah Fiduciary Tax return.

.00

.00

3

7

.00

41312

Part 1 - Utah Withholding Tax Schedule
EIN or SSN

TC-41W
2023

Estate/trust name

Pg. 1

USTC ORIGINAL FORM

Line Explanations

IMPORTANT

1
2

Do not send your W-2s or 1099s with your return. Instead enter
W-2 or 1099 information below, but only if there is Utah withholding
on the form.

3
4
5
6
7

Employer/payer ID number from W-2 box “b” or 1099
Utah withholding ID number from W-2 box “15” or 1099
(14 characters, ending in WTH, no hyphens)
Employer/payer name and address from W-2 box “c” or 1099
Enter “X” if reporting Utah withholding from form 1099
Employee’s Social Security number from W-2 box “a” or 1099
Utah wages or income from W-2 box “16” or 1099
Utah withholding tax from W-2 box “17” or 1099

First W-2 or 1099
1

Use additional forms TC-41W if you have more than four W-2s and/or
1099s with Utah withholding tax.
Enter mineral production withholding from TC-675R in Part 2 of TC-41W;
enter pass-through entity withholding in Part 3 of TC-41W.
Second W-2 or 1099
1

2

(14 characters, no hyphens)

2

3

3

4

4

5

5

(14 characters, no hyphens)

6

.00

6

.00

7

.00

7

.00

Third W-2 or 1099
1

Fourth W-2 or 1099
1

2

(14 characters, no hyphens)

2

3

3

4

4

5

5

(14 characters, no hyphens)

6

.00

6

.00

7

.00

7

.00

Enter total Utah withholding tax from all lines 7 here and on TC-41, line 33:
Submit page ONLY if data entered.
Attach completed schedule to your Utah Fiduciary Tax Return.
Do not attach W-2s or 1099s to your Utah return.

.00

41313

Mineral Production and Pass-through Withholding
EIN or SSN

TC-41W
2023

Estate/trust name

USTC ORIGINAL FORM

Pg. 2

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-41Ws if needed.
Line Explanations
1 Producer’s EIN number 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)

4

3

(14 characters, no hyphens)

4

.00

5

5

.00

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

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

2

2

3

(14 characters, no hyphens)

4

3

(14 characters, no hyphens)

4

.00

5

5

.00

Enter total mineral production withholding tax from all lines 5 here and on TC-41A, Part 5, using code 46.

.00

Part 3 -Utah Pass-through Entity Taxpayer Withholding - Utah Schedule K-1
Do not send Utah Schedule(s) K-1 with return. Enter information below. Use additional TC-41Ws if needed.
Line Explanations
1 Pass-through entity EIN from Utah Schedule K-1 box “A”
2 Name of pass-through entity from Utah Schedule K-1 box “B”
3 Utah withholding tax paid by pass-through entity
First Utah Schedule K-1
Second Utah Schedule K-1
1
1
2

2

.00

3

3

Third Utah Schedule K-1
1

Fourth Utah Schedule K-1
1

2

2

3

.00

3

.00

.00

Enter total pass-through withholding tax from all lines 3 here and on TC-41A, Part 5, using code 43:
Submit page ONLY if data entered.
Attach completed schedule to your Utah Fiduciary Tax Return.

.00

25301

Credits Received from Upper-tier Pass-through Entities
and Mineral Production Withholding Tax Credit on TC-675R

TC-250
2023

EIN

(use with TC-20S, TC-41 and TC-65)

USTC ORIGINAL FORM

Part 1 - Utah Nonrefundable Credits Received from Upper-tier Pass-through Entities
Upper-tier pass-through
entity EIN from Utah
Sch. K-1, box “A”

Name of upper-tier pass-through entity
from Utah Schedule K-1, box “B”

Credit
Code

UT nonrefundable
credit from
Utah Sch. K-1

1
2
3
4
5
6
Enter these credits on Utah TC-20S Sch. K, line 18, or TC-41 Sch. A, Part 3 or 4, or TC-65 Sch. K, line 17, using the credit code above.
Combine amounts for the same codes.

Part 2 - Utah Refundable Credits Received from Upper-tier Pass-through Entities
Upper-tier pass-through
entity EIN from Utah
Sch. K-1, box “A”

Name of upper-tier pass-through entity
from Utah Schedule K-1, box “B”

Credit
Code

UT refundable credit
from Utah Sch. K-1

1
2
3
4
5
6
7
8
9
10
11
12
13
14
Enter these credits on Utah TC-20S Sch. K, line 19, or TC-41 Sch. A, Part 5, or TC-65 Sch. K, line 18, using the credit code above.
Combine amounts for the same codes.

Part 3 - Utah Mineral Production Withholding Tax Credit Received on TC-675R
Producer EIN from
TC-675R, box “2”

Producer’s name from TC-675R, box “1”

Mineral production
withholding from
TC-675R, box “6”

1
2
3
4
5
6
7
8
9
10
Total Utah mineral production withholding tax credit received on TC-675R
Enter total credit on Utah TC-20S Sch. K, line 19, or TC-41 Sch. A, Part 5, or TC-65 Sch. K, line 18, using credit code 46.

Statement of Dependent Beneficiary Income

TC-41DB
2023

Required by Utah Code §59-10-1402(17)
USTC ORIGINAL FORM

By signing below, I declare that, for the taxable year ending _____ /_____ /20_____, I have or will claim the beneficiary named below as a dependent on
my federal income tax return.

Name of dependent beneficiary

Dependent’s Social Security Number

I attest that the dependent named above is a beneficiary of a trust that is a pass-through entity, and the dependent’s federal adjusted gross income for
the taxable year does not exceed the basic standard deduction calculated under Internal Revenue Code Section 63 for the taxable year.

Signed

Date

Print name

Taxpayer’s Social Security Number

Instructions:
1 Give this form to the fiduciary estate or trust.
2 Keep a copy with your tax records.
3 Do not send a copy of this form to the Tax Commission.
4 This statement must be kept by the trustee of the trust and made available to the Tax Commission upon request (Utah Code §59-10-1403.2(6)).