Michigan Department of Treasury (Rev. 05-16), Page 1 of 3
Issued under authority of Public Act 281 of 1967, as amended.
2016 MICHIGAN Homestead Property Tax Credit Claim MI-1040CR
Type or print in blue or black ink. Print numbers like this: 0123456789 - NOT like this: 1 4
Attachment 05
1. Filer’s First Name M.I. Last Name
2. Filer’s Full Social Security No. (Example: 123-45-6789)
If a Joint Return, Spouse’s First Name M.I. Last Name
3. Spouse’s Full Social Security No. (Example: 123-45-6789)
Home Address (Number, Street, P.O. Box). If using a P.O. Box, you must complete line 45.
City or Town State ZIP Code 4. School District Code (5 digits - see page 60)
5. Check the box(es) for which you or your spouse qualify (excluding dependents). If you qualify for both, see instructions.
a.
Age 65 or older; or an unremarried spouse of a person
b.
Deaf, blind, hemiplegic, paraplegic, quadriplegic, or
who was 65 or older at the time of death. totally and permanently disabled.
6. 2016 FILING STATUS:
*If you checked box “c,” enter dates of Michigan residency in 2016.
Check one.
a. Single a. Resident FILER SPOUSE
FROM:
b. Married ling jointly b. Nonresident
2016 2016
TO:
2016 2016
c. Married ling separately c. Part-Year Resident *
(Attach Form 5049)
8. Homestead Status
Check here if the taxable value of your homestead includes unoccupied farmland classied as agricultural by your assessor.
9.
Homeowners: Enter the 2016 taxable value of your homestead (see instructions). If you did not
check box 8 above and your taxable value is greater than $135,000, STOP; you are not eligible.
Farmers: enter the taxable value of your homestead, including eligible unoccupied farmland
............. 9. 00
10. Property Taxes levied on your home for 2016 (see instructions) or amount from line 51, 56 and/or 57 10. 00
11. Renters: Enter rent you paid for 2016 from line 53 and/or 55 ............... 11.
00
12. Multiply
line 11 by 20% (0.20)
................................................................................................................ 12. 00
13. Total. Add lines 10 and 12
.................................................................................................................... 13. 00
TOTAL HOUSEHOLD RESOURCES. If ling a joint return, include income from both spouses.
If married ling separately, you must attach Form 5049 available on Treasury’s Web site.
14.
Wages, salaries, tips, sick, strike
21.
Social Security, SSI, and/or
and SUB pay, etc.
......................... 14.
00
railroad retirement benets.
.. 21.
00
15.
All interest and dividend income
22.
Child support and foster
(including nontaxable interest)...... 15.
00
parent payments.
.................. 22.
00
16.
Net business income (including net
23.
Unemployment
farm income). If negative enter “0” 16.
00
compensation.
...................... 23.
00
17.
Net royalty or rent income.
24.
Gifts or expenses paid on
If negative enter “0”.
..................... 17.
00
your behalf.
........................... 24.
00
18.
Retirement pension, annuity, and
25.
Other nontaxable income
IRA benets.
................................. 18.
00
Describe:
_______________ 25.
00
19.
26.
Workers’/veterans’ disability
(see instructions).
......................... 19.
26.
Capital gains less capital losses,
00
compensation/pension benets
00
20.
Alimony and other taxable income
27.
FIP and other MDHHS benets
Describe:
___________________ 20.
00
(Do not include food assistance) 27.
00
28. SUBTOTAL.
Add lines 14 through 27
............................................................................. SUBTOTAL 28.
00
+
Continue on page 2. This form cannot be
0000 2016 25 01 27 5
processed if pages 2 and 3 are not completed and attached.
7. 2016 RESIDENCY STATUS:
Check all that apply.
Enter dates as MM-DD-YYYY (Example: 04-15-2016).