Fillable 2019 Schedule M1PSC, Credit for Parents of Sllborn (Minnesota Department of Revenue)

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2019 Schedule M1PSC, Credit for Parents of Sllborn (Minnesota Department of Revenue)

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Your First Name and Inial Last Name Social Security Number
A Did you experience the birth of a sllborn child in 2019?................................................... Yes No
(If you answered no, STOP HERE. You do not qualify for this credit.)
B Do you have a Cercate of Birth Resulng in Sllbirth from the Minnesota Department of Health?............... Yes No
(If you answered no, but experienced the birth of a sllborn child in Minnesota in 2019, see instrucons.)
C Would you have claimed the child as your dependent in 2019 had the child been born alive?
.................... Yes No
(If you answered no, STOP HERE. You do not qualify for this credit.)
Enter the following informaon. If you have a Cercate of Birth Resulng in Sllbirth for more than one child in 2019, complete a separate
schedule and include with your Form M1.
1 Name of Parent 1 on Cercate of Birth Resulng in Sllbirth ............................ 1
2 Name of Parent 2 on Cercate of Birth Resulng in Sllbirth (if listed)..................... 2
3 Date of delivery on the Cercate of Birth Resulng in Sllbirth........................... 3
4 State le number on the Cercate of Birth Resulng in Sllbirth ......................... 4
5 Document control number on the Cercate of Birth Resulng in Sllbirth ................. 5
6 Credit allowed per child ............................................................ 6
Full-year residents: Include this amount on line 4 of Schedule M1REF.
7
Part-year residents and nonresidents: Mulply the amount on line 6 by line 24
of Schedule M1NR. Include the result here and on line 4 of Schedule M1REF.
However, if your Minnesota gross income is less than $12,200, see instrucons;
enter the result from step 5 of the worksheet here:
Enter the result from step 6 on line 7 and on line 4 of Schedule M1REF
..................... 7
You must include this schedule with your Form M1.
2019 Schedule M1PSC, Credit for Parents of Sllborn Children
Complete this schedule if all of the following are true:
• You experienced the sllbirth of a child in 2019.
• You received a Cercate of Birth Resulng in Sllbirth from Minnesota.
• The child would have been your dependent in 2019 if they had been born alive.
9995
2,000
*191561*
Worksheet for Line 7
1
Line 11, column B, of Schedule M1NR
........................................................................
2 Line 21, column B, of Schedule M1NR ......................................................................
3 Subtract step 2 from step 1. If zero or less, STOP HERE. You do not qualify. ........................................
4 Line 23 of Schedule M1NR ...............................................................................
5 Dividestep3bystep4(carrytovedecimalplaces).Ifstep3ismorethanstep4,enter1.0.
Enter result on the space provided on line 7 of Schedule M1PSC
..................................................
6
Multiply step 5 by line 6 of Schedule M1PSC
..................................................................
Enter the step 6 result on line 7 of Schedule M1PSC and on line 4 of Schedule M1REF.
Am I eligible?
Youmaybeeligiblefora$2,000refundablecreditifallofthefollowingaretrue:
• Youexperiencedastillbirthin2019.
• YoureceivedaCerticateofBirthResultinginStillbirthfromtheMinnesotaDepartmentofHealth,OceofVitalRecords.
• Youwouldhaveclaimedthechildasadependentifthechildhadbeenbornalive.
What is a Cercate of Birth Resulng in Sllbirth?
ACerticateofBirthResultinginStillbirthisarecordofbirththatisissuedbytheMinnesotaDepartmentofHealth,OceofVitalRecords,toparents
whohaveexperiencedapregnancyloss(fetaldeath)resultinginstillbirth.
What is a state le number?
ItisthenumberprintedintheupperrightareainsidethemarginontheCerticateofBirthResultinginStillbirth.
What if my cercate does not have a state le number?
CalltheOceofVitalRecordsat651-201-5970toaskforareplacementcerticate.
What is a document control number?
ThedocumentcontrolnumberisthenumberprintedinthelowerleftcornerunderthebarcodeontheCerticateofBirthResultinginStillbirth.
How do I request a Cercate of Birth Resulng in Sllbirth?
AparentmayrequestaCerticateofBirthResultinginStillbirthatanytimeafterthelingofafetaldeathreport.UnderMinnesotalaw,afetaldeath
reportmustbeledwithinvedaysofthedeathofafetusforwhom20ormoreweeksofgestationhaveelapsed.Generally,oneoftwopartieslethis
report:themedicalfacilitywherethechildwasdelivered,orthemedicalprofessionalpresentatthetimeofthedelivery.Oncethefetaldeathhasbeen
reported,parentsmayrequestaCerticateofBirthResultinginStillbirthbycompletingarequest/applicationandsubmittingtheformandfeetotheOf-
ceofVitalRecords(Youcanndtheapplicationonlineatwww.health.state.mn.us/people/vitalrecords/docs/stillbirthapp.pdf).
Do both parents need to request a Cercate of Birth Resulng in Sllbirth?
No.Onlyonecreditisallowedperbirthresultinginstillbirth.Ifyouarelingajointreturnwiththepersonlistedonthefetaldeathreport,you
onlyneedtoobtainonecerticateforeachstillbornchild.Ifyouarenotlingjointlywiththepersonlistedonthefetaldeathreport,onlythe
personwhowouldhaveclaimedthechildasaqualifyingdependentin2019,ifthechildhadbeenbornalive,mayclaimthiscredit.
How do I know if I would have had a qualifying dependent?
Generally,thismeansthechildwouldhavelivedwithyouandwouldnothavepaidmorethanhalfoftheirownsupport.Minnesotausesthe
federaldenitionforadependent.Formoreinformation,seeInternalRevenueServicePublication501.
What if I had more than one sllborn child in 2019?
1. Complete a separate Schedule M1PSC for each child.
2. Addtheamountsfromline6orline7,whicheverapplies,fromeachScheduleM1PSC.
3. Enter the result from step 2 on line 4 of Schedule M1REF.
Do I qualify for this credit if I had a sllborn child before 2019?
No.Thedeliverymusthaveoccurredin2019.
Do I qualify for this credit if I received a Cercate of Birth Resulng in Sllbirth from another state for a loss in 2019?
No.TheCerticateofBirthResultinginStillbirthmustbeissuedbytheMinnesotaDepartmentofHealth,OceofVitalRecords.
What do I need to provide?
Toqualifyforthiscredit,youmusthavereceivedaCerticateofBirthResultinginStillbirthissuedbytheMinnesotaDepartmentofHealthforadeliv-
erythatoccurredin2019.Wemayaskyoutoprovideacopyofthisrecordifweareunabletoverifytheinformation.
Line Instrucons
Line B
IfyoudeliveredastillbornchildinMinnesotain2019butdidnotrequestaCerticateofBirthResultinginStillbirth,youcanrequestonebycomplet-
ingarequest/applicationandsubmittingtheformandfeetotheOceofVitalRecords(Youcanndtheapplicationonlineatwww.health.state.mn.us/
people/vitalrecords/docs/stillbirthapp.pdf).YouwillneedthiscerticatetocompleteScheduleM1PSC.
Line 7
IfyourMinnesotagrossincomeisbelowthelingrequirementandyou’relingFormM1toclaimthiscredit,youshouldhaveenteredzeroonline24
of Schedule M1NR, Nonresidents/Part-Year Residents.However,tocorrectlydeterminethiscredit,youmustrstfullycompleteScheduleM1NR(do
notskiplines12-21)todeterminewhattheamountswouldhavebeen,andthenfollowtheWorksheetforLine7.
2019 Schedule M1PSC Instrucons
.
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2019 Schedule M1PSC, Credit for Parents of Sllborn (Minnesota Department of Revenue)

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Completed 29 July 2020

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