Fillable Form 2021: Schedule 1CM Additional Income and Adjustment

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Form 2021: Schedule 1CM Additional Income and Adjustment

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Schedule 1CM
(Form 1040CM)
Additional Income
Name(s) shown on Form 1040CM
A.
INCOME WITHOUT
INCOME WITHIN
C.C.
TOTAL INCOME
1
2a
b
3
4
5
6
7
8
a
b
c
d
e
f
g
h
i
j
k
l
m
n
o
p
z
9
10
1
2a
3
4
5
6
7
8a
8b
8c
8d
8e
8f
8g
8h
8i
8j
8k
8l
8m
8n
8o
8p
8z
9
10
Taxable refunds, credits, or offsets of state and local income taxes
Alimony received
. . . . . . . . . . . . . . .
Date of original divorce or separation agreement
(see instructions) ____________________________________
Busines income or (loss). Attach Schedule C
. . . . . .
Farm income or (loss). Attach Schedule F . . . . . . .
Rental real estate, royalties, partnerships, S corporations, trusts,
etc. Attach Schedule E
. . . . . . . . . . . . .
Other gains or (losses). Attach Form 4797 . . . . . . .
Unemployment compensation . . . . . . . . . . .
Other income:
, Combine the amounts shown in each column for lines 7 through 21, Combine the amounts shown in each column for lines 7 through 21b
Additional Income and Adjustment to Income
For Paperwork Reduction Act Notice, see your tax return instructions. Schedule 1CM (Form 1040CM) 2021
Your social security number
2021
B.
Attach to Form 1040CM or 1040NR-CM
https://finance.gov.mp
Attachment
Sequence No. 01
Department of Finance
Division of Revenue and Taxation
Commonwealth of the Northern Mariana Islands
Part I
Net operaring loss . . . . . . . . . . . . .
Gambling income . . . . . . . . . . . . .
Cancellation of debt. . . . . . . . . . . . .
Section 461(I) excess business loss adjustment . . . . .
Alaska Permanent Fund dividends . . . . . . . . .
Taxable Health Savings Account distribution . . . . . .
Foreign earned income exclusion from Form 2555. . . . .
Other income: List type and amount ______________________
____________________________________________________
Prices and award . . . . . . . . . . . . .
Income from the rental of personal property if you engaged in the
rental for profit but were not in the business of renting such
property. . . . . . . . . . . . . . . .
Activity not engaged in for profit income . . . . . . .
Jury duty pay . . . . . . . . . . . . . .
Section 951(A)(a) inclusion (see instructions) . . . . . .
Section 951(a) inclusion (see instructions) . . . . . . .
Olympic and Paralympic medals and USOC prize money (see
instructions). . . . . . . . . . . . . . .
Stock options . . . . . . . . . . . . . .
Taxable distributions from an ABLE account (see instructions). .
Total other income. Add lines 8a through 8z . . . . . .
Combine lines 1 through 7 and 9. Enter here and on line 8 of
Form 1040CM or 1040NR-CM . . . . . . . . . .
Adjustment to Income
Schedule 1CM (Form 1040CM) 2021
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19a
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23
Educator expenses
. . . . . . . . . . . . . . . . . . . . .
Health savings account deduction. Attach Form 8889. . . . . . . . . . .
Moving expenses for members of the Armed Forces. Attach Form 3903 . . . . . . . . .
Deductible part of self-employment tax. Attach Schedule SE . . . . . . . . . . . .
Self-employed SEP, SIMPLE, and qualified plans . . . . . . . . . . . . . . . .
Self-employed health insurance deduction . . . . . . . . . . . . . . . . . .
Penalty on early withdrawal of savings . . . . . . . . . . . . . . . . . . .
IRA deduction . . . . . . . . . . . . . . . . . . . . . . . . . .
Student loan interest deduction . . . . . . . . . . . . . . . . . . . . .
Reserved for future use . . . . . . . . . . . . . . . . . . . . . . .
Alimony paid . . . . . . . . . . . . . . . . . . . . . . . . . . .
Recipients SSN . . . . . . . . . . . . . . .
Date of original divorce or separation agreement (see instructions) __________________
Certain business expenses of reservists, performing artists, and fee-basis government
officials. Attach Form 2106
. . . . . . . . . . . . . . . . . . . . . .
Page 2
Part II
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19a
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c
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21
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24
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b
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Archer MSA deduction . . . . . . . . . . . . . . . . . . . . . . . .
Other adjustments:
Jury duty pay (see instructions) . . . . . . . . . . .
Deductible expenses related to income reported on line 8k from the rental
of personal propery engaged in for profit . . . . . . . . .
Nontaxable amount of the value of Olympic and Paralympic medals and
USOC prize money reported on line 8l . . . . . . . . .
Reforestation amortization and expenses . . . . . . . .
Repayment supplemental unemployment benefits under the Trade Act
of 1974
. . . . . . . . . . . . . . . . . . .
Contributions to section 501(c)(18)(D) pension plans . . . . .
Attorney fees and court costs you paid in connection with an award from
the IRS for information you provided that helped the IRS detect tax law
violations
. . . . . . . . . . . . . . . . . . .
Housing deduction from Form 2555 . . . . . . . . . . .
Excess deductions of section 67(e) expenses from Schedule K-1 (Form
1041)
. . . . . . . . . . . . . . . . . . . .
Other adjustments. List type and amount ________________________
___________________________________________________________
Total other adjustments. Add line 24a through 24z
. . . . . . . . . . . . . . . .
Add lines 11 through 23 and 25. These are your adjustments to income.
Enter here and on line 10 of Form 1040CM, or line 10a of 1040NR-CM
. . . . . . . . . .
24a
24b
24c
24d
24e
24f
24g
24h
24i
24j
24k
24z
Contributions by certain chaplains to section 403(b) plans . . . .
Attorney fees and court costs for actions involving certain unlawful
discrimination claims (see instructions) . . . . . . . . .
25
26
25
26
Schedule 1CM (Form 1040CM) 2021
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Form 2021: Schedule 1CM Additional Income and Adjustment

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Completed 23 April 2022

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