For Privacy Notice, see instructions.
2020 Certification of Rent Paid
Form
MO-CRP
1. Social Security Number
Form MO-CRP (Revised 12-2020)
*20315010001*
20315010001
Spouse’s Social Security Number
5. Rental Period During Year
From:
(MM/DD/YY)
To:
(MM/DD/YY)
8. Net rent paid - Multiply Line 6 by the percentage on Line 7............................................
9. Multiply Line 8 by 20%. Enter amount here and on Line 10 of Form MO-PTC or Line 12 of Form MO-PTS
.......
00
.
Taxation Division
Attach to Form MO-PTC or MO-PTS and mail to the Missouri Department of Revenue.
00
.
7. Select the appropriate box below and enter the corresponding percentage on Line 7 ........................
A. Apartment, House, Mobile Home, or Duplex - 100% F. Low Income Housing - 100% (Rent cannot exceed 40% of total
B. Mobile Home Lot - 100%
C. Boarding Home or Residential Care - 50%
G.
Shared Residence – If you shared your rent with relatives or friends
D. Skilled or Intermediate Care Nursing Home - 45%
E. Hotel - 100%; if meals are included - 50%
Select this box if related to your landlord. If so, explain.
2. Name (First, Last)
Physical Address of Rental Unit (P.O. Box Not Allowed) Apartment Number
3. Landlord’s Name (First, Last)
Landlord’s Street Address (Must be completed)
4. Landlord’s Phone Number (Must be completed)
City State ZIP Code
1 (50%) 2 (33%) 3
(25%)
8
9
One Form MO-CRP must be provided for each rental location in which you resided.
Failure to provide landlord information will result in denial or delay of your claim.
household income.)
(other than your spouse or children under 18), select the appropriate
box based on the additional person(s) sharing rent:
City State ZIP Code
- -- -
Apartment Number
%
you are not eligible for a Property Tax Credit ....................................................
assistance, enter the amount of rent you paid. Note: If you rent from a facility that does not pay property tax,
6. Enter your gross rent paid. Attach a completed Verification of Rent Paid (Form 5674). If you received housing
00
.
6
7
