Fillable form mo-1040 missouri individual income tax return

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For Calendar Year January 1 - December 31, 2018
Missouri Department of Revenue
2018 Individual Income
Tax Return - Long Form
Department Use Only
Form
MO-1040
Fiscal Year Beginning (MM/DD/YY)
Fiscal Year Ending (MM/DD/YY)
Age 62 through 64
Yourself Spouse
Age 65 or Older Blind 100% Disabled Non-Obligated Spouse
Yourself Spouse Yourself Spouse Yourself Spouse Yourself Spouse
Amended Return
Print in BLACK ink only and DO NOT STAPLE.
NameAddress
If filing a fiscal year return enter the beginning and ending dates here.
Composite Return
Social Security Number Spouse’s Social Security Number
- -
M.I.
In Care Of Name (Attorney, Executor, Personal Representative, etc.)
County of Residence
Present Address (Include Apartment Number or Rural Route)
City, Town, or Post Office
State ZIP Code
Last Name
in 2018
_
First Name Suffix
Spouse’s Last NameSpouse’s First Name
M.I.
Suffix
*18322010006*
18322010006
You may contribute to any one or all of the trust funds on Line 44. See pages 10-11 of the instructions for more trust fund information.
DeceasedDeceased
in 2018
Name
- -
MO-1040 Page 1
0
Vendor Code
0 6
Single
Married Filing
Combined
Married Filing
Separately
Head of
Household
Qualifying
Widow(er)
Veterans
Trust Fund
Children’s
Trust Fund
Elderly Home
Delivered Meals
Trust Fund
Missouri
National Guard
Trust Fund
Workers
Workers’
Memorial
Fund
LEAD
Childhood
Lead Testing
Fund
Missouri Military
Family Relief
Fund
General
Revenue
General
Revenue
Fund
Organ Donor
Program Fund
Claimed as a
Dependent
Filing Status
(For use by S corporations or Partnerships)
Print Form
Reset
Calculate
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browser and Adobe Reader for PDF viewer)
INSTRUCTIONS:
- Enter numbers without decimals (integers)
- Don't forget to attach all required forms
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the field you want.
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is entered, a zero will be displayed.
006
SELECT COUNTY
%
00
.
%
6. Total Missouri adjusted gross income - Add columns 5Y and 5S ...........
7. Income percentages - Divide columns 5Y and 5S by total on
Line 6. (Must equal 100%) . . . . . . . . . . . . . . . . . . . . . . . . . . . .
7Y
7S
6
Exemptions and Deductions
00
.
8. Pension, Social Security, Social Security Disability, and Military exemption (from Form
MO-A, Part 3, Section E) ........................................................
8
10. Other tax from federal return - Attach a copy of your
federal return (pages 1 and 2, and all applicable schedules) .......
11. Total tax from federal return - Add Lines 9 and 10..............
12. Federal income tax deduction - Enter the amount from Line 11, not to exceed $5,000 for an
individual filer or $10,000 for combined filers (see instructions on page 7)..................
00
.
9
00
.
10
00
.
11
00
.
12
00
.
13
13. Missouri standard deduction or itemized deductions.
• Single or Married Filing Separate - $12,000
• Head of Household - $18,000
*18322020006*
18322020006
Income
Yourself (Y) Spouse (S)
1. Federal adjusted gross income from federal return
(see worksheet on page 7 of the instructions) .............
2. Total additions (from Form MO-A, Part 1, Line 7) . . . . . . . . . .
3. Total income - Add Lines 1 and 2.......................
4. Total subtractions (from Form MO-A, Part 1, Line 18) .......
5. Missouri adjusted gross income - Subtract Line 4 from Line 3..
00
.
1S
00
.
1Y
00
.
5S
00
.
5Y
00
.
4S
00
.
4Y
00
.
3S
00
.
3Y
00
.
2S
00
.
2Y
• Married Filing Combined or Qualifying Widow(er) - $24,000
If age 65 or older, blind, or claimed as a dependent, see pages 7 and 8.
If itemizing, see Form MO-A, Part 2.
...................................................
MO-1040 Page 2
9. Tax from federal return - Do not enter federal income tax
withheld (see instructions on page 7 and 8) . . . . . . . . . . . . . . . . . .
18. Transportation facilities deduction ................................................
00
.
18
00
.
19
17. Bring jobs home deduction ......................................................
00
.
17
14. Long-term care insurance deduction ..............................................
00
.
14
15. Health care sharing ministry deduction.............................................
00
.
15
16. Military income deduction .......................................................
00
.
16
19. Total deductions - Add Lines 8 and 12 through 18 ....................................
20. Subtotal - Subtract Line 19 from Line 6 ............................................
00
.
20
00
.
22S
00
.
22Y
22. Enterprise zone or rural empowerment zone income
modification . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
21. Multiply Line 20 by appropriate percentages (%) on
00
.
21S
00
.
21Y
Lines 7Y and 7S ...................................
A. Port Cargo Expansion B. International Trade Facility C. Qualified Trade Activities
Worksheet
Line 1
MO-A
0
0
Line 2
0
0
MO-A
0
0
Line 4
0
0
0
0
0
Line 7
MO-A
0
Line 8
Line 9
Line 10
0
0
Line 12
Itemized Deductions Worksheet
0
Line 13
Long-term Care Worksheet
0
Line 14
Line 15
Line 16
Line 17
Line 18
0
0
Line 20
0
0
Line 22
*18322030006*
18322030006
Tax
00
.
23S
00
.
23Y
23. Taxable income - Subtract Line 22 from Line 21...........
00
.
24S
00
.
24Y
24. Tax (see tax chart on page 20 of the instructions)..........
00
.
25S
00
.
25Y
income tax return(s).................................
25. Resident credit - Attach Form MO-CR and other states’
completing Form MO-NRI. Attach Form MO-NRI and a
26. Missouri income percentage - Enter 100% unless you are
copy of your federal return if less than 100% .............
00
.
27S
00
.
27Y
multiply Line 24 by percentage on Line 26 ...............
27. Balance - Subtract Line 25 from Line 24; OR
00
.
28S
00
.
28Y
28. Other taxes - Select box and attach federal form indicated.
Lump sum distribution (Form 4972)
Recapture of low income housing credit (Form 8611)
00
.
29S
00
.
29Y
29. Subtotal - Add Lines 27 and 28 ........................
00
.
30
30. Total Tax - Add Lines 29Y and 29S................................................
Payments and Credits
31. MISSOURI tax withheld - Attach Forms W-2 and 1099.................................
32. 2018 Missouri estimated tax payments - Include overpayment from 2017 applied to 2018 ........
33. Missouri tax payments for nonresident partners or S corporation shareholders - Attach Forms
MO-2NR and MO-NRP .........................................................
00
.
31
00
.
32
00
.
33
26S %26Y %
MO-1040 Page 3
36. Miscellaneous tax credits (from Form MO-TC, Line 13) - Attach Form MO-TC ..............
00
.
36
37. Property tax credit - Attach Form MO-PTS ..........................................
00
.
37
38. Total payments and credits - Add Lines 31 through 37 .................................
00
.
38
35. Amount paid with Missouri extension of time to file (Form MO-60)........................
00
.
35
34. Missouri tax payments for nonresident entertainers - Attach Form MO-2ENT ...............
00
.
34
0
0
0
0
Line 24
MO-CR
0
0
Line 25
MO-NRI
100
100
Line 26
0
0
Line 28
0
0
0
Line 31
Line 32
Line 33
Line 34
Line 35
MO-TC
0
Line 36
MO-PTS
0
Line 37
0
Refund
42. If Line 38, or if amended return, Line 41, is larger than Line 30, enter the difference.
00
.
42
Amount of OVERPAYMENT .........................................................
43. Amount of Line 42 to be applied to your 2019 estimated tax ............................
00
.
43
44. Enter the amount of your donation in the trust fund boxes below. See instructions for additional trust fund codes.
45. Amount of Line 42 to be deposited into a Missouri 529 Education Savings Plan (MOST)
00
.
45
account. Enter amount from Line E of Form 5632 ....................................
*18322040006*
18322040006
00
.
44
Skip Lines 39 through 41 if you are not filing an amended return.
39. Amount paid on original return....................................................
00
.
39
40. Overpayment as shown (or adjusted) on original return ................................
00
.
40
D. Correction other than A, B, or C .......
Indicate Reason for Amending
A. Federal audit......................
B. Net operating loss carryback .........
C. Investment tax credit carryback .......
41. Amended return total payments and credits - Add Line 39 to Line 38 or subtract Line 40
00
.
41
from Line 38..................................................................
Enter date of federal amended return, if filed. (MM/DD/YY)
Enter year of credit (YY)
Enter year of loss (YY)
Enter date of IRS report (MM/DD/YY)
00
.
00
.
00
.
Children’s
Trust Fund
Veterans
Trust Fund
Elderly Home
Delivered Meals
Trust Fund
00
.
00
.
00
.
Missouri
National Guard
Trust Fund
Workers’
Memorial Fund
Childhood
Lead
Testing Fund
00
.
00
.
00
.
General
Revenue Fund
Organ Donor
Program Fund
Missouri
Military Family
Relief Fund
00
.
Total Donation - Add amounts from Boxes 44a through 44k and enter here.................
44a. 44b. 44c.
44d. 44e. 44f.
44g. 44h. 44i.
44j.
Additional
Fund
Code
Additional
Fund
Amount
00
.
44k.
Additional
Fund
Code
Additional
Fund
Amount
Amended Return
MO-1040 Page 4
46. REFUND - Subtract Lines 43, 44, and 45 from Line 42 and enter here ....................
00
.
46
a. Routing
Number
b. Account
c. SavingsChecking
Line 39
Line 40
These fields are locked.
To unlock them, Click on
the "amended" check box
on page 1 of this form (top
left).
0
Line 42
0
Line 43
0
Line 44
44 part2
MOST
0
Line 46
Yes No
Preparer’s Telephone
Signature
Preparer’s Signature
Spouse’s Signature (If filing combined, BOTH must sign)
Daytime Telephone
Date (MM/DD/YY)
Preparer’s Address ZIP CodeState
Mail To: Balance Due: Refund or No Amount Due: Phone (Balance Due): (573) 751-7200
Missouri Department of Revenue Missouri Department of Revenue Phone (Refund or No Amount Due): (573) 751-3505
P.O. Box 3370 P.O. Box 3222 Fax: (573) 751-2195
Jefferson City, MO 65105-3370 Jefferson City, MO 65105-3222 E-mail: income@dor.mo.gov
(Revised 12-2018)
I authorize the Director of Revenue or delegate to discuss my return and attachments with the preparer
or any member of the preparer’s firm
........................................................
E-mail Address
Preparer’s FEIN, SSN, or PTIN
Date (MM/DD/YY)
Date (MM/DD/YY)
*18322050006*
18322050006
electronically. Any returned check may be presented again electronically . . . . . . . . . . . . . . . . . .
Amount Due
47. If Line 30 is larger than Line 38 or Line 41, enter the difference.
00
.
47
Amount of UNDERPAYMENT (see the instructions for Line 48)........................
48. Underpayment of estimated tax penalty - Attach Form MO-2210. Enter penalty amount here ...
00
.
48
49. AMOUNT DUE - Add Lines 47 and 48.
00
.
49
If you pay by check, you authorize the Department of Revenue to process the check
Signature
FA E10A DE
Department Use Only
F
Select this box if you are a farmer exempt from the underpayment of estimated tax penalty.
.
MO-1040 Page 5
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best
of my knowledge and belief it is true, correct, and complete. By signing or entering my name in the “Signature” field(s) below, I am providing
the Department of Revenue with my signature as required under Section 143.561, RSMo. Declaration of preparer (other than taxpayer) is
unauthorized aliens as defined under federal law and that I am not eligible for any tax exemption, credit, or abatement if I employ such
aliens.
based on all information of which he or she has knowledge. As provided in Chapter 143, RSMo, a penalty of up to $500 shall be
imposed on any individual who files a frivolous return. I also declare under penalties of perjury that I employ no illegal or
0
Line 48
0
Line 49
Click here to finish
20
2018 Tax Chart
To identify your tax, use your Missouri taxable income from Form MO-1040, Line 23Y and 23S and the tax chart in
Section A below. A separate tax must be computed for you and your spouse.
Calculate your Missouri tax using the online tax calculator at http://dor.mo.gov/personal/individual or by using the
worksheet in Section B below. Round to the nearest whole dollar and enter on Form MO-1040, Line 24Y and 24S.
*18000000001*
18000000001
Section B Section A
Tax Rate Chart
Tax Calculation Worksheet
Yourself Spouse Example A Example B
1. Missouri taxable income (Form MO-1040,
Line 23Y and 23S)..........................
$
_____________ _____________
$ 3,090 $ 12,000
2. Enter the minimum taxable income for your tax
bracket (see Section A above). If below $1,028
enter $0 ..................................
- $
_____________ _____________
- $ 3,084 $9,253
3. Difference - Subtract Line 2 from Line 1 . . . . . . . . .
= $
_____________ _____________
= $ 6 $ 2,747
4. Enter the percent for your tax bracket (see
Section A above)...........................
X
_____________
%
_____________
%
X 3% 5.9%
5. Multiply Line 3 by the percent on Line 4 .........
= $
_____________ _____________
= $ .18 $ 162.07
6. Enter the tax from your tax bracket - before
applying the percent (see Section A above) . . . . . .
+ $
_____________ _____________
+ $ 62 $ 324
7. Total Missouri Tax - Add Line 5 and 6. Enter here
and on Form MO-1040, Line 24Y and 24S .......
= $
_____________ _____________
= $ 62 $ 486
($62.18
rounded to the
nearest dollar)
($486.07
rounded to the
nearest dollar)
If the Missouri taxable income is: The tax is:
$0 to $102
................................................ $0
At least $103 but not over $1,028.............................. 1½% of the Missouri taxable income
Over $1,028 but not over $2,056 .............................. $15 plus 2% of excess over $1,028
Over $2,056 but not over $3,084 .............................. $36 plus 2½% of excess over $2,056
Over $3,084 but not over $4,113 .............................. $62 plus 3% of excess over $3,084
Over $4,113 but not over $5,141 .............................. $93 plus 3½% of excess over $4,113
Over $5,141 but not over $6,169 .............................. $129 plus 4% of excess over $5,141
Over $6,169 but not over $7,197 .............................. $170 plus 4½% of excess over $6,169
Over $7,197 but not over $8,225 .............................. $216 plus 5% of excess over $7,197
Over $8,225 but not over $9,253 .............................. $267 plus 5½% of excess over $8,225
Over $9,253 .............................................. $324 plus 5.9% of excess over $9,253
2018
Missouri Taxes Withheld
Earnings Tax
Diagram 1: Form W-2
0
0
0
0
0
0
0.0
0.0
0.00
0.00
0
0
0
0
21
MO Public-Private Transportation Act
*18340010001*
18340010001
Missouri Department of Revenue
2018 Individual Income Tax Adjustments
Department Use Only
(MM/DD/YY)
Form
MO-A
1. Interest on state and local obligations other than Missouri source....
Other (description)
4. Food Pantry contributions included on Federal Schedule A.........
Part 1 - Missouri Modifications to Federal Adjusted Gross Income
Attach to Form MO-1040. Attach your federal return. See information beginning on page 12 to assist you in completing this form.
Additions
3. Nonqualified distribution received from a qualified 529 plan ......... .
(education savings program) not used for qualified expenses ........
6. Nonqualified distribution received from a qualified Achieving a Better
Life Experience Program (ABLE) not used for qualified expenses.....
7. Total Additions - Add Lines 1 through 6. Enter here and on Form
Subtractions
8. Interest from exempt federal obligations included in federal adjusted
gross income - Attach a detailed list or all Federal Form(s) 1099 .....
9. Any state income tax refund included in federal adjusted gross income.
Other (description)
11. Exempt contributions made to a qualified 529 plan (education
savings program) .........................................
2. Partnership Fiduciary S Corporation
Net Operating Loss (Carryback/Carryforward)
00
.
2Y
00
.
2S
00
.
1Y
00
.
1S
5. Nonresident Property Tax...................................
Partnership Fiduciary S Corporation 10.
Build America and Recovery Zone Bond Interest
Railroad Retirement Benefits
Net Operating Loss
Military (nonresident) Combat Pay
00
.
3Y
00
.
3S
00
.
4Y
00
.
4S
00
.
5Y
00
.
5S
00
.
6Y
00
.
6S
00
.
7Y
00
.
7S
00
.
8Y
00
.
8S
00
.
9Y
00
.
9S
00
.
10Y
00
.
10S
00
.
11Y
00
.
11S
Social Security Number Spouse’s Social Security Number
M.I.
Last Name
First Name Suffix
Spouse’s Last NameSpouse’s First Name
M.I.
Suffix
Name
MO-1040, Line 2..........................................
12. Qualified Health Insurance Premiums - Attach the Qualified Health
00
.
12Y
00
.
12S
Insurance Premiums Worksheet (Form 5695) and supporting
- - - -
Spouse (S)Yourself (Y)
For Privacy Notice, see instructions.
documentation ...........................................
MO-A Page 1
Line 1
Line 2
Line 3
Line 4
Line 5
Line 6
0
0
Line 7
Back to 1040 Page 2
Line 8
Line 9
Line 10
Line 11
Qualified Health Insurance Premiums Worksheet
0
0
Line 12
22
*18340020001*
18340020001
MO-A Page 2
Part 2 - Missouri Itemized Deductions
1. Total federal itemized deductions from Federal Form 1040, Line 8 .................................
3. 2018 Social security tax - (Spouse) ..........................................................
4. 2018 Railroad retirement tax - Tier I and Tier II (Yourself) ........................................
5. 2018 Railroad retirement tax - Tier I and Tier II (Spouse) ........................................
6. 2018 Medicare tax - Yourself and Spouse (see instructions on page 43) ............................
7. 2018 Self-employment tax (see instructions on page 43) ........................................
8. Total - Add Lines 1 through 7 ..............................................................
9. State and local income taxes from Federal Schedule A, Line 5 or see
10. Earnings taxes included in Line 9 ............................
11. Net state income taxes - Subtract Line 10 from Line 9 or enter Line 7 from worksheet below ............
12. Missouri Itemized Deductions - Subtract Line 11 from Line 8. Enter here and on Form MO-1040, Line 13 ..
00
.
00
.
00
.
00
.
00
.
00
.
00
.
00
.
00
.
00
.
00
.
00
.
Part 1 Continued
2. 2018 Social security tax - (Yourself) .........................................................
1
2
3
4
5
6
7
8
9
10
11
12
Complete this section only if you itemize deductions on your federal return. Attach your Federal Form 1040 (pages 1 and 2) and Federal Schedule A.
18. Total Subtractions - Add Lines 8 through 17. Enter here and on
Form MO-1040, Line 4 .....................................
16. Agriculture Disaster Relief ..................................
15. Exempt contributions made to a qualified Achieving a Better Life
Experience Program (ABLE) ................................
Sold or disposed property previously taken as addition modification
13. Missouri depreciation adjustment (Section 143.121, RSMo)
14. Home Energy Audit Expenses - Attach the Home Energy Audit
00
.
13Y
00
.
13S
00
.
14Y
00
14S
00
.
15Y
00
15S
00
.
16Y
00
16S
00
.
18Y
00
18S
.
.
.
.
the worksheet below.......................................
Expense (Form MO-HEA) ..................................
17. Business Income Deduction – see worksheet on page 42..........
00
.
17Y
00
17S
.
1. Enter the sum of your state and local taxes on Federal Form 1040, Schedule A, Line 5d. ..... 1
2. State and local income taxes from Federal Form 1040, Schedule A, Line 5a. .............. 2
3. Earnings taxes included on Federal Form 1040, Schedule A, Line 5a. .................... 3
4. Subtract Line 3 from Line 2. ..................................................... 4
5. Divide Line 4 by Line 1......................................................... 5 %
6. Enter $10,000 ($5,000 if married filing separately). .................................. 6
7. Multiply Line 6 by percentage on Line 5. Enter here and on Missouri Itemized Deductions,
00
.
00
.
00
.
00
.
00
.
00
.
Complete this worksheet only if your total state and local taxes included in your federal itemized deductions
(Federal Schedule A, Line 5d) exceeds $10,000 (or $5,000 for married filing separate filers).
Part 2 Worksheet - Net State Income Taxes, Line 11
Line 11, above. .............................................................. 7
Line 13
HEA Worksheet
0
0
Line 14
Line 15
Line 16
Line 17
0
0
Line 18
Back to 1040 Page 2
Line 1
Line 2
Line 3
Line 4
Line 5
Line 6
Line 7
0
Line 9
Line 10
0
0
Line 12
Carry amount to 1040 Line 13
0
10,000
0
Use data from worksheet
Reset Worksheet
23
1 through 8 of Section C, and enter the amount(s) from Line(s) 6Y
5. Subtract Line 4 from Line 3 and enter on Line 5. If Line 4 is greater than Line 3, enter $0 ...............
6. Taxable pension for each spouse from public sources from Federal
7. Amount from Line 6 or $37,720 (maximum social security benefit),
Private Pension Calculation -
Annuities, pensions, IRAs, and 401(k) plans funded by a private source.
8. If you received taxable social security, complete Form MO-A, Lines
and 6S. See instructions if Line 3 of Section C is more than $0......
9. Subtract Line 8 from Line 7. If Line 8 is greater than Line 7, enter $0 .
10. Add amounts on Lines 9Y and 9S ..........................................................
11. Total public pension, subtract Line 5 from Line 10. If Line 5 is greater than Line 10, enter $0 ............
Section B
1. Missouri adjusted gross income from Form MO-1040, Line 6 .....................................
2. Taxable social security benefits from Federal Form 1040, Line 5b .................................
3. Subtract Line 2 from Line 1 ...............................................................
4. Select the appropriate filing status and enter the amount on Line 4.
• Married Filing Combined (joint federal) - $32,000
5. Subtract Line 4 from Line 3. If Line 4 is greater than Line 3, enter $0 ...............................
7. Amounts from Line 6Y and 6S or $6,000, whichever is less ........
8. Add Lines 7Y and 7S .....................................................................
9. Total private pension, subtract Line 5 from Line 8. If Line 5 is greater than Line 8, enter $0...............
*18340030001*
18340030001
00
.
00
.
00
.
00
.
00
.
00
.
00
.
00
.
00
.
Form 1040, Line 4b .......................................
whichever is less .........................................
00
.
Public Pension Calculation -
Pensions received from any federal, state, or local government.
Part 3 - Pension and Social Security/Social Security Disability/Military Exemption
Section A
1. Missouri adjusted gross income from Form MO-1040, Line 6 .....................................
2. Taxable social security benefits from Federal Form 1040, Line 5b .................................
3. Subtract Line 2 from Line 1 ...............................................................
00
.
00
.
00
.
00
.
1
2
3
4
5
10
11
1
2
3
4
5
8
9
6. Taxable pension for each spouse from private sources from
Federal Form 1040, Line 4b .................................
00
.
6Y
00
.
6S
00
.
7Y
00
.
7S
00
.
8Y
00
.
8S
00
.
9Y
00
.
9S
00
.
6Y
00
.
6S
00
.
7Y
00
.
7S
• Single, Head of Household and Qualifying Widow(er) - $25,000
• Married Filing Separate - $16,000........................................................
4. Select the appropriate filing status and enter amount on Line 4.
• Married Filing Combined (joint federal) - $100,000
• Single, Head of Household, Married Filing Separate, and Qualifying Widow(er) - $85,000 ............
MO-A Page 3
0
Line 1
0
85,000
0
0
0
0
0
Line 8
0
0
0
0
0
Line 2
0
25,000
0
Line 6
0
0
0
0
24
Section D
Enter total amount here and on Form MO-1040, Line 8. .............................................
Military Pension Calculation
Total Pension and Social Security/Social Security Disability/Military Exemption
1. Military retirement benefits included on Federal Form 1040, Line 4b................................
2. Taxable public pension from Federal Form 1040, Line 4b ........................................
3. Divide Line 1 by Line 2 (Round to whole number) ..............................................
4. Multiply Line 3 by Line 11 of Section A. If you are not claiming a public pension exemption, enter $0 ......
5. Total military pension, subtract Line 4 from Line 1 ..............................................
Section E
Add Line 11 (Section A), Line 9 (Section B), Line 8 (Section C), and Line 5 (Section D) from Form MO-A.
*18340040001*
18340040001
00
.
00
.
00
.
00
.
00
.
Section C
1. Missouri adjusted gross income from Form MO-1040, Line 6 .....................................
2. Select the appropriate filing status and enter the amount on Line 2.
• Married Filing Combined (joint federal) - $100,000
3. Subtract Line 2 from Line 1 and enter on Line 3. If Line 2 is greater than Line 1, enter $0 ...............
4. Taxable social security benefits for each spouse from
5. Taxable social security disability benefits for each spouse from
6. Amount from Line(s) 4Y or 5Y, and 4S or 5S ....................
7. Add Lines 6Y and 6S ....................................................................
8. Total social security/social security disability, subtract Line 3 from Line 7. If Line 3 is greater than Line 7,
00
.
00
.
00
.
00
.
00
.
enter $0 ..............................................................................
Federal Form1040, Line 5b .................................
Federal Form 1040, Line 5b .................................
1
2
3
1
2
3
4
5
7
8
Social Security or Social Security Disability Calculation -
To be eligible for social security deduction you must be 62 years of age by
00
.
4Y
00
.
4S
00
.
5Y
00
.
5S
00
.
6Y
00
.
6S
• Single, Head of Household, Married Filing Separate, and Qualifying Widow(er) - $85,000 ............
December 31 and have selected the 62 and older box on page 1 of Form MO-1040. Age limit does not apply to social security disability deduction.
Attach to Form MO-1040. Attach your federal return.
See information beginning on page 12 to assist you in completing this form.
%
MO-A Page 4 (Revised 12-2018)
0
85,000
0
Line 4
Line 5
0
0
0
0
0
0
0
0
Back to MO-1040, page 2
25
For Privacy Notice, see Instructions.
Missouri Department of Revenue
2018 Credit for Income Taxes Paid To
Other States or Political Subdivisions
Form
MO-CR
Name
Spouse’s Name
Yourself (Y) Spouse (S)
1. Claimant’s total adjusted gross income (Form MO-1040, Line 5Y
2. Claimant’s Missouri income tax (Form MO-1040, Line 24Y and
3. Wages and commissions................................
5.
Total - Add Lines 3 and 4................................
6. Less, related adjustments (Federal Form 1040, Line 36) .......
7. Net amounts - Subtract Line 6 from Line 5 ..................
24S). Use the two letter abbreviation for the state or name of
8. Percentage of your income taxed - Divide Line 7 by Line 1 .....
9. Maximum credit - Multiply Line 2 by percentage on Line 8 . . . . . .
10. Income tax you paid to another state or political subdivision.
before entering on Form MO-1040 ........................
Attach Form MO-CR and all income tax returns for each state or political subdivision to Form MO-1040.
Complete this form if you or your spouse have income from another state or political subdivision. If you had multiple credits, complete a
separate form for each state or political subdivision.
State of:
State of:
Form MO-CR (Revised 12-2018)
*18313010001*
18313010001
4. Other income (Describe nature ________________________ ) ..
Social Security Number
Spouse’s Social Security Number
- -
- -
00
.
11S
00
.
11Y
%%
11. Credit - Enter the smaller amount of Line 9 or Line 10 here and
credits, add the amounts on Line 11 from each Form MO-CR
on Form MO-1040, Line 25Y or Line 25S. If you have multiple
all credits, except withholding and estimated tax..............
This is not income tax withheld. The income tax is reduced by
00
.
10S
00
.
10Y
00
.
9S
00
.
9Y
00
.
8S
00
.
8Y
7S7Y
00
.
6S
00
.
6Y
00
.
5S
00
.
5Y
00
.
4S
00
.
4Y
00
.
3S
00
.
3Y
________________________________________________
abbreviation, or enter the name of the political subdivision below.
political subdivision. See the table on back for the two letter
00
.
2S
00
.
2Y
and Line 5S) .........................................
00
.
1S
00
.
1Y
0
0
Line 1
0
0
Line 2
Line 3
Line 4
0
0
Line 5
Line 6
0
0
Line 7
0
0
Line 8
0
0
Line 9
Line 10
0
0
Line 11
Back to MO-1040, page 3
25
For Privacy Notice, see Instructions.
Missouri Department of Revenue
2018 Credit for Income Taxes Paid To
Other States or Political Subdivisions
Form
MO-CR
Name
Spouse’s Name
Yourself (Y) Spouse (S)
1. Claimant’s total adjusted gross income (Form MO-1040, Line 5Y
2. Claimant’s Missouri income tax (Form MO-1040, Line 24Y and
3. Wages and commissions................................
5.
Total - Add Lines 3 and 4................................
6. Less, related adjustments (Federal Form 1040, Line 36) .......
7. Net amounts - Subtract Line 6 from Line 5 ..................
24S). Use the two letter abbreviation for the state or name of
8. Percentage of your income taxed - Divide Line 7 by Line 1 .....
9. Maximum credit - Multiply Line 2 by percentage on Line 8 . . . . . .
10. Income tax you paid to another state or political subdivision.
before entering on Form MO-1040 ........................
Attach Form MO-CR and all income tax returns for each state or political subdivision to Form MO-1040.
Complete this form if you or your spouse have income from another state or political subdivision. If you had multiple credits, complete a
separate form for each state or political subdivision.
State of:
State of:
Form MO-CR (Revised 12-2018)
*18313010001*
18313010001
4. Other income (Describe nature ________________________ ) ..
Social Security Number
Spouse’s Social Security Number
- -
- -
00
.
11S
00
.
11Y
%%
11. Credit - Enter the smaller amount of Line 9 or Line 10 here and
credits, add the amounts on Line 11 from each Form MO-CR
on Form MO-1040, Line 25Y or Line 25S. If you have multiple
all credits, except withholding and estimated tax..............
This is not income tax withheld. The income tax is reduced by
00
.
10S
00
.
10Y
00
.
9S
00
.
9Y
00
.
8S
00
.
8Y
7S7Y
00
.
6S
00
.
6Y
00
.
5S
00
.
5Y
00
.
4S
00
.
4Y
00
.
3S
00
.
3Y
________________________________________________
abbreviation, or enter the name of the political subdivision below.
political subdivision. See the table on back for the two letter
00
.
2S
00
.
2Y
and Line 5S) .........................................
00
.
1S
00
.
1Y
0
0
Line 1
0
0
Line 2
Line 3
Line 4
0
0
Line 5
Line 6
0
0
Line 7
0
0
Line 8
0
0
Line 9
Line 10
0
0
Line 11
Back to MO-1040, page 3
26
Two Letter Abbreviations for States
Complete this form if you are a Missouri resident, resident estate, or resident trust with income from another state(s).
A part-year resident may elect to use this form to determine his or her tax as if he or she were a resident for the entire taxable
year. If you pay tax to more than one state, you must complete a separate Form MO-CR for each state.
Before you begin:
• Complete your Missouri return, Form MO-1040 (Lines 1 through 24).
• Complete the other state’s return(s) to determine the amount of income tax you paid to the other state(s).
Line 1 - Enter the amount from Form MO-1040, Line 5Y and 5S.
Line 2 - Enter the amount from Form MO-1040, Line 24Y and 24S.
Lines 3 and 4 - Enter the total amount of wages, commissions, and other income you or your spouse received from the other
state(s), as reported on the other state(s) return.
Line 5 - Add Lines 3 and 4; enter the total on Line 5.
Line 6 - Enter any federal adjustments from:
• Federal Form 1040, Line 36
Line 7 - Subtract Line 6 from Line 5. Enter the difference on Line 7.
Line 8 - Divide Line 7 by Line 1. If greater than 100 percent, enter 100 percent. Round in whole percent, such as 91 percent
instead of 90.5 percent. If percentage is less than 0.5 percent, use exact percentage. Enter percentage on Line 8.
Line 9 - Multiply Line 2 by percentage on Line 8. Enter amount on Line 9.
Line 10 - Enter your income tax liability as reported on the other state(s) income tax return. This is not income tax withheld. The
income tax entered must be reduced by all credits, except withholding and estimated tax. If both you and your spouse
paid income tax to the other state(s), each must claim his or her own portion of the tax liability.
Line 11 - Enter the smaller amount from Form MO-CR, Line 9 or Line 10. This is your Missouri resident credit. Enter the amount
on Form MO-1040, Line 25Y and 25S. (If you have multiple credits, add the amounts on Line 11 from each MO-CR).
Your total credit cannot exceed the tax paid or the percent of tax due to Missouri on that part of your income.
Information to complete Form MO-CR
*18000000001*
18000000001
AL
- Alabama
AK - Alaska
AZ - Arizona
AR - Arkansas
CA - California
CO - Colorado
CT - Connecticut
DC - District of Columbia
DE - Delaware
FL - Florida
GA - Georgia
HI - Hawaii
ID - Idaho
IL - Illinois
IN - Indiana
IA - Iowa
KS - Kansas
KY - Kentucky
LA - Louisiana
ME - Maine
MD - Maryland
MA - Massachusetts
MI - Michigan
MN - Minnesota
MS - Mississippi
MT - Montana
NE - Nebraska
NV - Nevada
NH - New Hampshire
NJ - New Jersey
NM - New Mexico
NY - New York
NC - North Carolina
ND - North Dakota
OH - Ohio
OK - Oklahoma
OR - Oregon
PA - Pennsylvania
RI - Rhode Island
SC - South Carolina
SD - South Dakota
TN - Tennessee
TX - Texas
UT - Utah
VT - Vermont
VA - Virginia
WA - Washington
WV - West Virginia
WI - Wisconsin
WY - Wyoming
27
Missouri Department of Revenue
2018 Missouri Income Percentage
Form
MO-NRI
Attach Federal Return. See instructions
and diagram on page 3 of Form MO-NRI.
Part A
Resident/Nonresident Status - Select your status in the appropriate box below.
Name
Address
City, State, ZIP Code
Social Security Number
- -
Spouse’s Name
Address
City, State, ZIP Code
Spouse’s Social Security Number
- -
1. Nonresident of Missouri
State of residence during 2018 ______________________ State of residence during 2018 ______________________
2. Part-Year Missouri Resident
Indicate the dates you were a Missouri Resident in 2018. Indicate the dates you were a Missouri Resident in 2018.
A. Date From: _______________ Date To: _____________
B. Indicate the other state of residence
Based on the Military Spouse’s Residency Relief Act, if you are the spouse of a military servicemember residing outside of Missouri solely
because your spouse is there on military orders, and Missouri is your state of residence, any income you earn is taxable to Missouri. Do not
complete Form MO-NRI. You must report 100% on Line 26 of Form MO-1040.
3. Military/Nonresident Tax Status - Indicate your tax status
Missouri Home of Record
below and complete Part C - Missouri Income Percentage.
I did not at any time during the 2018 tax year maintain a
permanent place of abode in Missouri, nor did I spend more
than 30 days in Missouri during the year. I did maintain a
permanent place of abode in the state of
_____________ .
Non-Missouri Home of Record
I resided in Missouri during 2018 solely because my spouse
or I was stationed at
_____________________________
on military orders. My home of record is in the state of
and dates you resided there __________________________
B. Indicate the other state of residence
and dates you resided there __________________________
*18314010001*
18314010001
For Privacy Notice, see Instructions.
A. Date From: _______________ Date To: _____________
Date From: _______________ Date To: _____________ Date From: _______________ Date To: _____________
1. Nonresident of Missouri
2. Part-Year Missouri Resident
______________ .
3. Military/Nonresident Tax Status - Indicate your tax status
Missouri Home of Record
below and complete Part C - Missouri Income Percentage.
I did not at any time during the 2018 tax year maintain a
permanent place of abode in Missouri, nor did I spend more
than 30 days in Missouri during the year. I did maintain a
permanent place of abode in the state of
_____________ .
Non-Missouri Home of Record
I resided in Missouri during 2018 solely because my spouse
or I was stationed at
_____________________________
on military orders. My home of record is in the state of
______________ .
MO-NRI Page 1
Line 1
Line 2
Line 3
28
11
00Q
00
0000
Part B
Worksheet for Missouri Source Income
Adjusted Gross
Income Computations
A. Wages, salaries, tips, etc. ...................................
B. Taxable interest income.....................................
C. Dividend income ..........................................
D. State and local income tax refunds (from schedule 1) .............
E. Alimony received (from schedule 1) ...........................
F. Business income or (loss) (from schedule 1) ....................
G. Capital gain or (loss) (from schedule 1) ........................
H. Other gains or (losses) (from schedule 1).......................
.
A
.
A
I. Taxable IRA distributions....................................
J. Taxable pensions and annuities ..............................
K. Rents, royalties, partnerships, S corporations, etc. (from schedule 1)
L. Farm income or (loss) (from schedule 1) .......................
M. Unemployment compensation (from schedule 1) . . . . . . . . . . . . . . . . .
N. Taxable social security benets ...............................
O. Other income (from schedule 1) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
P. Total - Add Lines A through O ................................
Q. Less: federal adjustments to income (from schedule 1) . . . . . . . . . . . .
R. SUBTOTAL (Line P - Line Q) If no modications to income,
S. Missouri modications - additions to federal adjusted gross income
T. Missouri modications - subtractions from federal adjusted gross income
enter this amount on Part C, Line 1 ............................
(Missouri source from Form MO-1040, Line 2) ..............................
(Missouri source from Form MO-1040, Line 4) ..............................
U. MISSOURI INCOME (Missouri sources). Line R plus Line S, minus
Line T. Enter this amount on Part C, Line 1.................................
Yourself or
One Income Filer
Spouse (On A
Combined Return)
Missouri Sources Missouri Sources
Federal Form
1040,
Line No.
.
00T
.
00T
.
00S
.
00S
.
00R
.
00R
Q
PP
OO
NN
MM
LL
KK
JJ
II
HH
GG
FF
EE
DD
CC
BB
.
00U
.
00U
7
36
21
5b
19
18
17
4b
4b
14
13
12
10
1
3b
2b
Part C
Missouri Income Percentage
1. Missouri Income - Enter wages, salaries, etc. from Missouri. (You must
le a Missouri return if the amount on this line is more than $600) ........
2. Taxpayer’s total adjusted gross income (From Form MO-1040, Lines 5Y
and 5S or from your federal form if you are a military nonresident and you
are not required to le a Missouri return) ............................
3. Missouri Income Percentage - Divide Line 1 by Line 2. If greater than
100%, enter 100%. (Round to a whole percent such as 91% instead of
90.5% and 90% instead of 90.4%. However, if percentage is less than
0.5%, use the exact percentage.) Enter percentage here and on Form
3Y %
Yourself or
One Income Filer
Spouse
(On A Combined Return)
*18314020001*
18314020001
Signature
Under penalties of perjury, I declare that I have examined this form and to the best of my knowledge and believe it is true, correct, and complete.
Declaration of preparer (other than taxpayer) is based on all information of which he/she has any knowledge. As provided in Chapter 143, RSMo,
a penalty of up to $500 shall be imposed on any individual who files a frivolous return.
Signature
Date (MM/DD/YY)
Spouse’s Signature (if filing combined, BOTH must sign)
Date (MM/DD/YY)
1S
00
.
1Y
00
.
2S
00
.
2Y
00
.
MO-1040, Lines 26Y and 26S ....................................
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
.
.
3S %
MO-NRI Page 2
0
0
0
0
0
0
Use worksheet values in NRI,
Part C, Line 1
Reset
0
0
Check boxes to carry amount to MO-1040 with values below
CHECK to fill Line 26Y
CHECK to fill Line 26S
0
0
Back to MO-1040, page 3
29
Instructions - MO-NRI, Part A
Part A, Line 1: Nonresidents of Missouri
If you are a Missouri nonresident and had Missouri source income, complete Part A, Line 1, Part B, and Part C. Attach a copy of
your federal return, Form(s) W-2 and 1099 and this form to your Missouri return.
Part A, Line 2: Part-Year Resident
If you were a Missouri part-year resident with Missouri source income and income from another state; you may use Form MO-NRI
or Form MO-CR, whichever is to your benefit. When using Form MO-NRI, complete Part A, Line 2, Part B, and Part C. Missouri
source income includes any income (pensions, annuities, etc.) that you received while living in Missouri. Attach a copy of your
federal return, Form(s) W-2 and 1099 and this form to your Missouri return.
Part A, Line 3: Military Nonresident Tax Status
Missouri Home of Record - If you have a Missouri home of record and you:
a) Did not have any Missouri income other than military income, were not in Missouri for more than 30 days, did not maintain a
home in Missouri during the year, but did maintain living quarters elsewhere, you qualify as a nonresident for tax purposes.
Complete Part A, Line 3 and enter “0” on Part C, Line 1.
b) Did have Missouri income other than military income, were in Missouri for more than 30 days or maintained a home in
Missouri during the year, you cannot use this form. You must file Form MO-1040 because 100 percent of your income is
taxable, including your military income. Do not complete this form.
c) Did not have Missouri income other than military income but spent more than 30 days in Missouri or maintained a home in
Missouri during the year, you must file Form MO-1040 because 100 percent of your income is taxable, including your military
income. Do not complete this form.
d) Are married to a Missouri resident, who is not in the military, but lives with you outside of Missouri on military orders, you may
use Form MO-NRI to calculate your Missouri income percentage. However, any income earned by your spouse is taxable to
Missouri. Your spouse is not eligible to complete Form MO-NRI.
Military Nonresident Stationed in Missouri - If you are a military nonresident, stationed in Missouri and you:
a) Earned non-military income while in Missouri - You must file Form MO-1040. Complete Part A, Line 3, Part B and Part C.
The nonresident military pay should be subtracted from your federal adjusted gross income using Form MO-A, Part 1, Line
10, as a “Military (nonresident) Subtraction”.
b) Only had military income while in Missouri - You may complete a Military - No Return Required Form online at
https://sa.dor.mo.gov/nri/.
Note: If you file a joint federal return, you must file a combined Missouri return (regardless of whom earned the income).
Complete each column of Part B and Part C of this form. Do not combine incomes for you and your spouse.
1. Did you maintain a permanent
place of residency in Missouri?
2. Did you spend more than 30
days in Missouri?
You are a
Resident.
Did you maintain a permanent place of
residency elsewhere?
1. Did you maintain a permanent
place of residency in Missouri?
2. Did you spend more than 183
days in Missouri?
Are you domiciled* in Missouri?
NO
YES
NO
to
both
YES
to
either
You are a
Nonresident
(for tax
purposes).
You are a Resident.
You are a
Nonresident.
You are a
Resident.
NO to either
YES
to
both
NO
YES
Use this diagram to determine if you or your spouse are a RESIDENT OR NONRESIDENT
*Domicile (Home of Record) - The place an individual intends to be his or her permanent home; a place that he or she intends to return whenever absent.
A domicile, once established, continues until the individual moves to a new location with the true intention of making his or her permanent home there.
An individual can only have one domicile at a time.
*18000000001*
18000000001
MO-NRI Page 3
30
*18317010001*
18317010001
Missouri Department of Revenue
2018 Home Energy Audit Expense
Form
MO-HEA
Street Address
City
Any taxpayer who paid an individual certied by the Division of Energy to complete a home energy audit may deduct 100 percent of the costs
incurred for the audit and the implementation of any energy efciency recommendations made by the auditor. The subtraction may not exceed
$1,000, for a single taxpayer or $2,000 for taxpayers ling combined returns. To qualify for the subtraction, you must have incurred expenses
in the taxable year you are ling a claim, and the expenses incurred must not have been excluded from your federal adjusted gross income or
reimbursed through any other state or federal program.
QualificationsInstructions
In the spaces provided below:
• Report the name of the auditor who conducted the audit
• Report the auditor’s certication number
• Summarize each of the auditor’s recommendations
• Enter the amount paid for the audit on Line A
• Enter the total amount paid to implement the energy
efciency recommendations on Line B
• Enter the total amount paid for the audit and any
implemented recommendations on Line C
• Attach applicable receipts
• Attach completed MO-HEA and receipts
to Form MO-1040
Auditor Summary
Auditor Name Auditor Certification Number
Summary of Recommendations
1
2
4
5
3
A
C
D
E
B
00
.
00
.
.
00
.
00
.
00
Form MO-HEA (Revised 12-2018)Taxation Division
A. Amount paid for audit ..............................................................
B. Amount paid to implement recommendations ...........................................
C. Total Paid - Add Lines A and B and enter here ..........................................
D. Enter $1,000 if a single ler or $2,000 if ling a combined return ............................
E. Amount from Line C or Line D, whichever is less. Enter here and on Form MO-A, Line 14. If you are
ling a combined return, you may split the amount reported on Line 14 between both spouses.....
Department Use Only
(MM/DD/YY)
Social Security Number
Taxpayer Name
- -
State ZIP Code
_
Spouse’s Social Security Number
Spouse’s Name
- -
Yourself
Spouse
Back to MO-A Part 2
35
For Privacy Notice, see instructions.
Missouri Tax
I.D. Number
Federal Employer
I.D. Number
• Benefit Number - The number is the last six (6) digits of the number located on your Certificate of Eligibility.
Example: For benefit, ABC-2018-12345-123456, enter 123456, on Form MO-TC.
• Alpha code - The three (3) character code located on the back of this form. Each credit is assigned an alpha code to ensure proper processing of
the credit claimed.
• If you are claiming more than 10 credits, attach additional MO-TC(s).
Form MO-TC (Revised 12-2018)
Form
MO-TC
Missouri Department of Revenue
2018 Miscellaneous Income Tax Credits
Social Security
Number
Name
(Last, First)
Spouse’s Social
Security Number
Spouse’s Name
(Last, First)
Use Column 1 if you are filing:
• An individual income tax return with a single type filing status;
• A fiduciary return; or,
• A corporation income tax return.
I declare under penalties of perjury that I employ no illegal or unauthorized aliens as defined under federal law and that I am not eligible for any tax
exemption, credit or abatement if I employ such aliens. I also declare that if I am a business entity, I participate in a federal work authorization program
with respect to the employees working in connection with any contracted services and I do not knowingly employ any person who is an unauthorized
alien in connection with any contracted services.
Instructions
*18306010001*
18306010001
Charter
Number
Corporation
Name
Department Use Only
(MM/DD/YY)
1. 1. 00 00
2. 2. 00 00
3. 3. 00 00
4. 4. 00 00
5. 5. 00 00
6. 6. 00 00
7. 7. 00 00
8. 8. 00 00
9. 9. 00 00
10. 10. 00 00
11. Subtotals - add Lines 1 through 10. ......................................................... 11. 00 00
12. Enter the amount of the tax liability from Form MO-1040, Line 29Y for yourself and Line 29S for your spouse,
or Form MO-1120, Line 15 plus Line 16 for income from or Form MO-1041, Line 18.
.....................
12. 00 00
13. Total Credits - add amounts from Line 11, Columns 1 and 2. (Enter here and on Form MO-1120, Line 18; Form MO-1040,
Line 36; or Form MO-1041, Line 19.) Line 13 cannot exceed the amount on Line 12, unless the credit is refundable. ........
13. 00
• Yourself
• Corporation Income
• Fiduciary
• Spouse
(on a combined return)
Column 1 Column 2
Alpha Code
(3 characters)
from back
Benet Number
(See example above)
Credit Name
Each credit will apply against your tax
liability in the order they appear below
If you are a shareholder or partner claiming a credit, attach a copy of the shareholder listing or Federal Schedule K-1, specifying your percentage and the
corporation’s percentage of ownership.
If you are filing a combined return and both you and your spouse have income:
• Use Column 1 for yourself and Column 2 for spouse.
• Both names must be on the credit certificate.
Use this form to claim income tax credits on Form MO-1040, MO-1120,
or MO-1041. Attach to Form MO-1040, MO-1120, or MO-1041.
,
,
For Privacy Notice CLICK HERE
35
For Privacy Notice, see instructions.
Missouri Tax
I.D. Number
Federal Employer
I.D. Number
• Benefit Number - The number is the last six (6) digits of the number located on your Certificate of Eligibility.
Example: For benefit, ABC-2018-12345-123456, enter 123456, on Form MO-TC.
• Alpha code - The three (3) character code located on the back of this form. Each credit is assigned an alpha code to ensure proper processing of
the credit claimed.
• If you are claiming more than 10 credits, attach additional MO-TC(s).
Form MO-TC (Revised 12-2018)
Form
MO-TC
Missouri Department of Revenue
2018 Miscellaneous Income Tax Credits
Social Security
Number
Name
(Last, First)
Spouse’s Social
Security Number
Spouse’s Name
(Last, First)
Use Column 1 if you are filing:
• An individual income tax return with a single type filing status;
• A fiduciary return; or,
• A corporation income tax return.
I declare under penalties of perjury that I employ no illegal or unauthorized aliens as defined under federal law and that I am not eligible for any tax
exemption, credit or abatement if I employ such aliens. I also declare that if I am a business entity, I participate in a federal work authorization program
with respect to the employees working in connection with any contracted services and I do not knowingly employ any person who is an unauthorized
alien in connection with any contracted services.
Instructions
*18306010001*
18306010001
Charter
Number
Corporation
Name
Department Use Only
(MM/DD/YY)
1. 1. 00 00
2. 2. 00 00
3. 3. 00 00
4. 4. 00 00
5. 5. 00 00
6. 6. 00 00
7. 7. 00 00
8. 8. 00 00
9. 9. 00 00
10. 10. 00 00
11. Subtotals - add Lines 1 through 10. ......................................................... 11. 00 00
12. Enter the amount of the tax liability from Form MO-1040, Line 29Y for yourself and Line 29S for your spouse,
or Form MO-1120, Line 15 plus Line 16 for income from or Form MO-1041, Line 18.
.....................
12. 00 00
13. Total Credits - add amounts from Line 11, Columns 1 and 2. (Enter here and on Form MO-1120, Line 18; Form MO-1040,
Line 36; or Form MO-1041, Line 19.) Line 13 cannot exceed the amount on Line 12, unless the credit is refundable. ........
13. 00
• Yourself
• Corporation Income
• Fiduciary
• Spouse
(on a combined return)
Column 1 Column 2
Alpha Code
(3 characters)
from back
Benet Number
(See example above)
Credit Name
Each credit will apply against your tax
liability in the order they appear below
If you are a shareholder or partner claiming a credit, attach a copy of the shareholder listing or Federal Schedule K-1, specifying your percentage and the
corporation’s percentage of ownership.
If you are filing a combined return and both you and your spouse have income:
• Use Column 1 for yourself and Column 2 for spouse.
• Both names must be on the credit certificate.
Use this form to claim income tax credits on Form MO-1040, MO-1120,
or MO-1041. Attach to Form MO-1040, MO-1120, or MO-1041.
,
,
0
0
0
0
0
Back to MO-1040, page 3
For Privacy Notice CLICK HERE
36
* Must be approved by the issuing agency
Individuals with speech or hearing impairments may call TTY (800) 735-2966 or fax (573) 526-1881.
Miscellaneous tax credits are administered by various agencies. For more information, forms, and approval to claim these credits,
contact the following Departments. Visit http://dor.mo.gov/taxcredit/ for a description of each credit and more contact information for
agencies administering each credit.
P.O. Box 118, Jefferson City, MO 65102-0118
http://www.ded.mo.gov
Alpha Attach to
Code Name of Credit and Phone Number Form MO-TC
AFI Alternative Fuel Infrastructure - (573) 751-2254 Certificate*
BFC New or Expanded Business Facility - (573) 526-5417 Schedule 150,
Fed. K-1, Form 4354
BJI Brownfield “Jobs and Investment” - (573) 522-8004 Certificate*
DAL Distressed Area Land Assemblage - (573) 522-8006 Certificate*
DFH Dry Fire Hydrant - (573) 751-9048 Certificate*
DPC Development Tax Credit - (573) 526-3285 Certificate*
EZC Enterprise Zone - (573) 522-2790 Schedule 250,
Fed. K-1, Form 4354
FDA Family Development Account - (573) 751-4539 Certificate*
FPC Film Production - (573) 751-9048 Certificate*
HPC Historic Preservation - (573) 522-8004 Certificate*
ISB Small Business Investment (Capital) - (573) 526-5417 Certificate*
ICT Innovation Campus Tax Credit - (573) 751-4539 Certificate*
MQJ Missouri Quality Jobs - (573) 751-4539 Certificate*
MWC Missouri Works Credit - (573) 522-9062 Certificate*
NAC Neighborhood Assistance - (573) 522-2629 Certificate*
NEC New Enterprise Creation - (573) 522-2790 Certificate*
NEZ New Enhanced Enterprise Zone - (573) 751-4539 Certificate*
NMC New Market Tax Credit - (573) 522-8004 Certificate*
RCC Rebuilding Communities - (573) 526-3285 Certificate*
RCN Rebuilding Communities and Neighborhood
Preservation Act - (573) 522-8004 Certificate*
REC Qualified Research Expense - (573) 526-0124 Certificate*
RTC Remediation - (573) 522-8004 Certificate*
SBG Small Business Guaranty Fees - (573) 751-9048 Certificate*
SBI Small Business Incubator - (573) 751-4539 Certificate*
SEC Sporting Event Credit - (573) 522-8004 Certificate*
SPC Sporting Contribution Credit - (573) 522-8004 Certificate*
TDC Transportation Development - (573) 751-4539 Certificate*
WEC Processed Wood Energy - (573) 526-1723 Certificate*
WGC Wine and Grape Production - (573) 751-9048 Certificate*
YOC Youth Opportunities - (573) 751-4539 Certificate*
Missouri Development Finance Board
P.O. Box 567, Jefferson City, MO 65102-0567
http://www.mdfb.org • (573) 751-8479
Alpha Attach to
Code Name of Credit Form MO-TC
BEC Bond Enhancement Certificate*
BUC Missouri Business Use Incentives for Large Certificate*
Scale Development (BUILD)
DRC Development Reserve Contribution Credit Certificate*
EFC Export Finance Certificate*
IDC Infrastructure Development Certificate*
Missouri Housing Development Commission
3435 Broadway, Kansas City, MO 64111
http://www.mhdc.com
Alpha Attach to
Code Name of Credit and Phone Number Form MO-TC
AHC Affordable Housing Assistance - (816) 759-6878 Certificate*
LHC Missouri Low Income Housing - (816) 759-6878 Eligibility Statement,
Fed. K-1, 8609A,
8609 (first year)
P.O. Box 2200, Jefferson City, MO 65105-2200
http://dor.mo.gov/ • (573) 751-3220 or (573) 751-4541
Alpha Attach to
Code Name of Credit Form MO-TC
ATC Special Needs Adoption Form ATC, and
Federal Form 8839
Missouri Department of Economic Development
Missouri Department of Revenue (Continued)
Form MO-TC (Revised 12-2018)
*18000000001*
18000000001
Missouri Department of Revenue
BFT Bank Franchise Tax Form INT-2, INT-2-1
BTC Bank Tax Credit for S Corporation Form BTC, and Form
Shareholders INT-3,
2823, INT-2, Fed. K-1
CIC Children in Crisis Contribution
Verification from
Issuing Agency
CFC Champion for Children Contribution
Verification from
Issuing Agency
DAC Disabled Access Federal Form 8826
and Form MO-8826
DAT Residential Dwelling Accessibility Form MO-DAT
FPT Food Pantry Tax Form MO-FPT
SHC Self-Employed Health Insurance Form MO-SHC
SSC Public Safety Officer Surviving Spouse Form MO-SSC
Missouri Agricultural and Small
Business Development Authority
P.O. Box 630, Jefferson City, MO 65102-0630
http://www.agriculture.mo.gov • (573) 751-2129
Alpha Attach to
Code Name of Credit Form MO-TC
APU Agricultural Product Utilization Contributor Certificate*
FFC Family Farms Act Certificate*
MPF Meat Processing Facility Investment Tax Credit Certificate*
NGC New Generation Cooperative Incentive Certificate*
QBC Qualified Beef Certificate*
Missouri Department of Natural Resources
Jefferson City, MO 65105
http://www.dnr.mo.gov
Alpha Attach to
Code Name of Credit and Phone Number Form MO-TC
CPC Charcoal Producers - (573) 751-4817 Certificate*
Missouri Department of Social Services
Jefferson City, MO 65109
http://www.dss.mo.gov/dfas/taxcredit/index.htm • (573) 751-7533
Alpha Attach to
Code Name of Credit Form MO-TC
DBC Diaper Bank Certificate*
DDC Developmental Disability Care Provider Certificate*
DVC Shelter for Victims of Domestic Violence Certificate*
MHC Maternity Home Certificate*
PRC Pregnancy Resource Certificate*
RTA Residential Treatment Agency Certificate*
SCH School Children Health and Hunger Certificate*
Missouri Department of Health
Division of Senior Services
P.O. Box 570, Jefferson City, MO 65102-0570
http://www.dhss.mo.gov
Alpha Attach to
Code Name of Credit and Phone Number Form MO-TC
SCT Shared Care - (573) 751-4842 Must Register Each
Year With Division of
Senior and Disability
Services
- Attach
Form MO-SCC
1. Wages, salaries, tips, etc............................................... 1 00 1 00
2. Taxable interest income............................................... 2b 00 2 00
3. Dividend income.................................................... 3b 00 3 00
4. State and local income tax refunds (from schedule 1) ........................ 10 00 4 00
5. Alimony received (from schedule 1) ..................................... 11 00 5 00
6. Business income or (loss) (from schedule 1)................................ 12 00 6 00
7. Capital gain or (loss) (from schedule 1) ................................... 13 00 7 00
8. Other gains or (losses) (from schedule 1) .................................. 14 00 8 00
9. Taxable IRA distributions.............................................. 4b 00 9 00
10. Taxable pensions and annuities ......................................... 4b 00 10 00
11. Rents, royalties, partnerships, S corporations, trusts, etc. (from schedule 1)........... 17 00 11 00
12. Farm income or (loss) (from schedule 1) .................................. 18 00 12 00
13. Unemployment compensation (from schedule 1)............................ 19 00 13 00
14. Taxable social security benefits ......................................... 5b 00 14 00
15. Other income (from schedule 1) ........................................ 21 00 15 00
16. Total (add Lines 1 through 15) .......................................... 00 16 00
17. Less: federal adjustments to income (from schedule 1)........................ 36 00 17 00
18. Federal adjusted gross income (Line 16 less Line 17)
Enter amounts here and on Lines 1Y and 1S, Form MO-1040..................... 7 00 18 00
Adjusted Gross Income Worksheet for Combined Return
Federal Form
1040 Line No.
Y - Yourself
S - Spouse
Missouri law requires a combined return for married couples filing together. A combined return means taxpayers are required to split their total federal adjusted gross income
(including other state income) between spouses when beginning the Missouri return.
Splitting the income can be as easy as adding up your separate Form(s) W-2 and 1099. Or it may require allocating to each spouse the percentage of ownership in jointly
held property, such as businesses, farm operations, dividends, interest, rent, and capital gains or losses. State refunds should be split based on each spouse’s 2017 Missouri
tax withheld, less each spouse’s 2017 tax liability. The result should be each spouse’s portion of the 2017 refund. Taxable social security benefits must be allocated by each
spouse’s share of the benefits received for the year.
The worksheet below lists income that is included on your federal return, along with federal line references. Find the lines that apply to your federal return, split the income between
you and your spouse, and enter the amounts on the worksheet. When you have completed the worksheet, transfer the amounts from Line 18 to Form MO-1040, Lines 1Y and 1S.
Note: Remember, the incomes listed separately on Line 18 of this worksheet must equal your total federal adjusted gross income when added together.
Worksheet for Line 1 - Instructions for Completing the Adjusted Gross Income Worksheet
0
0
0
0
Carry amounts to MO-1040, Line 1Y and 1S.
Back to MO-1040, page 2
32
This form must be attached to Form MO-1040 or MO-1040P.
*18323010001*
18323010001
Missouri Department of Revenue
2018 Property Tax Credit Schedule
Department Use Only
(MM/DD/YY)
Social Security Number
Spouse’s Social Security Number
Form
MO-PTS
Date of Birth (MM/DD/YYYY)
Spouse’s Date of Birth (MM/DD/YYYY)
Select only one qualification. Copies of letters, forms, etc., must be included with claim.
A. 65 years of age or older - You must be a full year resident. (Attach Form SSA-1099.)
B. 100% Disabled Veteran as a result of military service (Attach letter from Department of Veterans Affairs - see instructions.)
C. 100% Disabled (Attach letter from Social Security Administration or Form SSA-1099.)
D. 60 years of age or older and received surviving spouse benefits (Attach Form SSA-1099.)
Qualifications
Select only one filing status. If married filing combined, you must report both incomes.
1. Enter the amount of income from Form MO-1040, Line 6 or Form MO-1040P, Line 4 .........
2. Enter the amount of nontaxable social security benefits received by you, your spouse, and your
minor children before any deductions and the amount of social security equivalent railroad
retirement benefits. Attach Form(s) SSA-1099 or RRB-1099 (TIER I) .....................
3. Enter the total amount of pensions, annuities, dividends, rental income, or interest income not
included in Line 1. Include tax exempt interest from MO-A, Part 1, Line 8 (if filing Form
4. Enter the amount of railroad retirement benefits (not included in Line 2) before any deductions.
Attach Form RRB-1099-R (Tier II). If filing Form MO-1040, refer to MO-A, Part 1, Line 10 . . . . .
Attach letter from Veterans Affairs (see instructions) ..................................
Filing
Status
MO-1040). Attach Form(s) W-2, 1099, 1099-R, 1099-MISC, 1099-INT, 1099-DIV, etc ........
1
2
3
4
5
Income
00
.
00
.
00
.
00
.
00
.
5. Enter the amount of veterans payments or benefits before any deductions.
Single Married - Filing Combined Married - Living Separate for Entire Year
M.I. Last NameFirst Name
M.I. Last NameSpouse’s First Name
- -
- -
For Privacy Notice, see Instructions.
Failure to provide the following attachments will result in denial or delay of your claim:
rent receipt(s), Verification of Rent Paid (Form 5674) or a signed landlord statement, Form(s) 1099, W-2, etc.
MO-PTS Page 1
0
Line 2
Line 3
Line 4
Line 5
33
*18323020001*
18323020001
9. Enter the appropriate amount from the options below ..................................
10. Net household income - Subtract Line 9 from Line 8 and enter the amount here .............
• If you rented or did not own and occupy your home for the entire year and Line 10 is
greater than $27,500, you are not eligible to file this claim.
• If you owned and occupied your home for the entire year and Line 10 is greater
than $30,000, you are not eligible to file this claim.
11. If you owned your home, enter the total amount of property tax paid for your home, less
special assessments, or $1,100, whichever is less. Attach a copy of paid real estate tax
receipt(s). If your home is on more than five acres or you own a mobile home, attach the
12. If you rented, enter the total amount from Certification of Rent Paid (Form(s) MO-CRP), Line 9
or $750, whichever is less. Attach a completed Verification of Rent Paid (Form 5674).
Note: If you rent from a facility that does not pay property tax, you are not eligible for a
13. Enter the total of Lines 11 and 12, or $1,100, whichever is less ..........................
14. Apply Lines 10 and 13 to the chart in the instructions for MO-1040, pages 49-51 or MO-1040P,
pages 29-31 to figure your Property Tax Credit. You must use the chart to see how much credit
you are allowed. Enter this amount on Form MO-1040, Line 37 or Form MO-1040P, Line 17 .....
This form must be attached to Form MO-1040 or Form MO-1040P.
11
12
14
13
Income (continued)Real Estate or RentCredit
8. Total household income - Add Lines 1 through 7 and enter the total here .................
8
00
.
9
00
.
10
00
.
00
.
00
.
00
.
00
.
Assessor’s Certification (Form 948) ...............................................
7. Enter the amount of nonbusiness loss(es). You must include nonbusiness loss(es) in your
household income (as a positive amount) here. (Include capital loss from Federal Form 1040,
7
00
. Schedule 1, Line 13.) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
6. Enter the total amount received by you, your spouse, and your minor children from: public
assistance, SSI, child support, or Temporary Assistance payments (TA and TANF). Attach a
letter from the Social Security Administration that includes the total amount of assistance
received and Form 1099 from Employment Security, if applicable ........................
6
00
.
• Single or Married Living Separate - Enter $0
• Married and Filing Combined - rented or did not own your home for the entire year - Enter $2,000
• Married and Filing Combined - owned and occupied your home for the entire year - Enter $4,000
K RA U
Department Use Only
Property Tax Credit ............................................................
MO-PTS Page 2 (Revised 12-2018)
Line 6
Line 7
0
0
Line 9
Check if you owned and occupied
your home for the entire year
0
Line 10
Line 11
Go to MO-CRP
0
Line 12
0
Line 13
0
Line 14
Back to MO-1040, page 3
For Privacy Notice, see instructions.
Missouri Department of Revenue
2018 Certification of Rent Paid
Form
MO-CRP
1. Social Security Number
Form MO-CRP (Revised 12-2018)
*18315010001*
18315010001
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
Landlord’s Last 4 Digits of Social Security Number
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 persons 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
Landlord’s Federal Employee Identification Number (FEIN) - if applicable
Line 1
2018
2018
Line 6
Line 7
0
Line 8
0
Line 9
Back to MO-PTS
For Privacy Notice, see instructions.
Missouri Department of Revenue
2018 Certification of Rent Paid
Form
MO-CRP
1. Social Security Number
Form MO-CRP (Revised 12-2018)
*18315010001*
18315010001
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
Landlord’s Last 4 Digits of Social Security Number
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 persons 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
Landlord’s Federal Employee Identification Number (FEIN) - if applicable
Line 1
2018
2018
Line 6
Line 7
0
Line 8
0
Line 9
Back to MO-PTS
For Privacy Notice, see instructions.
Missouri Department of Revenue
2018 Certification of Rent Paid
Form
MO-CRP
1. Social Security Number
Form MO-CRP (Revised 12-2018)
*18315010001*
18315010001
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
Landlord’s Last 4 Digits of Social Security Number
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 persons 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
Landlord’s Federal Employee Identification Number (FEIN) - if applicable
Line 1
2018
2018
Line 6
Line 7
0
Line 8
0
Line 9
Back to MO-PTS
For Privacy Notice, see instructions.
Missouri Department of Revenue
2018 Certification of Rent Paid
Form
MO-CRP
1. Social Security Number
Form MO-CRP (Revised 12-2018)
*18315010001*
18315010001
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
Landlord’s Last 4 Digits of Social Security Number
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 persons 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
Landlord’s Federal Employee Identification Number (FEIN) - if applicable
Line 1
2018
2018
Line 6
Line 7
0
Line 8
0
Line 9
Back to MO-PTS
For Privacy Notice, see instructions.
Missouri Department of Revenue
2018 Certification of Rent Paid
Form
MO-CRP
1. Social Security Number
Form MO-CRP (Revised 12-2018)
*18315010001*
18315010001
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
Landlord’s Last 4 Digits of Social Security Number
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 persons 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
Landlord’s Federal Employee Identification Number (FEIN) - if applicable
Line 1
2018
2018
Line 6
Line 7
0
Line 8
0
Line 9
Back to MO-PTS
A. Enter the amount paid for qualified
long-term care insurance policy.
.....A) $ ______________
If you itemized on your federal return
and your federal itemized deductions
included medical expenses, go to
Line B. If not, skip to H.
B. Enter the amount from Federal
Schedule A, Line 4
...............B) $ ______________
C. Enter the amount from Federal
Schedule A, Line 1.
...............C) $ ______________
D. Enter the amount of qualified
long-term care included on Line C
...D) $ ______________
E. Subtract Line D from Line C ........E) $ ______________
F. Subtract Line E from Line B.
If amount is less than zero, enter “0”.
F) $ ______________
G. Subtract Line F from Line A .........G) $ ______________
H. Enter Line G (or Line A if you did not
have to complete Lines B through G)
on Form MO-1040, Line 14.
Attach a copy of your Federal Form 1040 (pages 1 and 2) and
Federal Schedule A (if you itemized your deductions).
Worksheet for Long-Term Care Insurance Deduction
0
0
0
Back to MO-1040, page 2
31
Missouri Department of Revenue
Qualified Health Insurance Premiums
Worksheet for MO-A, Line 12
Form
5695
Yourself (Y) Spouse (S)
1. Enter the amount from Federal Form 1040, Line 5a. If $0, skip to Line 6 and enter your total health insurance
premiums paid ...........................................................................
00
.
1
Complete this worksheet and attach it, along with proof of premiums paid, to Form MO-1040 if you included health insurance premiums paid as an
itemized deduction or had health insurance premiums withheld from your social security benefits.
If you had premiums withheld from your social security benefits, complete Lines 1 through 4 to determine your taxable percentage of social security
2. Enter amount from Federal Form 1040, Line 5b .................................................
00
.
4S
00
.
4Y
3. Divide Line 2 by Line 1 .....................................................................
00
.
2
3
4. Enter the health insurance premiums withheld from your social
security income .............................................
5. Multiply the amounts on Line 4Y and 4S by the percentage on Line 3. ...
6. Enter the total of all other health insurance premiums paid, which
were not included on 4Y or 4S ..................................
7. Add the amounts from Lines 5 and 6 .............................
00
.
5S
00
.
5Y
00
.
6S
00
.
6Y
00
.
7S
00
.
7Y
8. Add the amounts from Lines 7Y and 7S .......................................................
00
.
8
9. Divide Line 7Y and 7S by the total found on Line 8. If you itemized
9S9Y
on your federal return and your federal itemized deductions included
health insurance premiums as medical expenses, go to Line 10.
If not, go to Line 15 ...........................................
10. Enter the amount from Federal Schedule A, Line 1 ...............................................
00
.
10
11. Enter the amount from Federal Schedule A, Line 4................................................
00
.
11
12. Divide Line 11 by Line 10 (round to full percent) .................................................
12 %
13. Multiply Line 8 by percent on Line 12 ..........................................................
00
.
13
14. Subtract Line 13 from Line 8.................................................................
00
.
14
15. Enter your federal taxable income from Federal Form 1040, Line 10..................................
00
.
15
16. If you itemized on your federal return and completed Lines 10 through 14 above, enter the amount from
00
.
16
Line 14 or Line 15, whichever is less. If not, enter the amount from Line 8 or Line 15, whichever is less ......
17. Multiply Line 16 by the percentage on Line 9Y and Line 9S.
Enter the amounts on Line 17Y and 17S of this worksheet on Line 12
Form 5695 (Revised 12-2018)
income and the corresponding taxable portion of your health insurance premiums included in your taxable income.
*18351010001*
18351010001
of Form MO-A ...............................................
00
.
17S
00
.
17Y
%
%%
Social Security Number
- -
Spouse’s Social Security Number
- -
0
0
0
0
0
0
0
0
0
0
0
0
0
Back to MO-A, Line 12
Missouri Department of Revenue
2018 MOST - Missouri’s 529 Education Savings
Plan Direct Deposit Form - Individual Income Tax
Form
5632
Taxpayer
*18348010001*
18348010001
MOST-Missouri’s 529 Education Savings Plan
Form 5632 (Revised 12-2018)
If you wish to deposit all or a portion of your refund into a Missouri MOST 529 Education Savings Plan, you must include this form with
Taxation Division
Add the amounts from Line A through Line D and enter the total deposit amount here
Requirements
If you want to deposit your refund as a contribution to one or more Missouri MOST 529 Education Savings Plan accounts:
• You must have an open Missouri MOST 529 Education Savings Plan account that is administered by the Missouri Education
Savings Program. See the contact information below.
• Your total deposit must be at least $25.
• If your overpayment is adjusted and the amount you requested to deposit exceeds your available refund, the Department will
• If your refund is offset to pay another debt, the Department will cancel your deposit.
cancel your deposit and issue a refund to you.
Enter the 11-digit MOST 529 account number and the amount you want contributed to each account. (You may contribute to a
maximum of four accounts.)
529 Account
A) Account Number
B) Account Number
C) Account Number
D) Account Number
Total Deposit
and on Form MO-1040, Line 45; Form MO-1040A, Line 16; or Form MO-1040P, Line 22.
Contact Information
-
A) Amount
B) Amount
C) Amount
D) Amount
your Missouri Individual Income Tax Return.
E-mail: most529@missourimost.org
Telephone: (888) 414-6678
https://www.missourimost.org
00
.
-
-
-
M.I.
Last Name
First Name Suffix
Spouse’s Last NameSpouse’s First Name
M.I.
Suffix
00
.
00
.
00
.
00
.
Social Security Number Spouse’s Social Security Number
- - - -
Department Use Only
(MM/DD/YY)
Back to MO-1040, page 4
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Completed 9 December 2019

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