Form M1pr, Homestead Credit Refund (For Homeowners) printable pdf download

FINAL 10/3/16

201621

Form M1PR, Homestead Credit Refund (for Homeowners)

and Renter Property Tax Refund 2016

Leave unused boxes blank. DO NOT USE STAPLES.

Your First Name and Initial

Last Name

Your Social Security Number

If a Joint Return, Spouse’s First Name and Initial

Spouse’s Last Name

Spouse’s Social Security Number

Mark

an X if a

Current Home Address (Street, Apartment Number, Route)

Your Date of Birth

foreign

Mark an X if a

new address:

address:

City

State

Zip Code

Spouse’s Date of Birth

Mark an X in

Renter

Homeowner

Nursing Home or Adult

Mobile Home

the oval boxes

Foster Care Resident

Owner

that apply:

State Elections Campaign Fund. If you did not designate

Political party and code number:

Your

Spouse’s

code:

on your 2016 Form M1, and you want $5 to go to candidates

Republican . . . . . . . . . . . . . 11 Grassroots—Legalize Cannabis 14

Legal Marijuana Now . . . .17

for state offices for campaign expenses, enter the code number

Democratic/Farmer-Labor 12 Green . . . . . . . . . . . . . . . . . . . . . 15

General Campaign

for the party of your choice. This will not reduce your refund.

Independence . . . . . . . . . . 13 Libertarian . . . . . . . . . . . . . . . . . 16

Fund . . . . . . . . . . . . . . . . . .99

1 Federal adjusted gross income (from line 37 of federal Form 1040,

If a negative number, mark an X in oval box.

line 21 of Form 1040A, or line 4 of Form 1040EZ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

2 Nontaxable Social Security and/or Railroad Retirement Board benefits received

and not included in line 1 above (determine from instructions) . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2

3 Deduction for contributions to a qualified retirement plan (add lines 28 and 32 of federal

Form 1040 or from line 17 of Form 1040A). Also see line 33 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3

Total payments from programs including MFIP (

MN Family Investment Program), MSA (MN Supplemental

. . . . . . . 4

and GRH (

Aid), SSI (Supplemental Security Income), GA (General Assistance)

Group Residential Housing)

5 Additional nontaxable income such as distributions from a Roth account, contributions

to a deferred compensation plan, scholarships, and grants (see instructions) . . . . . . . . . . . . . . . . . . . . 5

Income Types:

6 Add lines 1 through 5. If your income is less than the rent you paid, enclose an explanation . . . . 6

7 Dependent, over 65, disabled, and retirement contribution subtraction

. . . 7

(use Schedule 2, on back)

8 Total household income. Subtract line 7 from line 6 (if result is zero or less, leave blank) . . . . . . 8

9 Renters: Line 3 of your 2016 Certificate(s) of Rent Paid (CRP).

Continue with line 10; this amount is not your refund (you must enclose your CRPs) . . . . . . . . . . 9

10 Renters: Using the amounts on line 8 and line 9, find the amount to enter here from the

renters refund table in the instructions. Continue with lines 15-17 . . . . . . . . . . . . . . . . . . . . . . . . 10

ALL HOMEOWNERS: REQUIRED — Property ID number (use numbers only):

County in which the property is located

1 1 Property tax from line 1 of Statement of Property Taxes Payable in 2017 . . . . . . . . . . . . . . . . . . . 11

(Mobile homeowners: See instructions)

1 2 If claiming the special refund, enter amount from line 30, Schedule 1 (see instructions) . . . . . 12

1 3 Subtract line 12 from line 11 (if result is zero or less, leave blank) . . . . . . . . . . . . . . . . . . . . . . . . 13

14 Homestead Credit Refund: Using the amounts on line 8 and line 13, find the

amount to enter here from the homeowners refund table in the instructions . . . . . . . . . . . . . . . . 14

15 Add lines 10, 12, and 14 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15

16 Nongame Wildlife Fund contribution. Your refund will be reduced by this amount . . . . . . . . . . . . 16

17 YOUR REFUND. Subtract line 16 from line 15 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17

9995

Form M1pr, Homestead Credit Refund (For Homeowners)

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