Form Mo-Ptc - Property Tax Credit Claim Fillable Calculating - 2012, Form Mo-Crp - Certification Of Rent Paid For 2012

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DO NOT file this claim if you are going to file a Missouri income tax return! See the instructions.

AMENDED CLAIM

2012 FORM MO-PTC

Do automatic calculations

Don't do any calculations

MISSOURI DEPARTMENT OF REVENUE

VENDOR

006

CODE

PROPERTY TAX CREDIT CLAIM

000

INSTRUCTIONS:

- You must use the print button at the top of page to print form

SOCIAL SECURITY NO.

SPOUSE’S SOCIAL SECURITY NO.

- Don't forget to attach all required forms

- You can tab from one field to another or use the mouse to

JR, SR

LAST NAME

FIRST NAME

INITIAL

click in the field you want.

- You must use your mouse to click in the check boxes.

BIRTHDATE (MMDDYY)

TELEPHONE NUMBER

DECEASED

__ __/__ __/__ __

2012

- If a field does not allow a negative number, and a negative

(_ _ _)_ _ _-_ _ _ _

number is entered, a zero will be displayed.

JR, SR

SPOUSE’S LAST NAME

FIRST NAME

INITIAL

IN CARE OF NAME (ATTORNEY, EXECUTOR, PERSONAL REPRESENTATIVE, ETC.)

BIRTHDATE (MMDDYY)

DECEASED

__ __/__ __/__ __

2012

PRESENT HOME ADDRESS

APT. NUMBER

CITY, TOWN, OR POST OFFICE

STATE

ZIP CODE

You must check a qualification to be eligible for a credit. Check only one. REQUIRED COPIES OF LETTERS, FORMS, ETC., MUST BE INCLUDED WITH CLAIM.

A. 65 years of age or older (Attach a copy of Form SSA-1099.)

C. 100% Disabled (Attach a copy of the letter from Social Security Administration

or Form SSA-1099.)

B. 100% Disabled Veteran as a result of military service

D. 60 years of age or older and received surviving spouse benefits (Attach a copy of

(Attach a copy of the letter from Department of Veterans

Affairs.)

Form SSA-1099.)

If married filing combined,

Married — Living Separate for Entire Year

Single

Married — Filing Combined

FILING STATUS

you must report both incomes.

FAILURE TO PROVIDE THE ATTACHMENTS LISTED BELOW (RENT RECEIPT(S), TAX RECEIPT(S), FORMS 1099, W-2, ETC.) WILL RESULT IN DENIAL OR DELAY OF YOUR CLAIM!

1. Enter the amount of social security benefits received by you, your spouse, and your minor children before any deductions

Line 1

and the amount of social security equivalent railroad retirement benefits. Attach Forms SSA-1099 and RRB-1099. ..........

2. Enter the total amount of wages, pensions, annuities, dividends, interest income, rental income, or other income.

Line 2

Attach Forms W-2, 1099, 1099-R, 1099-DIV, 1099-INT, 1099-MISC, etc. ................................................................................

Line 3

3. Enter the amount of railroad retirement benefits (not included in Line 1) before any deductions.Attach Form RRB-1099-R (Tier II). .

4. Enter the amount of veteran’s payments or benefits before any deductions. Attach letter from Veterans Affairs. .................

Line 4

5. Enter the total amount received by you, your spouse, and your minor children from: public assistance, SSI, child support, Temporary

Assistance payments (TA and TANF). Attach copy of Forms SSA-1099, a letter from the Social Security Administration

and Social Services that includes the total amount of assistance received and Employment Security 1099, if applicable. .......

Line 5

6. TOTAL household income — Add Lines 1 through 5. .................................................................................................................

7. Mark the box that applies and enter the appropriate amount.

a. Enter $0 if filing status is Single or Married Living Separate;

If married and filing combined;

b. Enter $2,000 if you rented or did not own your home for the entire year;

Line 7

c. Enter $4,000 if you owned and occupied your home for the entire year; .......................................................................

8. Net household income — Subtract Line 7 from Line 6 and enter the amount; mark the box that applies.

a. If you rented or did not own and occupy your home for the entire year, Line 8 cannot exceed $27,500.

If the total is greater than $27,500, STOP - no credit is allowed. Do not file this claim.

b. If you owned and occupied your home for the entire year, Line 8 cannot exceed $30,000.

If the total is greater than $30,000, STOP - no credit is allowed. Do not file this claim. ...............................................

Line 8

9. 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 Form 948, Assessor’s Certification. ....................................................................................................

Line 9

Go To Form MO-CRP

10. If you rented, enter the total amount from Form(s) MO-CRP, Line 9, or $750, whichever is less. Attach rent receipts or a signed

statement from your landlord. NOTE: If you rent from a facility that does not pay property tax, you are not eligible for

Line 10

a Property Tax Credit. ................................................................................................................................................................... 10

Enter the total of Lines 9 and 10, or $1,100, whichever is less

11.

. ............................................................................................. 11

Line 11

12. You must use the chart on pages 13-15 to see how much refund you are allowed.

Apply amounts from Lines 8 and 11 to chart on pages 13-15 to figure your Property Tax Credit.

Debit Card 12

Check the box if you want your refund issued on a debit card. See instructions for Line 12. .............................

Line 12

If you would like your refund deposited directly to your checking or savings account, complete boxes a, b, and c below.

a. Routing Number

b. Account Number

Checking

Savings

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. Declaration of

preparer (other than taxpayer) is based on all information of which he or 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.

I also 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.

E-MAIL ADDRESS

PREPARER’S PHONE

I authorize the Director of Revenue or delegate to discuss my claim and attachments

with the preparer or any member of the preparer’s firm.

YES

(__ __ __) __ __ __- __ __ __ __

SIGNATURE

DATE (MMDDYYYY)

PREPARER’S SIGNATURE

FEIN, SSN, OR PTIN

_ _/_ _/_ _ _ _

SPOUSE’S SIGNATURE (If filing combined, BOTH must sign)