Form Crp - Certificate Of Rent Paid - Minnesota Department Of Revenue - 2016

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CRP, Certificate of Rent Paid 2016
Eligible renters (see eligibility requirements below) may receive a refund based on property taxes paid on their principal place of
residence in Minnesota and their income .
The landlord is required to give each renter a completed CRP, Certificate of Rent Paid, no later than January 31, 2017 .
Renters will need this CRP to apply for a property tax refund .
You must file Form M1PR and include all CRPs to claim a refund. Your refund will be denied or delayed if you do not include
all CRPs when filing Form M1PR.
Roommates: The landlord is required to give each unmarried renter living in a unit a separate CRP showing that each roommate
paid an equal portion of the rent, regardless of the portion actually paid or whose names are on the lease .
Renter’s name and address of the unit rented
Owner’s or managing agent’s name and address (including zip code)
Property ID number or parcel number
County
Number of units on this property
Rented from (MM/DD/YYYY): to (MM/DD/YYYY):
Total months rented
Number of adults living in unit
Place an X in box if count
(count married couple as 1)
includes married couple
Place an X if:
Nursing home
Intermediate care facility
Adult foster care
Assisted living
A. Amount paid for the renter by medical assistance (Medicaid) . . . . . . . . . . . . . . . . .
B. Group Residential Housing (GRH) payments received by landlord
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
on behalf of this renter
. . . . . . .
1
Rent paid to you by this individual renter or married couple for 2016 (round to nearest whole dollar)
1
If a government housing agency paid you part of the rent for this unit, place an X in this box,
but do not include the amounts paid by the government agency in line 1 .
Place an X in this box if rent was for a mobile home lot .
Place an X in this box if this renter received reduced rent for being caretaker .
Enter the rent reduction for this renter that is included on line 1 here:
17 %
The percentage for all renters is 17 percent (.17)
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
2
3
(round to nearest whole dollar)
3
Multiply line 1 by line 2 . Renters: Include this amount on line 9 of Form M1PR
Landlord: I declare that this certificate is correct and complete to the best of my knowledge and belief.
Owner’s or agent’s signature
Date
Business phone
Eligibility Requirements for Renters
You may qualify for the property tax refund if all of the following conditions apply to you for 2016:
• You were a full-year or part-year resident of Minnesota;
• You cannot be claimed as a dependent on someone else’s 2016 federal income tax return; and
• Your total household income is less than $58,880 . (Household income is your federal adjusted gross income plus most nontax-
able income . If you are married and living together, both incomes are included in household income . If you are single, use your
income only; do not include the income of any other person living with you . Also, to arrive at your total household income, a
subtraction is allowed if you have dependents, if you contribute to a qualified retirement plan, or if you or your spouse are age 65
or older or disabled .)
If you meet the above eligibility requirements, complete Form M1PR, Homeowners Homestead Credit Refund and Renters Property
Tax Refund, to determine the amount of your refund. You must include this CRP when you file your return. Your refund will be delayed
or denied if you do not include your CRP(s) when you file Form M1PR.
You can find Form M1PR and other tax-related information on our website at
If you have questions, call the department at 651-296-3781 or 1-800-652-9094 .
If you qualify, complete and file Form M1PR. You must include this CRP when you file your M1PR return. Your refund will be
delayed or denied if you do not include this CRP when you file your M1PR.
Make copies of your Form M1PR and this form and keep them with your records.

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