M1
2016 Individual Income Tax
1611
20
Leave unused boxes blank . Do not use staples on anything you submit .
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
Place
an X If a
Current Home Address (Street, Apartment Number, Route)
Your Date of Birth
Foreign
Place an X if a
new address:
Address:
City
State
Zip Code
Spouse’s Date of Birth
2016 Federal
Filing Status
Single
Married filing jointly
Married filing separate:
(1)
(2)
(3)
(place an X in
Head of
Enter spouse’s name and
(4)
one oval box):
household
Qualifying widow(er)
Social Security number here
(5)
State Elections Campaign Fund
If you want $5 to go to help candidates for state of-
Political party and code number:
Your Code: Spouse's Code:
fices pay campaign expenses, you may each enter
Republican . . . . . . . . . . . . . 11
Grassroots—Legalize Cannabis 14 Legal Marijuana Now . . . .17
Democratic/Farmer-Labor 12
Green . . . . . . . . . . . . . . . . . . . . 15 General Campaign
the code number for the party of your choice . This
will not increase your tax or reduce your refund .
Independence . . . . . . . . . . 13
Libertarian . . . . . . . . . . . . . . . . 16 Fund . . . . . . . . . . . . . . . . .99
From Your Federal Return (for line references see instructions), enter the amount of:
D Federal adjusted gross income :
A Wages, salaries, tips, etc.:
B IRA, Pensions, and annuities: C Unemployment:
If negative number, use a minus sign (-)
00
00
00
00
If negative number, use a minus sign (-)
1 Federal taxable income (from line 43 of federal Form 1040,
line 27 of Form 1040A, or line 6 of Form 1040EZ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
00
2 State income tax or sales tax addition . If you itemized deductions
on federal Form 1040, complete the worksheet in the instructions . . . . . . . . . . . . . . 2
00
3 Other additions to income, including disallowed itemized deductions,
personal exemptions, non-Minnesota bond interest, and domestic production
00
activities deduction (see instructions; enclose Schedule M1M) . . . . . . . . . . . . . . . . . . 3
If negative number, use a minus sign (-)
4 Add lines 1 through 3 (if a negative number, place an X in the oval box) . . . . . . . . . . . 4
00
00
5 State income tax refund from line 10 of federal Form 1040 . . . . . . . . . . . . . . . . . . . . 5
6 Other subtractions, such as net interest or mutual fund dividends from U .S . bonds
00
or K-12 education expenses (see instructions; enclose Schedule M1M) . . . . . . . . . . 6
00
7 Total subtractions . Add lines 5 and 6 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
00
8 Minnesota taxable income .
Subtract line 7 from line 4 . If zero or less, leave blank . . . .
8
00
9 Tax from the table in the M1 instructions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9
10 Alternative minimum tax (enclose Schedule M1MT) . . . . . . . . . . . . . . . . . . . . . . . . . . 10
00
00
1 1 Add lines 9 and 10 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 1
1 2
Full-year residents: Enter the amount from line 11 on line 12 . Skip lines 12a and 12b .
Part-year residents and nonresidents: From Schedule M1NR, enter the tax from line 27 on
00
. . . 1 2
line 12, from line 23 on line 12a, and from line 24 on line 12b (enclose Schedule M1NR)
a.
b.
00
1 3 Tax on lump-sum distribution (enclose Schedule M1LS) . . . . . . . . . . . . . . . . . . . . . . 1 3
00
1 4 Tax before credits . Add lines 12 and 13 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 4
9995