Schedule H-Ez - Wisconsin Homestead Credit Form - 2015
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1
2H‑EZ
Wisconsin
2015
Check here if
homestead credit
an amended return
Claimant’s social security number
Spouse’s social security number
Check below then fill in either the name of city,
village, or town, and the county in which you lived
at the end of 2015.
M.I.
Claimant’s legal last name
Legal first name
City
Village
Town
City, village,
Spouse’s legal last name
Spouse’s legal first name
M.I.
or town
Current home address (number and street)
Apt. no.
County of
City or post office
State
Zip code
Special
(See page 7 of the
Schedule H instructions.)
conditions
1 a What was your age as of December 31, 2015?
Fill in age
(If you were under 18, you do not qualify for homestead credit for 2015.)
1a
b If you are married and your spouse was age 65 or over as of December 31, 2015, check where indicated . . . . 1b
Check here
Were you a legal resident of Wisconsin from 1-1-15 through 12-31-15? (If “No,” you do not qualify.) . . . . . . . . . 2
Yes
No
2
Were you claimed or will you be claimed as a dependent on someone else’s 2015 federal income tax return?
3
(If “Yes” and you were under age 62 on December 31, 2015, you do not qualify.) . . . . . . . . . . . . . . . . . . . . . . . . 3
Yes
No
Household Income
Print numbers like this
NO COMMAS; NO CENTS
Wisconsin income from line 12 of Form 1A or line 13 of Form 1 (see instructions) . . . . . . . . . . . . . . . 4
4
.00
If not filing a 2015 Wisconsin return, fill in Wisconsin taxable income below.
5
.
.
.
a Wages
Dividends
= . . . 5a
00
00
00
+
+
.00
Interest
(list type and amount)
.00
b Other taxable income
5b
Nontaxable income not included on line 4, 5a, or 5b.
6
.00
a Unemployment compensation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6a
b Social security, federal and state SSI, SSI-E, SSD, and CTS payments (see instructions) . . . . . . . . 6b
.00
c Railroad retirement benefits . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6c
.00
d Pensions, annuities, and other retirement plan distributions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6d
.00
e Contributions to deferred compensation plans (see box 12 of wage statements) . . . . . . . . . . . . . . . . . 6e
.00
f Contributions to IRA and SIMPLE plans . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6f
.00
g Interest on United States bonds and notes and state and municipal bonds . . . . . . . . . . . . . . . . . . . . 6g
.00
h Child support, maintenance payments, and other support money (court ordered) . . . . . . . . . . . . . . . 6h
.00
i Wisconsin Works (W2) payments, county relief, kinship care, and other cash public assistance . . . . 6i
.00
7 a Add lines 4 through 6i (if less than the total of lines 8, 9a, and 9c, see instructions) . . . . . . . . . . . . . 7a
.00
b Fill in number of qualifying dependents (do not count yourself or your spouse)
x $500 = 7b
.00
c Household income. Subtract line 7b from line 7a (if $24,680 or more, no credit is allowed) . . . . . . . . . . . . . 7c
.00
Before completing this section, see instructions for taxes and/or rent (STEP 4) .
Taxes and/or Rent
.00
8
Homeowners – Net 2015 property taxes on your homestead. Attach your 2015 tax bill . . . . . . . . . . . . 8
Renters – Rent from your rent certificate(s), line 8a (or Shared Living Expenses Schedule) .
9
Heat included (8b of rent certificate is “Yes”) . . . . . . . . . . . . . 9a
.00
.20 (20%)
.00
x
=
9 b
Heat not included (8b of rent certificate is “No”) . . . . . . . . . . 9c
.00
.25 (25%)
.00
x
=
9 d
Add lines 8, 9b, and 9d ( or enter amount from line 6 of Taxes/Rent Reduction Schedule ) . . . . . . . . . . . . . 10
.00
10
Credit Computation
Fill in the smaller of the amount on line 10 or $1,460 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
.00
11
Using the amount on line 7c, fill in the appropriate amount from Table A (page 17) . . . . . . . . . . . . . 12
.00
12
Subtract line 12 from line 11 (if line 12 is more than line 11, fill in 0; no credit is allowable) . . . . . . . . . . 13
.00
13
Homestead credit – Using the amount on line 13, fill in the credit from Table B (page 18) . . . . . . . . 14
.00
14
Under penalties of law, I declare this homestead credit claim and all attachments are true, correct, and complete to the best of my knowledge and belief.
Claimant’s signature
Spouse’s signature
Date
Daytime phone number
Sign
(
)
Here
I-015i
For Department Use Only
C
Mail to:
Wisconsin Department of Revenue
PO Box 34
Madison WI 53786-0001
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