2015 Schedule M1nr - Nonresidents / Part-Year Residents Form
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3201533
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Sequence #11
Other State (see inst.)
Your Last Name
Social Security Number
Full-year Nonresident of MN . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Part-year MN Resident From
to
(mm/dd/yyyy)
Spouse’s Last Name
Spouse’s Social Security Number
Full-year Nonresident of MN . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Part-year MN Resident From
to
(mm/dd/yyyy)
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B. Minnesota Portion
A. Total Amount
(see instructions)
FRPSOHWH WKLV VFKHGXOH \RX PXVW FRPSOHWH OLQHV WKURXJK RI )RUP 0
1 Wages, salaries, tips, etc. (from line 7 of Form 1040 or Form 1040A
or line 1 of Form 1040EZ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
2 Taxable interest and ordinary dividend income (add lines 8a and 9a
of Form 1040 or Form 1040A or from line 2 of Form 1040EZ) . . . . . . . . . . . . . . 2
3 Business income or loss (from line 12 of Form 1040) . . . . . . . . . . . . . . . . . . . . . 3
4 Capital gain or loss (from line 13 of Form 1040 or line 10 of Form 1040A) . . . . 4
5 IRA distributions and pensions and annuities (add lines 15b and 16b of
Form 1040 or lines 11b and 12b of Form 1040A) . . . . . . . . . . . . . . . . . . . . . . . . 5
6 Net income from rents, royalties, partnerships, S corporations,
estates and trusts (from line 17 of Form 1040) . . . . . . . . . . . . . . . . . . . . . . . . . . 6
7 Farm income or loss (from line 18 of Form 1040) . . . . . . . . . . . . . . . . . . . . . . . . 7
8 Other income (add lines 10, 11, 14, 19, 20b and 21 of Form 1040,
lines 13 and 14b of Form 1040A or line 3 of Form 1040EZ) . . . . . . . . . . . . . . . . 8
9 Interest and dividends from non-Minnesota state or municipal bonds
(add lines 3 and 4 of Schedule M1M) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9
10 Other additions required by Minnesota (add lines 5, 6, 9, 11 and 13
of Schedule M1M) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10
11 Add lines 1 through 10 for each column . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
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instructions.
12 Educator expenses and certain business expenses
(add lines 23 and 24 of Form 1040 or from line 16 of Form 1040A) . . . . . . . . 12
13 6HOIHPSOR\HG 6(3 6,03/( DQG TXDOLÀHG SODQV DQG ,5$ GHGXFWLRQ
(add lines 28 and 32 of Form 1040 or from line 17 of Form 1040A) . . . . . . . . 13
14 Health savings account and Archer MSA deductions (add line 25 of Form
1040 and the Archer MSA amount included on line 36 of Form 1040) . . . . . . 14
15 Moving expenses (line 26 of Form 1040) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
16 One-half of self-employment tax and self-employed health insurance
(add lines 27 and 29 of Form 1040) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16
17 Deductions for alimony paid, student loan interest, and tuition and fees
(See instructions) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17
18 Penalty on early withdrawal of savings (from line 30 of Form 1040) . . . . . . . . . 18
19 Other subtractions required by Minnesota
(from lines 19, 20, 33 and 34 of Schedule M1M) . . . . . . . . . . . . . . . . . . . . . . . 19
20 Net U.S. bond interest (from line 16 of Schedule M1M) and active
military pay received while a nonresident (from line 27 of Schedule M1M) . . . 20
21 Job Opportunity Building Zone (JOBZ) business and investment
income exemptions (from line 30 of Schedule M1M) . . . . . . . . . . . . . . . . . . . . . 21
22 Add lines 12 through 21 for each column . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22
23 Subtract line 22, column B, from line 11, column B. Enter here and on line 12a of Form
M1. If your Minnesota gross income is below $10,300 or the result is a negative amount, enter 0 . . . . 23
24 Subtract line 22, column A, from line 11, column A.
Enter the result here and on line 12b of Form M1 . . . . . . . . . . . . . . . . . . . . . . . 24
25 Divide line 23 by line 24, and enter the result as a decimal FDUU\ WR ÀYH GHFLPDO
.
places). If line 23 is more than line 24, enter 1.0. If line 23 is zero, enter 0 . . . . . . . . . . . . . . . . . . . . . . . 25
26 Amount from line 11 of Form M1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26
27 Multiply line 25 by line 26. Enter the result here and on line 12 of Form M1 . . . . . . . . . . . . . . . . . . . . . . . 27
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