Form 2m - 2012 Montana Individual Income Tax Return Page 3
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4Form 2M, Page 3 – 2012
Social Security Number:
Schedule I – Montana Form 2M Itemized Deductions
Enter your itemized deductions on the corresponding line.
File Schedule I with your Montana Form 2M.
1. Medical and dental expenses .............................................................................................................................1.
00
2. Enter amount from Form 2M, line 38 ..................................................................................................................2.
00
3. Multiply line 2 by 7.5% (0.075) ...........................................................................................................................3.
00
4. Subtract line 3 from line 1 and enter the result here, but not less than zero. This is your deductible medical and dental expense
subject to 7.5% of Montana Adjusted Gross Income. ...................................................................................................................... 4.
00
5. Medical insurance premiums not deducted elsewhere on your tax return ............................................................................................ 5.
00
6. Long term care insurance premiums not deducted elsewhere on your tax return ................................................................................. 6.
00
Complete lines 7a through 7d reporting your total federal income tax paid in 2012 before completing line 7e.
7a. Federal income tax withheld in 2012 ................................................................................................................7a.
00
7b. Federal estimated tax payments paid in 2012 ..................................................................................................7b.
00
7c. 2011 federal income taxes paid in 2012 ........................................................................................................... 7c.
00
7d. Other back-year federal income taxes paid in 2012 .........................................................................................7d.
00
7e. Add lines 7a through 7d. Enter the result here, but not more than $5,000 if you are fi ling single or head of household, or $10,000 if fi ling
a joint return with your spouse. This is your federal income tax deduction. ..................................................................................................7e.
00
8. Real estate taxes paid in 2012 .............................................................................................................................................................. 8.
00
9. Personal property taxes paid in 2012 (see instructions on page 12) ..................................................................................................... 9.
00
10. Other deductible taxes. List type and amount __________________________________________________________________ 10.
00
11. Home mortgage interest and points reported to you on federal Form 1098 ........................................................................................ 11.
00
12. Home mortgage interest not reported to you on federal Form 1098. If paid to the person from whom you bought the house, provide
name, SSN, and address _________________________________________________________________________________
______________________________________________________________________________________________________ 12.
00
13. Points not reported to you on federal Form 1098 ................................................................................................................................ 13.
00
14. Qualifi ed mortgage insurance premiums (Caution – see instructions on page 13.) ........................................................................... 14.
00
15. Investment interest. Include federal Form 4952 .................................................................................................................................. 15.
00
16. Charitable contributions made by cash or check during 2012 ............................................................................................................. 16.
00
17. Charitable contributions made other than by cash or check during 2012 ............................................................................................ 17.
00
18. Charitable contribution carryover from the prior year .......................................................................................................................... 18.
00
19. Child and dependent care expenses. Include Montana Form 2441-M ................................................................................................ 19.
00
20. Casualty or theft loss(es). Include federal Form 4684 ......................................................................................................................... 20.
00
21. Unreimbursed employee business expenses. Include federal Form 2106 or 2106-EZ ....................................21.
00
22. Other expenses. List type and amount ______________________________________________________
_____________________________________________________________________________________22.
00
23. Add lines 21 and 22; enter the result here ........................................................................................................23.
00
24. Enter the amount on Form 2M, line 38 here .....................................................................................................24.
00
25. Multiply line 24 by 2% (0.02) and enter the result here ....................................................................................25.
00
26. Subtract line 25 from line 23 and enter the result here, but not less than zero ................................................................................... 26.
00
27. Political contributions (limited to $100 per taxpayer) ........................................................................................................................... 27.
00
28. Other miscellaneous deductions not subject to 2% of Montana Adjusted Gross Income. List type and amount _______________
______________________________________________________________________________________________________ 28.
00
29. Add lines 4 through 6, 7e through 20, and 26 through 28. Enter the result here and on Form 2M, line 39. This is your total
itemized deductions. ......................................................................................................................................................................... 29.
00
*12CC0301*
*12CC0301*
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