Maine Minimum Tax Credit And Carryforward To 2013 - 2012 Page 2
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Maine Minimum Tax
Income Modifi cation Worksheet for the
Exclusion Items Worksheet, Line b above
1. ADDITIONS - see instructions
a. Income from municipal and state bonds, other than Maine ....................................................................................................... ________________
b Net Operating Loss Adjustment (see instructions; attach a schedule showing your calculation) ............................................... ________________
c Maine Public Employees Retirement System Contributions ....................................................................................................... ________________
d Domestic Production Activities Deduction Add-back ................................................................................................................... ________________
e Bonus Depreciation Add-back (see instructions) ......................................................................................................................... ________________
f
Maine Capital Investment Credit Bonus Depreciation Add-back (see instructions) ................................................................... ________________
g Fiduciary Adjustment - additions only (attach a copy of your 2011 federal Schedule K-1) .................................................... ________________
h Other (see instructions). List the type and amount of income items included (attach a separate schedule,
if necessary) ______________________________________________________________________________ ................. ________________
i
Deductible costs incurred in the production of Maine exempt income (see instructions) ....................................................... ________________
j
Any loss, deduction or other expense attributable to income from an ownership interest
in a pass-through entity fi nancial institution (see instructions) ................................................................................................... ________________
k
Total additions (Add lines 1a through 1j) .................................................................................................................................. ________________
2. SUBTRACTIONS - see instructions
a
U.S. Government Bond interest ................................................................................................................................................ ________________
b
Social Security and Railroad Retirement Benefi ts ..................................................................................................................... ________________
c
Pension Income Deduction ........................................................................................................................................................ ________________
d
Interest from Maine Municipal General Obligation, Private Activity and Airport Authority Bonds .................................................. ________________
e
Premiums for Long-Term Care Insurance (Do not include health insurance premiums on this line).
NOTE: If you itemized deductions in 2011, complete worksheet below ............................................................................ ________________
f
Maine Public Employees Retirement System Pick-Up Contributions paid to the taxpayer during 2011
which have been previously taxed by the state .......................................................................................................................... ________________
g
Contributions to Qualifi ed Tuition Programs - 529 Plans ............................................................................................................ ________________
h
Fiduciary Adjustment-deductions only (attach a copy of your 2011 federal Schedule K-1) .................................................. ________________
i
Bonus Depreciation and Section 179 Recapture (See instructions) .......................................................................................... ________________
j
Other (see instructions). Do not enter non-Maine income on line 2j. List the type and amount of income items
included (attach a separate schedule, if necessary) ______________________________________________ .................. ________________
k
Deductible costs of producing income exempt from federal tax, but subject to Maine tax ......................................................... ________________
l
Total Subtractions (add lines 2a through 2k) ........................................................................................................................... ________________
3.
Net Modifi cation (subtract line 2l from line 1k — enter here and on line b, Maine Minimum Tax - Exclusion
Items Worksheet above [may be a negative amount]) ............................................................................................................... ________________
Maine Minimum Tax — Worksheet for Line 2e of the Income Modifi cation Worksheet above
For individuals who claimed a deduction for long-term care insurance premiums in 2011. Complete this worksheet only if you claimed Maine itemized
deductions in 2011 and your 2011 federal Schedule A, line 4 is greater than zero or you were self-employed in 2011 and your 2011 federal Form 1040, line
29 is greater than zero.
1. Enter total amount of long-term care insurance premiums paid during 2011: .......................... $
2. Enter amount from 2011 federal Schedule A, line 1 ................................................................................................................... ________________
3. Enter amount of long-term care premiums included in line 2 above ......................................................................................... ________________
4. Divide line 3 by line 2 ................................................................................................................................................................. __ . __ __ __ __
5. Enter 2011 federal Schedule A, line 4 minus federal Form 6251, line 2 $ __________________ .
Multiply this amount by the percentage on line 4 above and enter result here ........................................................................... ________________
6. Enter the amount of long-term care insurance premiums included on 2011 federal Form 1040, line 29 .................................. ________________
7. Subtract line 5 and line 6 from line 1. Enter result here and on Maine Minimum Tax - Income Modifi cation
Worksheet, line 2e above ........................................................................................................................................................... ________________
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