Form Mo-1040 Draft - Individual Income Tax Return (Long Form) - Missouri Department Of Revenue - 2016

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2016 FORM MO-1040
MISSOURI DEPARTMENT OF REVENUE
INDIVIDUAL INCOME TAX RETURN—LONG FORM
FOR CALENDAR YEAR JAN. 1–DEC. 31, 2016, OR FISCAL YEAR BEGINNING
20 ___ , ENDING
20 ___
006
AMENDED RETURN —
SOFTWARE VENDOR CODE
CHECK HERE
SOCIAL SECURITY NUMBER
SPOUSE’S SOCIAL SECURITY NUMBER
NAME (LAST)
(FIRST)
M.I. JR, SR
SPOUSE’S (LAST)
(FIRST)
M.I. JR, SR
IN CARE OF NAME (ATTORNEY, EXECUTOR, PERSONAL REPRESENTATIVE, ETC.)
COUNTY OF RESIDENCE
PRESENT ADDRESS (INCLUDE APARTMENT NUMBER OR RURAL ROUTE)
CITY, TOWN, OR POST OFFICE
STATE
ZIP CODE
You may contribute to any one or all of the trust funds
Elderly Home
Missouri
Workers’
Childhood
Missouri Military
General
Organ
LEAD
G
on Line 45. See pages 9–10 for a description of each trust
Workers
eneral
Veterans
Delivered Meals
National Guard
Memorial
Lead Testing
Family
Revenue
Donor
Children’s
R
evenue
fund, as well as trust fund codes to enter on Line 45.
Trust Fund
Trust Fund
Trust Fund
Fund
Fund
Relief Fund
Fund
Program Fund
Trust Fund
PLEASE CHECK THE APPROPRIATE BOXES THAT APPLY TO YOURSELF OR YOUR SPOUSE AS OF DECEMBER 31, 2016.
AGE 62 THROUGH 64
AGE 65 OR OLDER
BLIND
100% DISABLED
NON-OBLIGATED SPOUSE
YOURSELF
SPOUSE
YOURSELF
SPOUSE
YOURSELF
SPOUSE
YOURSELF
SPOUSE
YOURSELF
SPOUSE
Spouse
Yourself
1. Federal adjusted gross income from your 2016 federal return (See worksheet on page 6.) ...... 1Y
00 1S
00
2. Total additions (from Form MO‑A, Part 1, Line 7) ................................................................... 2Y
00 2S
00
3. Total income — Add Lines 1 and 2. ........................................................................................ 3Y
00 3S
00
4. Total subtractions (from Form MO‑A, Part 1, Line 17) ............................................................ 4Y
00 4S
00
5. Missouri adjusted gross income — Subtract Line 4 from Line 3. ............................................ 5Y
00 5S
00
6. Total Missouri adjusted gross income — Add columns 5Y and 5S. ..........................................
6
00
7. Income percentages — Divide columns 5Y and 5S by total on Line 6. (Must equal 100%) ......
7Y
% 7S
%
8. Pension and Social Security/Social Security Disability/Military exemption (from Form MO‑A, Part 3, Section E.) ...
8
00
9. Mark your filing status box below and enter the appropriate exemption amount on Line 9.
A. Single — $2,100 (See Box B before checking.)
E. Married filing separate (spouse
B. Claimed as a dependent on another person’s federal
NOT filing) — $4,200
tax return — $0.00
F. Head of household — $3,500
C. Married filing joint federal & combined Missouri — $4,200
G. Qualifying widow(er) with
D. Married filing separate — $2,100
9
00
dependent child — $3,500 ...............
10. Tax from federal return (Do not enter federal income tax withheld.)
• Federal Form 1040, Line 56 minus Lines 45, 46, 66a, 68, 69, and any amount from Form 8885 on Line 73.
• Federal Form 1040A, Line 37, minus Lines 29, 42a, 44, 45, and any alternative minimum tax included on Line 28
• Federal Form 1040EZ, Line 10 minus Line 8a ............................................................... 10
00
11. Other tax from federal return — Attach copy of your federal return (pages 1 and 2). ..... 11
00
12. Total tax from federal return — Add Lines 10 and 11. .................................................. 12
00
13. Federal tax deduction — Enter amount from Line 12 not to exceed $5,000 for individual filer;
$10,000 for combined filers. ..............................................................................................................................
13
00
14. Missouri standard deduction or itemized deductions. Single or Married Filing Separate — $6,300;
Head of Household— $9,300; Married Filing a Combined Return or Qualifying Widow(er) — $12,600;
If you are age 65 or older, blind, or claimed as a dependent, see your federal return or page 7.
If you are itemizing, see Form MO‑A, Part 2. ....................................................................................
14
00
15. Number of dependents from Federal Form 1040 OR 1040A, Line 6c
Do not
Check box if claiming a stillborn child, see instructions on Page 7 ................................
x $1,200 = .....
15
00
include
yourself
16. Number of dependents on Line 15 who are 65 years of age or older and do not
or
receive Medicaid or state funding (DO NOT INCLUDE YOURSELF OR SPOUSE.) .....
x $1,000 = .....
16
00
spouse.
17. Long‑term care insurance deduction ....................................................................................................................
17
00
18
18. Health care sharing ministry deduction ...............................................................................................................
00
19. Military income deduction .....................................................................................................................................
19
00
20. Bring jobs home deduction. ..................................................................................................................................
20
00
21. Total deductions — Add Lines 8, 9, 13, 14, 15, 16, 17, 18, 19, and 20 ...............................................................
21
00
22. Subtotal — Subtract Line 21 from Line 6 .............................................................................................................
22
00
23. Multiply Line 22 by appropriate percentages (%) on Lines 7Y and 7S ...................................
23Y
00 23S
00
24. Enterprise zone or rural empowerment zone income modification .........................................
00 24S
00
24Y
25. Subtract Line 24 from Line 23. Enter here and on Line 26 .....................................................
25Y
00 25S
00
MO-1040 2-D (Revised 12-2016)
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