1999 FORM MO-PTC
PAGE 2
SECTION B: REPORT YOUR HOUSEHOLD INCOME NOT INCLUDED IN SECTION A (SEE INSTRUCTIONS)
SECTION B: Complete Section B if you filed a Form MO-1040 or you have income from sources not included on
Items Must Be
Included With
Page 1, Section A. Complete this section only if you have income not listed on Page 1, Section A. If you
Return
do have other income, complete this section and enter total from Line H, on Page 1, Section A, Line 8.
If filing Form MO-1040, you must enclose Form MO-1040 with this form. If Filing Status 2
(MARRIED — FILING COMBINED) is checked, BOTH incomes must be entered.
Form MO-1040
A. If you file a Form MO-1040, Individual Income Tax Return, enter income from Form MO-1040,
00
Line 6 and skip to Line D . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
A
B. If you do not file a Form MO-1040, enter wages, salaries, tips, etc.
Form W-2s
00
(enclose all Form W-2(s)) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
B
Other Income or
C. If you do not file a Form MO-1040, enter other income or loss from Page 4,
Loss (Part 2,
00
Part 2, Line 4 of this form . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
C
Page 4)
D. Enter railroad retirement benefits before any deductions (enclose Form RRB-1099)
Form RRB-1099
YOURSELF
SPOUSE
+
=
00
D
00
00
. . . . . . . . . . . . . . . . . . . . . . . . .
E. Enter veteran’s payments and benefits before any deductions (enclose Form 1099-R)
Form 1099-R
00
(See instructions) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
E
F. If you file a Form MO-1040 and claim a subtraction for exempt contributions made to, or earnings
Form MO-1040
00
from, the Missouri Higher Education Savings Program, enter amount claimed. (see instructions) . . . .
F
00
G. Enter nonbusiness loss(es) (see instructions) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
G
Other Income or
Loss (Part 2,
Page 4)
H. TOTAL — Section B — add Lines A through G. Enter total here
and on Section A, Line 8 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
H
00
Use Form MO-CRP below if you only need to file one Certification of Rent Paid.
Complete Form MO-CRP for each rental unit occupied.
1999
• Instructions for Form MO-CRP are located on
MISSOURI DEPARTMENT OF REVENUE
reverse side of other Form MO-CRP(s)
FORM
CERTIFICATION OF RENT PAID FOR 1999
MO-CRP
• Print or Type
1. YOUR SOCIAL SECURITY NUMBER
YOUR SPOUSE’S SOCIAL SECURITY NUMBER
ARE YOU RELATED TO YOUR LANDLORD?
YES
NO
IF YES, HOW?
2.
YOUR NAME, ADDRESS OF RENTAL UNIT, AND CITY, STATE AND ZIP CODE
3. LANDLORD’S NAME, SOCIAL SECURITY NO., HOME ADDRESS AND CITY, STATE AND ZIP CODE
4. RENTAL PERIOD
FROM:
MONTH
DAY
YEAR
TO:
MONTH
DAY
YEAR
—
—
99
—
—
99
DURING YEAR
00
5. Enter your gross rent paid. (Enclose rental receipt. See instructions.) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
5
6. Check the type of rental unit you rented and enter the percentage on Line 6. (Check only one box.)
A. APARTMENT — 100%
E. DUPLEX — 100%
I. SKILLED OR INTERMEDIATE
CARE NURSING HOME — 45%
B. HOUSE — 100%
F. LOW INCOME HOUSING — 100%
J. HOTEL If meals are included,
C. MOBILE HOME — 100%
G. BOARDING HOME — 50%
enter — 50%
D. MOBILE HOME LOT — 100%
H. RESIDENTIAL CARE — 50%
Otherwise, enter — 100%
If you share your home with relatives and/or friends (other than your spouse, if filing combined), check this box.
Enter the appropriate percentage of your homestead occupied. _____________
%
You must enclose copies of your rent receipts or copies of cancelled checks for rent paid. . . . . . . . . . . .
6
7. Net rent paid. Multiply Line 5 by the percent on Line 6. ENTER HERE AND
ON FORM MO-PTC, LINE 13 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
7
00
MO 860-1089 (11-99)