Form Mo-1040p Draft - Missouri Individual Income Tax Return And Property Tax Credit Claim
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2016 FORM MO-1040P
MISSOURI DEPARTMENT OF REVENUE
MISSOURI INDIVIDUAL INCOME TAX RETURN AND
PROPERTY TAX CREDIT CLAIM/
006
PENSION EXEMPTION—
SHORT FORM
VENDOR CODE
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 REP., ETC.)
PRESENT ADDRESS (INCLUDE APARTMENT NO. OR RURAL ROUTE)
COUNTY OF RESIDENCE
CITY, TOWN, OR POST OFFICE
STATE
ZIP CODE
PLEASE CHECK THE APPROPRIATE BOXES THAT APPLY TO YOURSELF OR YOUR SPOUSE.
AGE 62 THROUGH 64 AGE 65 OR OLDER
BLIND
100% DISABLED
NON-OBLIGATED SPOUSE
YOURSELF
YOURSELF
YOURSELF
YOURSELF
YOURSELF
SPOUSE
SPOUSE
SPOUSE
SPOUSE
SPOUSE
You may contribute to any one or all of the
Workers’
Childhood
General
Missouri
Missouri
Elderly
trust funds that are listed to the right. Place the
Memorial
LEAD
Lead
G
Revenue
National
Military
Home
Workers
eneral
R
Fund
Testing
Fund
Children’s
Family Relief
Veterans
Delivered
Guard
total amount contributed on Line 24. See the
evenue
Organ Donor
Fund
Trust Fund
Fund
Trust Fund
Meals Trust Fund
Trust Fund
instructions for a list of Trust Fund Codes.
Program Fund
Spouse
Yourself
1. Federal Adjusted Gross Income from your 2016 federal return
00
00
1Y
1S
(See worksheet on page 8.). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
00
00
2Y –
2S –
2. Any state income tax refund included in your 2016 federal adjusted gross income. . . . . . . . .
00
00
3Y =
3S =
3. Subtract Line 2 from Line 1. This is your Missouri adjusted gross income. . . . . . . . . . . . . . .
00
4
4. TOTAL MISSOURI ADJUSTED GROSS INCOME — Add both numbers on Line 3 and enter here. . . . . .
5. Income percentages — Divide Line 3 by Line 4 for both you and your spouse.
%
%
5Y
5S
(The total of the two must equal 100%. Round to the nearest whole number.) . . . . . . . . . . . . . . . . . . . . .
6. Mark your filing status box below and enter the appropriate exemption amount on Line 6.
A. Single — $2,100 (See Box B before checking.)
E. Married filing separate (spouse
NOT filing) — $4,200
B. Claimed as a dependent on another person’s federal
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
dependent child — $3,500
00
6
CAUTION!
7. Tax from federal return (Do not
Single—maximum of $5,000;
enter amount from your Forms W-2 —
Married filing combined—maximum
00
00
7
NOT federal tax withheld.)
of $10,000 . . . . . . . . . . . . . . . . . . . . .
See Page 6,
Line 7.
8.
Missouri Standard or Itemized Deduction
Taxpayers Under Age 65
Taxpayers Age 65 or Older
Single. . . . . . . . . . . . . . . . . . . . . $6,300
Single . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$7,850
If 65 or
older or
Married Filing Combined and YOU are Age
Married Filing Combined . . . . . $12,600
blind the
Married Filing Separate . . . . . . . . $6,300
65 or Older . . . . . . . . . . . . . . . . . . . . . . . .$13,850
appropriate
Head of Household . . . . . . . . . . . $9,300
Married Filing Combined and You and Your
boxes must
Qualifying Widow(er) . . . . . . . . . $12,600
Spouse are BOTH Age 65 or Older . . . . .$15,100
be checked
Married Filing Separate . . . . . . . . . . . . . . . . . .$7,550
above.
Head of Household . . . . . . . . . . . . . . . . . . . .$10,850
Qualifying Widow(er) . . . . . . . . . . . . . . . . . . .$13,850
If blind or claimed as a dependent, see your federal return or page 6 and 7 of the instructions.
00
8
If itemizing, see page 18 or 22 of the instructions. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Do not
include
9. Number of dependents from Federal Form 1040 OR 1040A, Line 6c
yourself
00
+
Check this box if claiming a stillborn child, see instructions on Page 7. . . . . . . . . . .
x $1,200 = 9
or your
spouse.
10. Pension exemption (Complete worksheet on page 17 or 21 of the instructions.)
00
10 +
Attach worksheet, a copy of federal return, Forms W-2P and 1099-R. . . . . . . . . . . . . . . . . .
00
11 +
11. Long-term care insurance deduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
00
12 =
12. TOTAL DEDUCTIONS — Add Lines 6 through 11. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
13. Missouri Taxable Income — Subtract Line 12 (Total Deductions) from Line 4 (Total Missouri Income)
00
13
and enter here. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
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For Privacy Notice, see instructions.
MO-1040P 2-D (Revised 12-2016)
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