Form Ecc - Elderly Care Credit - 2014
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MONTANA
Clear Form
ECC
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Rev 04 14
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2014 Elderly Care Credit
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15-30-2366, MCA
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Social Security Numbers
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First Name and Initial
Last Name
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X X X X X X X X
X
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Spouse’s First Name and Initial
Last Name
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Name of Elderly Family Member
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You cannot use this form for calculating the elderly care credit if another individual paid qualified elderly care expenses
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for the same family member and that individual is also claiming this credit. Please contact the Department of Revenue at
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(866) 859-2254 (in Helena, 444-6900) for assistance if this situation applies to you.
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Part I. Eligibility
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If you answer yes to all four of these questions, you are eligible for this credit. If you answer no to one of these questions,
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stop here because you are not eligible for this credit.
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Is the elderly person related to you by blood or by marriage?................................................................
Yes
No
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Is the elderly person either at least 65 years old or been determined to be disabled for
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Social Security purposes? ......................................................................................................................
Yes
No
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Is the family income (gross income, including all nontaxable income) of the elderly person
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$15,000 or less, if single, or is the combined income of both spouses $30,000 or less, if married? ......
Yes
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No
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If your filing status is single or married filing jointly, is your Montana adjusted gross
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income on Form 2, line 41 or Form 2M, line 38, less than $55,000? If your filing status is
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married filing separately, is your Montana adjusted gross income on Form 2, line 41, less
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than $27,500?.........................................................................................................................................
Yes
No
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Part II. Credit Computation
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1. Amount of the qualified elderly care expenses that you paid during the tax year. See the
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instructions on the second page of this form for the definition of qualified elderly care expenses .1.
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2. Your Montana adjusted gross income from Form 2, line 41 or Form 2M, line 38 ...........................2.
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3. Adjusted gross income multiplier amount from the table located on the second page of
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this form ..........................................................................................................................................3.
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4. Multiply the amount on line 1 by the multiplier reported on line 3 above ........................................4.
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5. If your filing status is single or married filing jointly, enter $50,000. If your filing status is married
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filing separately, enter $25,000 .......................................................................................................5.
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6. Subtract line 5 from line 2 and enter the result, but not less than zero ..........................................6.
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7. Subtract line 6 from line 4 and enter the result. If the result is zero or less, stop here because
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you are not eligible for this credit ....................................................................................................7.
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8. If your filing status is single or married filing jointly, enter the smaller of line 7 or $5,000. If your
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filing status is married filing separately, enter the smaller of line 7 or $2,500. This is your
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elderly care credit. .......................................................................................................................8.
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Enter the amount from line 8 above on Form 2, Schedule V, or Form 2M, Schedule II.
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If you file your Montana tax return electronically, you do not need to mail this form to us unless we ask you for a copy. When you file electronically,
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you represent that you have retained the required documents in your tax records and will provide them upon the department’s request.
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