Form Pcr - Minnesota Political Contribution Refund Application - 2015 Page 3
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4Form PCR Instructions for 2015
Purpose of This Form
Include EP-3 Forms
If you are married and choose to fi le separate
applications, do not include your spouse’s
Minnesota voters who contributed gift s of
To receive your refund, you must include
name, date of birth and Social Security num-
money to candidates for state offi ce or to a
with your Form PCR the original Minneso-
ber. Enter your name only and check the box
state political party may be able to apply for
ta Political Contribution Receipt, Form EP-3,
for Married, fi ling separate application.
a refund of all or a portion of contributions
you received for each contribution.
made between January 1 and December 31,
Line Instructions
If you do not include the original receipts,
2015. Th e maximum refund is $50 for an
your form will be sent back to you. Your
Line 1
individual and $100 for a married couple.
contributions must have been made be-
Add the amounts shown on all of the Form
An individual or married couple fi ling a
tween January 1 and December 31, 2015, to
EP-3 receipts, and enter the total on line 1.
joint application may fi le only one Form
fi le the 2015 Form PCR.
Th e receipts must be for contributions made
PCR for each calendar year in which
between January 1 and December 31, 2015.
When to File
contributions were made, even if they
You may apply for your refund at any time,
Line 2
contributed to more than one candidate
but no later than April 15, 2016.
Enter $100 if you are fi ling a joint applica-
or party.
tion. If you are single or married and fi ling a
Do not mail your application in the same
You may receive a refund for all or a portion
separate application, enter $50.
envelope with your Minnesota income tax
of contribu tions you made between Janu-
return. Th e amount of your political con-
Line 3
ary 1 and December 31, 2015, to candidates
tribution refund cannot be used as a credit
Enter the amount from line 1 or line 2,
for the following Minnesota state offi ces—if
on your Form M1. Putting Form PCR in the
whichever is less.
the candidates have signed an agreement
same envelope with your return may delay
with the Minnesota Campaign Finance and
You will receive the total of your contribu-
processing of both forms.
Public Disclosure Board to observe the state
tions up to the maximum refund, which is
Amended Returns, Extensions for Fil-
campaign spending limit law:
$100 if you are married fi ling a joint applica-
ing are Not Permitted
• Minnesota House of Representatives
tion or $50 if you are single or married fi ling
• Minnesota State Senate
Form PCR cannot be amended.
a separate application.
• Governor and Lieutenant Governor of
You cannot get an extension to fi le Form
Line 4
Minnesota
PCR. It must be fi led by the April 15, 2016,
• Attorney General of Minnesota
If you want the refund to be directly
due date. A refund will not be issued for a
• Secretary of State of Minnesota
deposited into your checking or savings
2015 Form PCR fi led aft er that date.
• Minnesota State Auditor
account, enter the requested information
Completing Form PCR
on line 4.
You may also receive a refund of all or a
Important: You must enter your name,
portion of contri butions you made to the:
Note: You must use an account not associ-
address, date of birth and Social Security
• Independence Party
number (and your spouse’s name, date of
ated with any foreign banks.
• Republican Party
birth and Social Security number if fi ling
Refer to the sample below to fi nd the rout-
• Democratic Farmer-Labor (DFL) Party
a joint application) in the heading of Form
• Grassroots Party
ing and account numbers.
PCR. Also, be sure to indicate the number
• Libertarian Party
of receipts you are attaching. If this infor-
• any precinct, city, county, congressional
mation is not included, your refund may be
or legislative district unit of the Minne-
delayed.
sota parties listed above.
Filing Status Boxes
Who May File
If you are single, check the Single box.
To be eligible for the refund, you must be a
If you are married, you may:
registered voter in Minnesota or, if you are
Th e routing number must have nine
not a registered voter, you must:
• fi le one application together with your
digits.
spouse for a maximum refund of $100, or
• be a United States citizen,
Th e account number may contain up to
• each fi le a separate application for a maxi-
• be age 18 or older, and
mum refund of $50 each.
• have lived in Minnesota at least 20 days
17 digits (both numbers and letters). If
immediately before any 2014 statewide
your account number is less than 17 digits,
If you choose to fi le a joint application, you
or local election in which you would be
enter the number starting with the fi rst
must enter the name, date of birth and So-
eligible to vote if you were registered.
cial Security number for both you and your
box on the left —leave out any hyphens,
spouse. Check the box for Married, fi ling
spaces and symbols—and leave any un-
However, regardless of whether or not you
joint application.
used boxes blank.
are a registered voter, you are not eligible for
the refund if:
Sign your return
• you are under guardianship of the person,
Sign your return at the bottom of the form.
but have not retained the right to vote, or
Continued
• you have been found by a court to be
legally incompetent to vote, or
• you have been convicted of a felony and
your civil rights have not been restored.
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