Form M99 - Minnesota Credit For Military Service In A Combat Zone - 2014
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Form M99, Credit for Military Service in a Combat Zone 2014
First Name and Initial
Last Name
Social Security Number
Mark
Current Home Address (street, apartment number, route)
Date of Birth (mm/dd/yyyy)
an X if a
foreign
address:
City
State
ZIP Code
Mark an X if this is
an amended Form M99
Enter the number of months served in a combat zone for the year 2014. Count partial months as full months. Your home of record must
have been Minnesota during the months served to qualify for the credit.
1 Number of months in 2014 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1
2 Multiply line 1 by $120. This is the AMOUNT OF YOUR CREDIT . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2
For Direct Deposit of the full credit, enter the following information. Otherwise, you will receive a check.
(You must use an account not associated with a foreign bank.)
Account Type:
Routing Number
Account Number
Checking
Savings
Sign here: I declare that this return is correct and complete to the best of my knowledge and belief.
Your signature
Date
Phone
Paid preparer’s signature
Date
Phone
MN Tax ID, SSN, PTIN or VITA/TCE #
I authorize the Minnesota Department of Revenue to
discuss this tax return with the preparer.
You must enclose the following with this return:
Active-duty members:
• Attach a copy of your Leave and Earnings Statement for each month in qualifying status.
National Guard, Reservists, and retired or discharged active-duty members:
• Attach Form DD-214 for each period of qualifying service.
Completed forms and documentation will be accepted starting January 2015.
Mail to: Minnesota Revenue, Mail Station 0043, St. Paul, MN 55146-0043
See instructions for additional information.
9995
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