Form M1 - Individual Income Tax - 2012 Page 2
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22012 M1, page 2
1212
201212
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15 Tax before credits . Amount from line 14 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
16 Marriage credit for joint return when both spouses have taxable earned income
00
or taxable retirement income (enclose Schedule M1MA) . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16
00
17 Credit for taxes paid to another state (enclose Schedule M1CR) . . . . . . . . . . . . . . . . . . . . . 17
00
18 Other nonrefundable credits (enclose Schedule M1C) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18
00
19 Total nonrefundable credits . Add lines 16 through 18 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19
20 Subtract line 19 from line 15 (if result is zero or less, leave blank) . . . . . . . . . . . . . . . . . . . . 20
00
21 Nongame Wildlife Fund contribution (see instructions, page 15)
This will reduce your refund or increase amount owed . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21
00
22 Add lines 20 and 21 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22
00
23 Minnesota income tax withheld. Complete and enclose Schedule M1W to report Minne-
sota withholding from W-2, 1099 and W-2G forms (do not send in W-2s, 1099s, W-2Gs) . . . . 23
00
24 Minnesota estimated tax and extension (Form M13) payments made for 2012 . . . . . . . . . 24
00
25 Child and Dependent Care Credit (enclose Schedule
M1CD). Enter number of qualifying persons here:
. . . . . . . . 25
00
26 Minnesota Working Family Credit (enclose Schedule
M1WFC). Enter number of qualifying children here:
. . . . . . . . . 26
00
27 K–12 Education Credit (enclose Schedule M1ED) .
00
Enter number of qualifying children here:
. . . . . . . . . 27
00
28 Business and investment credits (enclose Schedule M1B) . . . . . . . . . . . . . . . . . . . . . . . . . . . 28
29 Total payments . Add lines 23 through 28 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29
00
30 REFUND . If line 29 is more than line 22, subtract line 22 from line 29
(see instructions, page 17) . For direct deposit, complete line 31 . . . . . . . . . . . . . . . . . . . . . 30
00
31 Direct deposit of your refund (you must use an account not associated with a foreign bank):
Account number
Account type
Routing number
Checking
Savings
32 AMOUNT YOU OWE . If line 22 is more than line 29, subtract
Make check out to Minnesota Rev-
line 29 from line 22 (see instructions, page 17) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32
enue and send with Form M60
00
33 Penalty amount from Schedule M15 (see instructions, page 17) . Also subtract
this amount from line 30 or add it to line 32 (enclose Schedule M15) . . . . . . . . . . . . . . . . . 33
00
IF YOU PAY ESTIMATED TAX and want part of your refund credited to estimated tax, complete lines 34 and 35 .
00
34 Amount from line 30 you want sent to you . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34
35 Amount from line 30 you want applied to your 2013 estimated tax . . . . . . . . . . . . . . . . . . . 35
00
I declare that this return is correct and complete to the best of my knowledge and belief.
Paid preparer: You must sign below.
Your signature
Date
Paid preparer's signature
Date
_____________________________ ____________________
Spouse’s signature (if filing jointly)
Daytime phone
Preparer's daytime phone
SSN, PTIN or VITA/TCE #
_____________________________ _____________________________________________________________________
Include a copy of your 2012 federal return and schedules.
Mail to: Minnesota Individual Income Tax
I authorize the Minnesota Department of
I do not want my paid
Revenue to discuss this return with my
St . Paul, MN 55145-0010
preparer to file my return
paid preparer or the third-party designee
To check on the status of your refund, visit
electronically .
indicated on my federal return .
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