Form Mi-1040cr - Michigan Homestead Property Tax Credit Claim - 2012

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Michigan Department of Treasury (Rev. 09-12), Page 1 of 3

Issued under authority of Public Act 281 of 1967.

2012 MICHIGAN Homestead Property Tax Credit Claim MI-1040CR

1 4

0123456789

Print numbers like this:

- NOT like this:

Attachment 05

1. Filer’s First Name

M.I.

Last Name

2. Filer’s Social Security No. (Example: 123-45-6789)

If a Joint Return, Spouse’s First Name

M.I.

Last Name

3. Spouse’s Social Security No. (Example: 123-45-6789)

Home Address (Number, Street, P.O. Box) If using a P.O. Box, you must complete line 46, page 3.

City or Town

State

ZIP Code

4. School District Code (5 digits - see p. 60)

5. Check the box for which you or your spouse qualify (excluding dependents). If you qualify for both boxes, see instructions on page 27.

Age 65 or older; or an unremarried spouse of a person

Deaf, hemiplegic, paraplegic, quadriplegic, or totally

who was 65 or older at the time of death.

and permanently disabled.

6. 2012 FILING STATUS:

7. 2012 RESIDENCY STATUS:

*If you checked box “c,” enter dates of Michigan residency in 2012.

Enter dates as MM-DD-YYYY (Example: 04-15-2012).

Check one.

Check all that apply.

Single

Resident

FILER

SPOUSE

2012

Married, Filing jointly

Nonresident

2012

Married, Filing separately

Part-Year Resident *

8. Homestead Status

Check here if the taxable value of your homestead includes unoccupied farmland classified as agricultural by your assessor.

9. Homeowners: Enter the 2012 taxable value of your homestead (see p. 27). If you did not check

box 8 above and your taxable value is greater than $135,000, STOP; you are not eligible.

Farmers: enter your taxable value including your homestead and unoccupied farmland .....................

10. Property Taxes levied on your home for 2012 (see p. 24) or amount from line 52, 57, or 58 ................ 10.

11. Renters: Enter rent you paid for 2012 from line 54 or 56 ......................

11.

12. Multiply line 11 by 20% (0.20) ................................................................................................................ 12.

13. Total. Add lines 10 and 12 .................................................................................................................... 13.

TOTAL HOUSEHOLD RESOURCES. Include income from both spouses.

NOTE: For line by line instructions see pages 27-28.

14. Wages, salaries, tips, sick, strike

21. Social Security and/or

railroad retirement benefits

and SUB pay, etc.

14.

21.

15. All interest and dividend income

22. Child support and foster

(including nontaxable interest)

15.