Form Mi-1040cr - Michigan Homestead Property Tax Credit Claim - 2012 Page 3

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2012 MI-1040CR, Page 3 of 3
Filer’s Social Security Number
PART 3: HOMEOWNERS WHO MOVED IN 2012.
Report on lines 46 and 47 the addresses of the homesteads for which you
are claiming a credit. Homesteads with a taxable value greater than $135,000 are not eligible for this credit.
46. Address where you lived on December 31, 2012, if different than reported on line 1.
Taxable Value
47. Address of homestead sold (moved from) during 2012 (Number, Street, City, ZIP Code).
Taxable Value
HOMESTEAD
A. Moved Into
B. Moved From
Homeowners who moved during 2012, complete lines 48 through 52.
48. Number of days occupied (total cannot be more than 366)............................................
49. Divide line 48A and 48B each by 366 and enter the percentages for each ....................
%
%
50. Property taxes levied for calendar year 2012 .................................................................
51. Prorated property taxes. Multiply line 50 by the percentages on line 49 ........................
52. Taxes eligible for credit. Add line 51, columns A and B. Enter here and on line 10 ................................
52.
00
PART 4: RENTERS (Do not include Alternate Housing Facility information, see Part 5.)
53.
A
B
C
D
E
Address of Homestead You Rented
# Months
Total Rent Paid
(Number, Street, Apt. #, City, ZIP Code)
Landowner’s Name and Address
Rented
Monthly Rent
Less Mobile Home Taxes
54.
Total rent you paid (not more than 12 months). Add total rent for each period. Enter here and on line 11. ......
54.
00
PART 5: ALTERNATE HOUSING FACILITIES
55. If you lived in one of these types of facilities for all or part of 2012, check the appropriate box and see instructions.
a.
Subsidized Housing: complete line 56. Enter result on line 11.
b.
Service Fee Housing: complete lines 56 and 57.
56. Enter the total rent you paid in 2012 while a resident of an Alternate Housing Facility. Do not include
amounts paid on your behalf by a government agency ................................................................................ 56.
00
57. If you checked 55b, multiply line 56 by 10% (0.10) (see instructions). Enter here and on line 10 .......... 57.
00
58. Special Housing: If you lived in one of these facility types for all or part of 2012, check the appropriate box and see instructions.
a.
Cooperative Housing
b.
Home for the Aged
c.
Nursing Home
d.
Adult Foster Care Home
e.
Paid Room and Board
Enter your prorated share of taxes from the type of facility checked above here and on line 10 ............
58.
00
59. Name and Address (including ZIP Code) of Housing Facility, Landowner, or Care Facility if you completed Part 5
DIRECT DEPOSIT
a. Routing Transit Number
b. Account Number
c. Type of Account
Deposit your refund directly to your
Checking
Savings
1.
2.
financial institution! See page 13 and
complete a, b and c
.
Preparer Certification.
Deceased Taxpayer.
I declare under penalty of perjury that
If Filer and/or Spouse died after December 31, 2011, enter dates below.
this return is based on all information of which I have any knowledge.
ENTER DATE OF DEATH ONLY.
Example: 04-15-2012 (MM-DD-YYYY)
Preparer’s PTIN, FEIN or SSN
Filer
Spouse
Preparer’s Business Name (print or type)
Taxpayer Certification.
I declare under penalty of perjury that the information in this return
and attachments is true and complete to the best of my knowledge.
Filer’s Signature
Date
Preparer’s Business Address (print or type)
Spouse’s Signature
Date
By checking this box, I authorize Treasury to discuss my return with my preparer.
If you are also filing Form MI-1040, attach this form behind it. If not, mail this form to: Michigan Department of Treasury, Lansing, MI 48956
+
0000 2012 25 03 27 9

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