2013
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MISSOURI DEPARTMENT OF REVENUE
FORM
MO-HEA
HOME ENERGY AUDIT EXPENSE
NAME OF TAXPAYER
ADDRESS
CITY
STATE
ZIP
QUALIFICATIONS
Any taxpayer who paid an individual certified by the Department of Natural Resources to complete a home energy audit may deduct 100% of the costs incurred
for the audit and the implementation of any energy efficiency recommendations made by the auditor. The maximum yearly subtraction may not exceed $1,000,
for a single taxpayer or a married couple filing a combined return. The maximum total lifetime subtraction you may claim is $2,000. To qualify for the deduction,
you must have incurred expenses in the taxable year for which you are filing a claim, and the expenses incurred must not have been excluded from your
federal adjusted gross income or reimbursed through any other state or federal program.
INSTRUCTIONS - IN THE SPACES PROVIDED BELOW:
• Report the name of the auditor who conducted the audit
• Enter the total amount paid to implement the energy efficiency recommendations on Line B
• Report the auditor’s certification number
• Enter the total amount paid for the audit and any implemented recommendations on Line C
• Attach applicable receipts
• Summarize each of the auditor’s recommendations
• Attach completed MO-HEA and receipts to Form MO-1040
• Enter the amount paid for the audit on Line A
NAME OF AUDITOR
AUDITOR CERTIFICATION NUMBER
SUMMARY OF RECOMMENDATIONS
1.
2.
3.
4.
5.
00
A.
A. Amount paid for audit ........................................................................................................................................
00
B. Amount paid to implement recommendations .................................................................................................
B.
C. Total Paid - Add Lines A and B and enter here. Enter Line C or $1,000, whichever is less, on Line 13 of Form
0
00
C.
MO-A. If you are filing a combined return, you may split the amount reported on Line 13 between both taxpayers .....
MO-HEA (12-2013)