Schedule Fc - Farmland Preservation Credit - 2012 Page 2
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1
22012
Name
Page
2 of 2
FC
SSN or FEIN
.00
9 L Fill in the amount from line 9k (page 1) here . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9L
.00
m Gain from sale of home excluded for federal tax purposes (see instructions) . . . . . . . . . . . . . . . . . . 9m
.00
n Nontaxable housing allowance provided to a member of the clergy . . . . . . . . . . . . . . . . . . . . . . . . . 9n
.00
o Income of a nonresident or part-year resident spouse . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9o
.00
p Interest on state and municipal bonds . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9p
.00
q Interest on United States securities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9q
r IRA, SEP, and SIMPLE distributions, distributions from retirement plans, pension, annuity,
.00
railroad retirement, and veterans’ pension or disability payments . . . . . . . . . . . . . . . . . . . . . . . . . . 9r
.00
s Military compensation or cash benefits . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9s
.00
t Nontaxable income from sources outside Wisconsin . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9t
.00
u Nontaxable income of a Native American . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9u
.00
v Rent reduction for a resident manager . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9v
.00
w Scholarships, fellowships, and grants . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9w
.00
x Social security and SSI payments (do not include Title XX payments) . . . . . . . . . . . . . . . . . . . . . . . 9x
.00
y Unemployment compensation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9y
.00
z Workers’ compensation and nontaxable loss of time insurance (for example, sick pay) . . . . . . . . . . 9z
.00
10 TOTAL HOUSEHOLD INCOME – Add lines 9L through 9z . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
10
Complete lines 11 through 18, as applicable (see instructions, pages 7 through 9).
Credit Computation
.00
11 a Fill in the net 2012 property taxes on which this claim is based . . . . .
11a
.00
b Fill in the SMALLER of the amount on line 11a or $6,000 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11b
.00
12 Using the income amount on line 10, fill in the appropriate amount from TABLE 1, page 15 . . . . . . . . . 12
.00
13 Subtract line 12 from line 11b (if line 12 exceeds line 11b, fill in 0) . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
.00
14 Using the amount on line 13, fill in the appropriate amount from TABLE 2, page 16 . . . . . . . . . . . . . . . 14
15 Regular Credit – Check below to indicate the percentage of credit for which you qualify:
.00
80% – Fill in 80% of line 14 amount . . . . . . . . . . . . . . . . . . . . . . . . 15a
a
.00
Multiple Percentages – From line 21 of WORKSHEET 2, page 12 15b
b
.00
16 10% Special Minimum Credit – Fill in 10% of line 11b . . . . . . . . . . . . . . . . 16
17 Credit Based on Prior Year’s Law – Fill in amount from line 11 of
WORKSHEET 1, page 11 – available only if your agreement was
.00
effective before 8/15/91 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17
18 FARMLAND PRESERVATION CREDIT – Fill in the LARGEST of line 15a through 17
on line 18. Fill in the credit from line 18 on one of the following lines: line 45a of Form 1;
.00
line 70a of Form 1NPR; line 23a of Form 2; or (for corporations) line 53a of Schedule CR . . . . . .
18
Certification
If applicable, check to the right of line 19 to certify both of the following (see instructions, page 9):
19 a None of the information on my previously submitted zoning certificate has changed, and
b I have notified the county land conservation committee that I intend to file a 2012 Schedule FC . . .
19
Sign Here
This farmland preservation credit claim and all enclosures are true, correct, and complete to the best of my knowledge.
Claimant’s signature ▲
Date ▲
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