Form M1x - Amended Minnesota Income Tax - 2012 Page 2
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42012 M1X, page 2
201214
A. Original Amount or
B. Amount of Change
C. Correct
Increase or (Decrease)
as Previously Adjusted
Amount
18 Amount from line 17 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18
19 Minnesota income tax withheld (Schedule M1W) . . . . . . . . . . . . . . . 19
20 Minnesota estimated tax payments made for 2012 . . . . . . . . . . . . . 20
21 Child and Dependent Care Credit (Schedule M1CD) . . . . . . . . . . . . . 21
22 Minnesota Working Family Credit (Schedule M1WFC) . . . . . . . . . . . 22
23 K-12 Education Credit (Schedule M1ED) . . . . . . . . . . . . . . . . . . . . . . 23
24 Business and investment credits (Schedule M1B) . . . . . . . . . . . . . . . 24
25 Amount from line 32 of your original Form M1 (see instructions) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25
26 Total credits and tax paid . Add lines 19C through 24C and line 25 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26
27 Amount from line 30 of your original Form M1 (see instructions) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27
28 Subtract line 27 from line 26 (if result is less than zero, enter the negative amount; do not enter 0) . . . . . . 28
29 REFUND . If line 28 is more than line 18C, subtract line 18C from line 28 and stop here . . . . . . . . . . . . . . . . 29
30 To have your refund direct deposited, enter the following . Otherwise, you will receive a check .
Account type
Routing number
Account number
(use an account not associated with any foreign bank)
Checking
Savings
31 Tax you owe . If line 18C is more than line 28, subtract line 28 from line 18C
(if line 28 is a negative amount, see instructions) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31
32 If you failed to timely report federal changes or the
IRS assessed a penalty, see instructions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32
33 Add line 31 and line 32 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33
34 Interest (see instructions) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34
Make check out to Minnesota
35 AMOUNT DUE . Add line 33 and line 34 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
35
Revenue and enclose Form M63
I declare that this return is correct and complete to the best of my knowledge and belief.
Your signature
Spouse’s signature (if filing jointly)
Date
Daytime phone
Paid preparer’s signature
PTIN or VITA/TCE #
Date
Daytime phone
I authorize the MN Department of
Revenue to discuss this return with
the paid preparer and/or third party .
EXPLANATION OF CHANGE—Briefly explain each change below . If you checked the box for “Claim due to a pending court case” or “Other” on
the front of this form as your reason for amending, you must also give a brief explanation of the changes that you are making to your original
Minnesota income tax return . If you need more space, enclose another sheet .
You must enclose any corrected schedules and, if you filed an amended federal return, a complete copy of Form 1040X.
Mail to: Minnesota Amended Individual Income Tax,
Mail Station 1060, St . Paul, MN 55145-1060
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