Massachusetts Form 1 - Schedule X, Schedule Y, Schedule Z, Schedule Di - 2013 Page 2
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1
2
3File pg. 6
SOCIAL SECURITY NUMBER
FIRST NAME
M.I.
LAST NAME
Note: If claiming other credits on Form 1, line 30 or Form 1-NR/PY, lines 34 or 35, you must complete and enclose Schedule Z with your return.
Schedule Z Other Credits.
2013
Enclose with Form 1 or Form 1-NR/PY. Do not cut or separate these schedules.
PART 1. CREDITS
0 0
1
Lead Paint (you must enclose Schedule LP). Not less than “0” . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 1
a. Total number of units in line(s) 1a and 3a of Schedule LP. . . . . . . . . . . . 3 1a
2
Economic Opportunity Area (you must enclose Schedule EOAC). Not less than “0”
Economic Development Incentive Program
0 0
Certificate number . . . . . . . . . . . . . . . . . . . . . . . . 3
. . . . . . . 3 2
0 0
3
Septic (you must enclose Schedule SC). Not less than “0” . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 3
4
Brownfields. Not less than “0”
0 0
Certificate number . . . . . . . . . . . . . . . . . . . . . . . . 3
. . . . . . . 3 4
5
Low-Income Housing. Not less than “0”
0 0
Building identification number . . . . . . . . . . . . . . 3
. . . . . . . 3 5
6
Historic Rehabilitation. Not less than “0”
0 0
Certificate number . . . . . . . . . . . . . . . . . . . . . . . . 3
. . . . . . . 3 6
7
Film Incentive. Not less than “0”
0 0
Certificate number . . . . . . . . . . . . . . . . . . . . . . . . 3
. . . . . . . 3 7
8
Medical Device. Not less than “0”
DRAFT AS OF
0 0
Certificate number . . . . . . . . . . . . . . . . . . . . . . . . 3
. . . . . . . 3 8
9
Employer Wellness Program credit
SEPTEMBER 18, 2013
0 0
Certificate number . . . . . . . . . . . . . . . . . . . . . . . . 3
. . . . . . . 3 9
10
Add lines 1 through 9. Not less than “0”. Nonresidents and part-year residents, enter the result
(SUBJECT TO CHANGE)
here and on Form 1-NR/PY, line 34. Part-year residents, also complete lines 11 through 13, if
0 0
applicable. Full-year residents, also complete lines 11 through 14 . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10
PART 2. CREDITS FOR FULL-YEAR AND PART-YEAR RESIDENTS ONLY
0 0
11
Income tax paid to another state or jurisdiction (from worksheet). Not less than “0” . . . . . . . . . . . 3 11
Enter two-letter state or jurisdictional postal code. . . 3
3
3
0 0
12
Solar and wind energy (you must enclose Schedule EC). Not less than “0” . . . . . . . . . . . . . . . . . . . 3 12
PART 3. TOTALS
13
Add lines 11 and 12. Not less than “0”. Part-year residents, enter the result here and on Form
0 0
1-NR/PY, line 35 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
14
Full-year residents only. Add lines 10 and 13. Not less than “0”. Enter the result here and on
0 0
Form 1, line 30 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14
Schedule RF Other Refundable Credits
0 0
1
Refundable film credit (you must enclose Schedule RFC). Not less than “0” . . . . . . . . . . . . . . . . . . . 3 1
2
Refundable dairy credit (see instructions)
0 0
Not less than “0”. Certificate number . . . . . . . . . 3
. . . . . . . 3 2
3
Refundable conservation land tax credit
0 0
Not less than “0”. Certificate number . . . . . . . . . 3
. . . . . . . 3 3
4
Total refundable credits. Add lines 1 through 3. Not less than “0”. Enter result here and on Form 1,
0 0
line 42 or Form 1-NR/PY, line 47 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
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