Form M1prx - Amended Minnesota Property Tax Refund - 2012
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M1PRX, Amended Minnesota Property Tax Refund 2012
Your first name and initial
Last name
Social Security number
Date of birth (mm/dd/yyyy)
If a joint return, spouse’s first name and initial
Last name
Social Security number
Spouse’s date of birth
Current home address (street, apartment, route)
For department use only.
Do not write in this space.
Effective interest date:
City
State
Zip code
Place an X in the
Nursing home or adult
Mobile home
boxes that apply:
Renter
Homeowner
foster care resident
owner
Place an X in this box if your income changed because of a federal adjustment. Enclose a complete copy of the federal adjustment.
You will need the 2012 Property Tax Refund instruction booklet, including refund tables, to complete this form.
Correct amount
1
Federal adjusted gross income (from line 37 of federal Form 1040,
line 21 of Form 1040A, or line 4 of Form 1040EZ). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
2
Nontaxable Social Security and/or Railroad Retirement Board benefits received
and not listed in line 1 above (determine from M1PR instructions, page 8) . . . . . . . . . . . . . . . . . . . . . 2
Deduction for payments made to an IRA, Keogh, Simplified Employee Pension (SEP) or
3
SIMPLE plan (add lines 28 and 32 of federal Form 1040 or from line 17 of Form 1040A) . . . . . . . . . 3
4
Total welfare received, including MFIP
(Minnesota Family Investment Program),
MSA
(Minnesota Supplemental
. . . . . . . . . . . . .4
SSI
GA
and GRH
Aid),
(Supplemental Security Income),
(General Assistance)
(Group Residential Housing)
5
Additional nontaxable income—such as 401(k) or deferred compensation plan contributions—
you must include (M1PR instructions, page 8). Enter income type(s) below . . . . . . . . . . . . . . . . . . . . . . . . . . .5
6
Add lines 1 through 5. If your income is less than the rent you paid, enclose an explanation. . . . . . . . . .6
7
Subtraction amount (determine from M1PR instructions, page 9):. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
7
65 or older
From worksheet in M1PR instructions,
Mark an X if you
enter number of dependents from step C:
disabled
or your spouse are:
8
Total household income. Subtract line 7 from line 6 (if result is zero or less, leave blank).
See page 9 of M1PR instructions for income limits . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .8
Renters: Line 3 of your 2012 Certificate(s) of Rent Paid (CRP).
9
Continue with line 10; this amount is not your refund (enclose your CRPs) . . . . . . . . . . . . . . . . . . . . . . 9
10 Renters: Using the amounts on line 8 and line 9, find the amount to enter here from the
renter refund table on pages 13–17 of the M1PR instructions. Continue with line 15 . . . . . . . . . . . . 10
ALL HOMEOWNERS: REQUIRED — Property ID number (use numbers only):
County in which the property is located
11 Property tax from line 1 of Statement of Property Taxes Payable in 2013 . . . . . . . . . . . . . . . . . . . . . . .11
(Mobile home owners: See M1PR instructions, page 7)
12 If claiming the special refund, enter amount from line 33, Schedule 1 on page 2 of this form . . . . . .12
13 Subtract line 12 from line 11 (if result is zero or less, leave blank) . . . . . . . . . . . . . . . . . . . . . . . . . . . .13
14 Regular refund: Using the amounts on line 8 and line 13, find the amount to enter here
from the homeowner refund table on pages 18–26 of the M1PR instructions . . . . . . . . . . . . . . . . . . .14
15 Add lines 10, 12 and 14 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .15
16 ORIGINAL REFUND. Refund amount from line 15 of your original M1PR return,
previous amend or audit report. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .16
17 ADDITIONAL REFUND. If line 15 is more than line 16, subtract line 16 from line 15 . . . . . . . . . . . . . 17
18 If line 16 is more than line 15, subtract line 15 from line 16. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .18
19 Interest (determine from M1PRX instructions) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19
Make check out to: Minnesota
20 AMOUNT YOU OWE. Add lines 18 and 19 (See M1PRX instructions) . . . . . . . . . . . . . . . . . . . . . . . . . . . 20
Revenue and attach PV48
You must sign the second page. See explanation of change and direct deposit option on the second page.
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