Form M1prx - Amended Homestead Credit Refund (For Homeowners) And Renter Property Tax Refund - 2017

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*175811*
2017 Form M1PRX, Amended Homestead Credit Refund (for Homeowners)
and Renter Property Tax Refund
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
Spouse's Last Name
Social Security Number
Spouse’s Date of Birth
Current Home Address (Street, Apartment, Route)
City
State
ZIP Code
For department use only.
Do not write in this space.
Place an X in
Effective interest date:
all that apply:
Renter
Homeowner
Nursing home or adult foster care resident
Mobile home 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 2017 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) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
3 Deduction for contributions to a qualified retirement plan (add lines 28 and 32 of federal Form
1040 or from line 17 of Form 1040A). Also see line 36 of this form . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
4
Total payments from programs including MFIP (
MN Family Investment Program), MSA (MN Supplemental
. . . . . . . . . . . . . . . . . . . . . . . 4
and GRH (
Aid), SSI (Supplemental Security Income), GA (General Assistance)
Group Residential Housing)
5 Additional nontaxable income such as distributions from a Roth account, contributions to
a deferred compensation plan, scholarships, and grants, (see M1PR instructions for more examples) . . . . . . . . . . . . . . 5
Income Types:
6 Add lines 1 through 5. If your income is less than the rent you paid, enclose an explanation. . . . . . . . . . . . . . . . . . . . 6
7 Dependent, over 65, disabled, and retirement contribution subtraction
. . . . . . . . . . . . . . . . . 7
(use Schedule 2, on back)
8 Total household income. Subtract line 7 from line 6 (if result is zero or less, leave blank) . . . . . . . . . . . . . . . . . . . . . 8
9 Renters: Line 3 of your 2017 Certificate(s) of Rent Paid (CRP).
Continue with line 10; this amount is not your refund (you must 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 in the M1PR instructions. Continue with line 15 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 0
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 2018 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 1
(Mobile home owners: See worksheet in M1PR instructions)
12
If claiming the special refund, enter amount from line 33, Schedule 1 on page 2 of this form. . . . . . . . . . . . . . . . . 1 2
Subtract line 12 from line 11 (if result is zero or less, leave blank) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 3
13
14
Homeowners' Homestead Credit Refund: Using the amounts on line 8 and line 13, find the
amount to enter here from the homeowner refund table in the M1PR instructions . . . . . . . . . . . . . . . . . . . . . . . . 1 4
15
Add lines 10, 12, and 14 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 5
16
ORIGINAL REFUND. Refund amount from line 15 of your original M1PR return,
previous amend or audit report (see M1PRX instructions) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 6
17
ADDITIONAL REFUND. If line 15 is more than line 16, subtract line 16 from line 15 . . . . . . . . . . . . . . . . . . . . . . . . 1 7
18
If line 16 is more than line 15, subtract line 15 from line 16 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 8
Interest (see M1PRX instructions) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 9
19
20
AMOUNT YOU OWE. Add lines 18 and 19 (see M1PRX instructions) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 0
9995
You must sign the second page.

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