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2014
MISSOURI DEPARTMENT OF REVENUE
FORM
HOME ENERGY AUDIT EXPENSE
MO-HEA
NAME OF TAXPAYER
ADDRESS
CITY
STATE
ZIP
QUALIFICATIONS
Any taxpayer who paid an individual certified by the Division of Energy to complete a home energy audit may deduct 100% of the costs incurred for the audit and the
implementation of any energy efficiency recommendations made by the auditor. The subtraction may not exceed $1,000, for a single taxpayer or $2,000 for taxpayers
filing combined returns. To qualify for the subtraction, you must have incurred expenses in the taxable year you are filing a claim, and the expenses incurred must not have
been excluded from your federal adjusted gross income or reimbursed through any other state or federal program.
INSTRUCTIONS - IN THE SPACES PROVIDED BELOW:
• Report the name of the auditor who conducted the audit
• Enter the total amount paid to implement the energy efficiency recommendations on Line B
• Report the auditor’s certification number
• Enter the total amount paid for the audit and any implemented recommendations on Line C
• Summarize each of the auditor’s recommendations
• Attach applicable receipts
• Enter the amount paid for the audit on Line A
• Attach completed MO-HEA and receipts to Form MO-1040
NAME OF AUDITOR
AUDITOR CERTIFICATION NUMBER
SUMMARY OF RECOMMENDATIONS
1.
2.
3.
4.
5.
A. Amount paid for audit .....................................................................................................................................................
A.
00
B. Amount paid to implement recommendations ...............................................................................................................
B.
00
C. Total Paid - Add Lines A and B and enter here. Enter on Line C or $1,000, whichever is less, on Line 13 of
Form MO-A. If you are filing a combined return, you may split the amount reported on Line 13 between both
0
taxpayers (not to exceed $2,000) ...................................................................................................................................
C.
00
D. Enter $1,000 if a single filer or $2,000 if filing a combined return ..................................................................................
D.
00
E. Amount from Line C or Line D, whichever is less. Enter here and on Form MO-A, Line 13
If you are filing a combined return, you may split the amount reported on Line 13 between both spouses ...................
E.
00
Form MO-HEA (Revised 12-2014)