Fillable Form Mo-Scc - Shared Care Tax Credit (Page 2 of 2) in pdf

I certify due to the physical or mental conditions described below, the recipient, listed above is incapable of living alone and must acquire necessary

home care to avoid placement in a care facility.

Description of physical or mental condition (include description of the care assistance needed): ______________________________________

___________________________________________________________________________________________________________________

Signature

Title

Printed Name

Date (MM/DD/YYYY)

___ ___ /___ ___ /___ ___ ___ ___

Name of Agent or Contact

Phone Number

(__ __ __) __ __ __ -__ __ __ __

Address

State

Zip Code

Frequently Asked Questions

1. Must I be a registered caregiver to receive the shared care tax credit?

Yes.

If you meet all other requirements, you may qualify for the tax credit if you register as a shared care member.

To register with the Division of Senior and Disability Services call 573-751-4842.

2. Do I have to be in Missouri caring for the care recipient for consecutive six months to receive the tax credit?

No. The amount of time you are caring for the recipient does not need to be consecutive; it can be aggregate as long as it is more

than six months per tax year.

3. I provided care for my mother half of the year, but I am not currently a Missouri resident. Do I still qualify for the credit?

Yes. If you have a Missouri tax liability and you met all of the requirements listed on the previous page; you may still qualify for the

shared care tax credit.

4. What is considered when determining whether or not the care recipient is incapable of living alone?

A physician or a Division of Senior and Disability Services Social Service Worker must determine whether or not the care recipient

is capable of living alone. The physician or counselor must provide a description of the care recipient’s physical or mental condition,

which prevents the recipient from living alone. The physician or social service worker must also describe the necessary treatment

or care needed for the care recipient.

5. Is the shared care tax credit refundable?

No. The credit is the amount of your Missouri tax liability or $500, whichever is less. If your Missouri tax liability is $200, you will

receive a credit of $200.

6. If I receive Medicaid, am I eligible for the credit?

No.

If you receive Medicaid funded home and community based services, you are not eligible for the tax credit.

If you receive Medicare, you may qualify for the credit.

This form must be attached to the Miscellaneous Income Tax Credits

(Form

MO-TC), and Individual Income Tax Return

(Form

MO-1040).

Form MO-SCC (Revised 12-2014)

Taxation Division

Phone: (573) 751-3220

P.O. Box 27

TDD: (800) 735-2966

Visit

Jefferson City, MO 65105-0027

Fax: (573) 751-2195

for additional information.

E-mail:

taxcredit@dor.mo.gov

Form Mo-Scc - Shared Care Tax Credit Page 2

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