1399
201399
2013 Form M99, Credit for Military Service in a Combat Zone
First name and initial
Last name
Social Security number
Mark
an X if a
Current home address (street, apartment number, route)
Date of birth (mmddyyyy)
foreign
address:
▼
State
Zip code
City
Mark an X if this is
an amended return
Enter the number of months served in a combat zone for the year 2013. Count partial months as full months. Your home of record must
have been Minnesota during the months served to qualify for the credit.
1 Number of months in 2013 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1
2 Multiply line 1 by $120. This is the AMOUNT OF YOUR CREDIT . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2
For Direct Deposit of the full credit, enter the following information. Otherwise, you will receive a check.
(You must use an account not associated with a foreign bank.)
Account type
Routing number
Account number
Checking
Savings
Sign here: I declare that this return is correct and complete to the best of my knowledge and belief.
Your signature
Date
Your phone
Preparer's phone
MN tax ID, SSN, PTIN or VITA/TCE
Paid preparer’s signature
Date
I authorize the Minnesota Department of Revenue to
discuss this tax return with the preparer.
You must enclose the following with this return:
Active-duty members:
• Attach a copy of your Leave and Earnings Statement for each month in qualifying status.
National Guard, Reservists, and retired or discharged active-duty members:
• Attach Form DD-214 for each period of qualifying service.
Completed forms and documentation will be accepted starting January 2014.
Mail to: Minnesota Revenue, Mail Station 0043, St. Paul, MN 55146-0043
See instructions for additional information.
9995