Schedule M1ls - Tax On Lump-Sum Distribution - 2017

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*171801*
2017 Schedule M1LS, Tax on Lump-Sum Distribution
Your First Name and Initial
Last Name
Social Security Number
Round amounts to the
You must complete federal Form 4972 before you can complete this schedule.
nearest whole dollar.
1 Portion of your lump-sum distribution that is eligible for averaging
(from line 19 of federal Form 4972) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
2 If you completed Schedule M1R, see instructions. If you did not complete Schedule M1R, enter 0 . . . . . . . . . . . . . . . 2
3 Subtract line 2 from line 1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
4 Multiply line 3 by 20% (.20) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
5 From the tax table in the M1 instructions, find the tax for the amount
on line 4 above using the column in the table for single persons . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
6 Multiply line 5 by 5 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
If you did not complete lines 20 through 22 of federal Form 4972, skip lines 7 through 10 below,
and enter the amount from line 6 on line 11.
7 Amount from line 22 of federal Form 4972 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
8 Multiply line 7 by 20% (.20) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
9 From the tax table in the M1 instructions, find the tax for the amount
on line 8 above using the column in the table for single persons . . . . . . . . . . . . . . . . . . . . . . . 9
10 Multiply line 9 by 5 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 0
11 Tax on the ordinary income portion of your lump-sum distribution (subtract line 10 from line 6).
If you shared the lump-sum distribution with other recipients, see instructions.
Enter the result here and on line 13 of Form M1.
(Estates and trusts: Include this amount on line 12 of Form M2 and check the box for M1LS) . . . . . . . . . . . . . . . . . . . 1 1
You must include this schedule and a copy of your federal Form 4972 when you file Form M1.
9995

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