Schedule M1home - First-Time Homebuyer Savings Account - 2017

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2017 Schedule M1HOME, First-Time Homebuyer Savings Account
If you are the account holder of more than one first-time homebuyer savings account, complete a separate Form M1HOME for each
account for which you are the account holder.
Your First Name and Initial
Last Name
Social Security Number
Registration Information
Bank Name
Date Account Opened
Account Number
End of Year Balance
Qualified Beneficiary
Date Qualified Beneficiary Named
Withdrawals from Account
Date of Withdrawal
Amount of Withdrawal
Purpose of Withdrawal
Round amounts to the nearest whole dollar.
Account Reporting
1 Amount of contributions made in 2017 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
2 Qualified withdrawals in 2017 (see instructions) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
3 Non-qualified withdrawals in 2017 (see instructions) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
Subtraction
4 Enter amount of interest earned on this savings account here and on line 41 of Schedule M1M
4
. . . . . . . . . . . . . . . . . . .
Addition
5 Subtract line 1 from line 3. If less than 0, stop here. You do not have an addition.
Do not complete the rest of this form. If you have a positive number, enter this amount on line 14
of schedule M1M and complete the next section . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
Additional Tax
6 Multiply line 5 by 10% (.10). Enter the amount here and on line 14 of Form M1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
9995

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