Form M99 - Minnesota Credit For Military Service In A Combat Zone - 2017

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*171991*

2017 Form M99, Credit for Military Service in a Combat Zone

Your First Name and Initial

Last Name

Your Social Security Number

Current Home Address

Check if: New Address

Foreign Address

Your Date of Birth

City

State

Zip Code

Check if Amended Form M99

Enter the number of months served in a combat zone during 2017. 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 2017 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .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

Phone