Fillable Printable 2014 Form Mo-Ptc, Property Tax Credit Claim
Fillable Printable 2014 Form Mo-Ptc, Property Tax Credit Claim
2014 Form Mo-Ptc, Property Tax Credit Claim
HOUSEHOLD INCOME
SOCIAL SECURITY NO. SPOUSE’S SOCIAL SECURITY NO.
LAST NAME FIRST NAME INITIAL JR, SR
BIRTHDATE (MMDDYY) TELEPHONE NUMBER
SPOUSE’S LAST NAME FIRST NAME INITIAL JR, SR
BIRTHDATE (MMDDYY)
2014 FORM MO-PTC
MISSOURI DEPARTMENT OF REVENUE
PROPERTY TAX CREDIT CLAIM
A. 65 years of age or older (Attach a copy of Form SSA-1099.)
B. 100% Disabled Veteran as a result of military service
(Attach a copy of the letter from Department of Veterans
Affairs.)
C. 100% Disabled (Attach a copy of the letter from Social Security Administration
or Form SSA-1099.)
D. 60 years of age or older and received surviving spouse benefits (Attach a copy of
Form SSA-1099.)
AMENDED CLAIM
QUALIFICATIONS
FILING STATUS
You must check a qualification to be eligible for a credit. Check only one. REQUIRED COPIES OF LETTERS, FORMS, ETC., MUST BE INCLUDED WITH CLAIM.
Single Married — Filing Combined Married — Living Separate for Entire Year
If married filing combined,
you must report both incomes.
FAILURE TO PROVIDE THE ATTACHMENTS LISTED BELOW (RENT RECEIPT(S), TAX RECEIPT(S), FORMS 1099, W-2, ETC.) WILL RESULT IN DENIAL OR DELAY OF YOUR CLAIM!
DECEASED
2014
DECEASED
2014
VENDOR
CODE
PRESENT HOME ADDRESS APT. NUMBER CITY, TOWN, OR POST OFFICE STATE ZIP CODE
IN CARE OF NAME (ATTORNEY, EXECUTOR, PERSONAL REPRESENTATIVE, ETC.)
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DO NOT file this claim if you are going to file a Missouri income tax return! See the instructions.
1. Enter the amount of social security benefits received by you, your spouse, and your minor children before any deductions and the
amount of social security equivalent railroad retirement benefits. ATTACH Forms SSA-1099, RRB-1099, or SSI Statement. ............ 1 00
2. Enter the total amount of wages, pensions, annuities, dividends, interest income, rental income, or other income.
ATTACH Forms W-2, 1099, 1099-R, 1099-DIV, 1099-INT, 1099-MISC, etc. ............................................ 2 00
3. Enter the amount of railroad retirement benefits (not included in Line 1) before any deductions. ATTACH Form RRB-1099-R (Tier II). . 3 00
4. Enter the amount of veteran’s payments or benefits before any deductions. ATTACH letter from Veterans Affairs. .............. 4 00
5. Enter the total amount
received by you, your spouse, and your minor children
from: public
assistance, SSI, child support, Temporary
Assistance payments (TA and TANF).
ATTACH copy of Forms SSA-1099, a letter from the
Social Security Administration and Social
Services that includes the total amount of assistance received and Employment Security 1099, if applicable. .......................
5 00
6. TOTAL household income — Add Lines 1 through 5. ............................................................. 6 00
7. MARK THE BOX THAT APPLIES and enter the appropriate amount.
a. Enter $0 if Single or Married Living Separate;
If Married and Filing Combined;
b. Enter $2,000 if you rented or did not own your home for the entire year;
c. Enter $4,000 if you owned and occupied your home for the entire year; ..........................................
7
00
8. Net household income — Subtract Line 7 from Line 6 and enter the amount; MARK THE BOX THAT APPLIES.
a. If you rented or did not own and occupy your home for the entire year, Line 8 cannot exceed $27,500.
If the total is greater than $27,500, STOP - no credit is allowed. Do not file this claim.
b. If you owned and occupied your home for the entire year, Line 8 cannot exceed $30,000.
If the total is greater than $30,000, STOP - no credit is allowed. Do not file this claim. ............................ 8 00
__ __/__ __/__ __
__ __/__ __/__ __
(_ _ _)_ _ _-_ _ _ _
9. If you owned your home, enter the total amount of property tax paid for your home, less special assessments, or $1,100,
whichever is less. ATTACH a copy of paid real estate tax receipt(s). If your home is on more than five acres or you own
a mobile home, ATTACH Form 948, Assessor’s Certification. ....................................................... 9 00
10.
If you rented, enter the total amount from Form(s) MO-CRP, Line 9, or $750, whichever is less. ATTACH rent receipts or a signed
statement from your landlord. NOTE: If you rent from a facility that does not pay property tax, you are not eligible for a
Property Tax Credit.
...................................................................................... 10 00
11. Enter the total of Lines 9 and 10, or $1,100, whichever is less. ...................................................... 11 00
12. You must use the chart on pages 13-15 to see how much refund you are allowed.
Apply amounts from Lines 8 and 11 to chart on pages 13-15 to figure your Property Tax Credit. ............................ 12 00
REAL ESTATE TAX /
RENT PAID
CREDITS
For Privacy Notice, see instructions.
MO-PTC 2-D (Revised 12-2014)
SIGNATURE DATE (MMDDYYYY) PREPARER’S SIGNATURE FEIN, SSN, OR PTIN
SPOUSE’S SIGNATURE (If filing combined, BOTH must sign) DAYTIME TELEPHONE PREPARER’S ADDRESS AND ZIP CODE DATE (MMDDYYYY)
I authorize the Director of Revenue or delegate to discuss my claim and attachments
with the preparer or any member of the preparer’s firm. YES NO
SIGNATURE
PREPARER’S PHONEE-MAIL ADDRESS
Mail claim and attachments to Missouri Department of Revenue, P.O. Box 3385, Jefferson City, MO 65105-3385.
(__ __ __)__ __ __-__ __ __ __
(__ __ __)__ __ __-__ __ __ __
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief it is true, correct, and complete. Declaration of
preparer (other than taxpayer) is based on all information of which he or she has any knowledge. As provided in Chapter 143, RSMo, a penalty of up to $500 shall be imposed on any individual who files a frivolous
return. I also declare under penalties of perjury that I employ no illegal or unauthorized aliens as defined under federal law and that I am not eligible for any tax exemption, credit or abatement if I employ such aliens.
__ __ /__ __/__ __ __ __
__ __ /__ __/__ __ __ __
If you would like your refund deposited directly to your checking or savings account, complete boxes a, b, and c below.
a. Routing Number b. Account Number c. Checking Savings
DIRECT
DEPOSIT
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INSTRUCTIONS:
- You must use the print button at the top of page to print form
- Don't forget to attach all required forms
- You can tab from one field to another or use the mouse to
click in the field you want.
- You must use your mouse to click in the check boxes.
- If a field does not allow a negative number, and a negative
number is entered, a zero will be displayed.
Line 1
Line 2
Line 3
Line 4
Line 5
0
Line 7
0
Line 8
Line 9
Go To Form MO-CRP
0
Line 10
Line 11
Line 12
M1
For Privacy Notice, CLICK HERE
28
Line 1
Line 6
Line 7
0
Line 8
0
Line 9
For Privacy Notice CLICK HERE
Go To Form MO-PTC
Line 1
Line 6
Line 7
0
Line 8
0
Line 9
For Privacy Notice CLICK HERE
Go To Form MO-PTC
28
Line 1
Line 6
Line 7
0
Line 8
0
Line 9
For Privacy Notice CLICK HERE
Go To Form MO-PTC
Line 1
Line 6
Line 7
0
Line 8
0
Line 9
For Privacy Notice CLICK HERE
Go To Form MO-PTC
28
Line 1
Line 6
Line 7
0
Line 8
0
Line 9
For Privacy Notice CLICK HERE
Go To Form MO-PTC
