Massachusetts Department of Revenue 2022 Form 1 Massachusetts Resident Income Tax Return SIGN HERE. Under penalties of perjury, I declare that to the best of my knowledge and belief this return and enclosures are true, correct and complete. YOUR SIGNATURE DATE SPOUSE’S SIGNATURE DATE

/ / / / TAXPAYER’S E-MAIL ADDRESS TAXPAYER’S PHONE TAXPAYER’S FIRST NAME M.I. LAST NAME TAXPAYER’S SOCIAL SECURITY NUMBER

SPOUSE’S FIRST NAME M.I. LAST NAME SPOUSE’S SOCIAL SECURITY NUMBER

MAILING ADDRESS (no. & street; apt./suite/postal box). If you have a foreign address, also complete line below. CITY/TOWN

STATE ZIP FOREIGN PROVINCE/STATE/COUNTY

FOREIGN COUNTRY (OR COUNTRY CODE) FOREIGN POSTAL CODE Fill in if (see instructions):

Amended return Other jurisdiction change (enter date of change) M M D D Y Y Y Y

Federal amendment Amended return due to IRS BBA Partnership Audit State Election Campaign Fund (this contribution will not change your tax or reduce your refund) $1 Taxpayer $1 Spouse. . . . . . . . . . . . . . Total $ Fill in if veteran of U.S. armed services who served in Operation Enduring Freedom, Iraqi Freedom, Noble Eagle or Sinai Peninsula. . . . . . Taxpayer Spouse Fill in appropriate oval(s) if taxpayer(s) is deceased. See instructions. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Taxpayer Spouse Fill in if under age 18. See instructions. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Taxpayer Spouse Fill in if name has changed since 2021. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Taxpayer Spouse Fill in if noncustodial parent. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Fill in if filing the following schedule(s). See instructions: Schedule TDS Schedule FCI Fill in if at any time during 2022 you received (as a reward, award, or payment for property or services) or sold, exchanged, gifted, or otherwise disposed of a digital asset (or a financial interest in a digital asset). See instructions. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

 IF A LOSS, MARK AN X IN BOX  IF A LOSS, MARK AN X IN BOX a Total federal income b Total federal adjusted gross income

(from U.S. Form 1040, line 9) 0 0 (from U.S. Form 1040, line 11) 0 0 1 FILING STATUS. Fill in one only.

Single Head of household (see instructions)

Married filing joint return (both must sign return) You are a custodial parent who has released claim to exemption for child(ren)

Married filing separate return (must enter spouse’s name and Social Security number in the appropriate areas above) 2 EXEMPTIONS

a. Personal exemptions. If single or married filing separately, enter $4,400. If head of household, enter $6,800. If married filing jointly, enter $8,800. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2a 0 0

b. Number of dependents (do not include yourself or your spouse). Enclose Schedule DI. . . . . . Total × $1,000 = 2b 0 0

c. Age 65 or over before 2023 You Spouse. . . . . . . . . . . . . . . . . . . . . . . . . Total

× $1,700 = 2c 0 0

d. Blindness You Spouse. . . . . . . . . . . . . . . . . . . . . . . . . Total × $2,200 = 2d 0 0

e. Medical/dental (from U.S. Schedule A, line 4). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2e 0 0

f. Adoption. See instructions. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2f 0 0

g. TOTAL EXEMPTIONS. Add lines 2a through 2f. Enter here and on line 18. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2g 0 0 Be sure to enclose any forms or schedules (W-2, W-2G, 1099, 3K-1, SK-1, PWH or LOA) that show Massachusetts withholding. Fill out in black ink. For a faster refund, file your return elec­tronically at mass.gov/dor. You must also complete and enclose Schedule HC.

TAXPAYER’S FIRST NAME M.I. LAST NAME TAXPAYER’S SOCIAL SECURITY NUMBER

INCOME 3 Wages, salaries, tips and other employee compensation (from all Forms W-2). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 0 0 4 Taxable pensions and annuities. Attach any Form(s) 1099-R with Massachusetts withholding. See instructions. . . . . . . . .4 0 0

Massachusetts bank interest Exemption amount. If married filing jointly, enter $200; otherwise enter $100. 5 a. 0 0 b. 0 0 . . . . . . . . . . . . . . . . a – b (not less than 0) = 5 0 0 6 a. Business/profession income or loss. Enclose Schedule C. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6a 0 0

b. Farming income or loss. Enclose U.S. Schedule F. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6b 0 0 7 If you are reporting rental, royalty, REMIC, partnership, S corporation, or trust income or loss, see instructions . . . . 7 0 0 8 a. Unemployment compensation. See instructions. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8a 0 0

b. Massachusetts state lottery winnings. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8b 0 0 9 Other income from Schedule X, line 7. Enclose Schedule X; not less than 0. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 0 0 10 TOTAL 5.0% INCOME. Add lines 3 through 9. Be sure to subtract any losses in lines 6 or 7. . . . . . . . . . . . . . . . 10 0 0 DEDUCTIONS 11 a. Amount you paid to Social Security, Medicare, Railroad, U.S. or Massachusetts retirement. Not more than $2,000 . . . . . . . . . . . . 11a 0 0

b. Amount spouse paid to Social Security, Medicare, Railroad, U.S. or Massachusetts retirement. Not more than $2,000. . . . . . . . . 11b 0 0 12 Reserved for future use. See line 45 for new Child under age 13, or disabled dependent/spouse credit. . . . . . . . . . . . . . . . . . . . 12 13 Reserved for future use. See line 46 for new Dependent member(s) of household under age 12, or dependent(s). . . . . . . . . . . . . . . . 13 0 0 0 0 0 0 age 65 or over (not you or your spouse) as of December 31, 2022 credit 14 Rental deduction. (See instructions)

a. Enter the total qualified rent paid in 2022 in the box then divide by 2. . . . . . . . . . . . . . . . . . . 0 0 ÷ 2 = 14 0 0 15 Other deductions from Schedule Y, line 19. Enclose Schedule Y. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15 0 0 16 TOTAL DEDUCTIONS. Add lines 11 through 15 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16 0 0 17 5.0% INCOME AFTER DEDUCTIONS. Subtract line 16 from line 10. Not less than 0. . . . . . . . . . . . . . . . . . . . . . . 17 0 0 18 Total exemption amount (from line 2g). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18 0 0 19 5.0% INCOME AFTER EXEMPTIONS. Subtract line 18 from line 17. Not less than 0. If line 17 is less than line 18, see instructions. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19 0 0 20 INTEREST AND DIVIDEND INCOME (from Schedule B, line 38). Not less than 0. Enclose Schedule B. . . . . . . . 20 0 0 21 TOTAL TAXABLE 5.0% INCOME. Add lines 19 and 20. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21 0 0 22 TAX ON 5.0% INCOME (from tax table). If line 21 is more than $24,000, multiply by .05. Note: If choosing the optional 5.85% tax rate, fill in oval and see instructions . . . . . . . . . . . . . . . . . . . . . . . . . . 22 0 0 2022 FORM 1, PAGE 2

TAXPAYER’S FIRST NAME M.I. LAST NAME TAXPAYER’S SOCIAL SECURITY NUMBER 23 12% INCOME (from Schedule B, line 39). Not less than 0. Enclose Schedule B. a.

0 0 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . × .12 = 23 0 0 24 TAX ON LONG-TERM CAPITAL GAINS (from Schedule D, line 22). Not less than 0. Enclose Schedule D. If filing Schedule D-IS, Installment Sales, fill in oval and enclose Schedule D-IS . . . . . . . . . . . . . . . . . . . . . . . 24 0 0 If excess exemptions were used in calculating lines 20, 23 or 24, fill in oval and see instructions 25 Credit recapture amount. Enclose Schedule CRS. See instructions. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25 0 0 26 Additional tax on installment sales. See instructions. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26 0 0 27 If you qualify for No Tax Status, fill in oval and enter 0 in line 28 (from worksheet) 28 TOTAL INCOME TAX. Add lines 22 through 26 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28 0 0 CREDITS 29 Limited Income Credit (from worksheet) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29 0 0 30 Income tax due to another state or jurisdiction (from worksheet). Not less than 0. Enclose Schedule OJC. . . . . . . . . 30 0 0 31 Other credits (from Schedule CMS). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31 0 0 32 INCOME TAX AFTER CREDITS. Subtract total of lines 29 through 31 from line 28. Not less than 0 . . . . . . . . . . . . 32 0 0 33 Voluntary fund contributions a. Endangered Wildlife Conservation. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33a 0 0 b. Organ Transplant. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33b 0 0 c. Massachusetts Public Health HIV and Hepatitis Fund . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33c 0 0 d. Massachusetts U.S. Olympic. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33d 0 0 e. Massachusetts Military Family Relief. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33e 0 0 f. Homeless Animal Prevention And Care. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33f 0 0

Total. Add lines 33a through 33f . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33 0 0 34 Use tax due on Internet, mail order and other out-of-state purchases (from worksheet). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34 0 0 35 Health Care penalty. Not less than 0 (from worksheet). Enclose Schedule HC. a. You

0 0 b. Spouse

0 0 Total. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . a + b = 35 0 0 36 AMENDED RETURN ONLY. Overpayment from original return. Not less than 0. See instructions. . . . . . . . . . . . . . . 36 0 0 37 INCOME TAX AFTER CREDITS, CONTRIBUTIONS, USE TAX and HC PENALTY. Add lines 32 through 36. . . . . 37 0 0 MASSACHUSETTS WITHHOLDING, PAYMENTS AND REFUNDABLE CREDITS 38 a. Massachusetts income tax withheld from Form(s) W-2. . . . . . . . . . . . . . . . . . . 38a 0 0 b. Massachusetts income tax withheld from Form(s) 1099. . . . . . . . . . . . . . . . . . 38b 0 0 c. Massachusetts income tax withheld from other forms. See instructions. . . . . . . 38c 0 0 Total. Add lines 38a through 38c. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 38 0 0 2022 FORM 1, PAGE 3

TAXPAYER’S FIRST NAME M.I. LAST NAME TAXPAYER’S SOCIAL SECURITY NUMBER

39 2021 overpayment applied to your 2022 estimated tax (from 2021 Form 1, line 51 or Form 1-NR/PY, line 55.) Do not enter 2021 refund. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39 0 0 40 2022 Massachusetts estimated tax payments. Do not include line 39 amount. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 40 0 0 41 Payments made with extension . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 41 0 0 42 AMENDED RETURN ONLY. Payments made with original return. Not less than 0. See instructions. . . . . . . . . . . . . 42 0 0 43 EARNED INCOME CREDIT.

a. Number of qualifying children

b. Amount from U.S. return 0 0 (See instructions) 43b × ____ = .43 0 0 Note: You cannot claim the Earned Income Credit if your filing status is married filing separately unless you qualify for an exception (see instructions). Fill in oval if you qualify for this exception. 44 Senior Circuit Breaker Credit. Enclose Schedule CB. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 44 0 0 45 Child under age 13, or disabled dependent/spouse credit (from worksheet). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45 0 0 46 Dependent member(s) of household under age 12, or dependent(s)

age 65 or over (not you or your spouse) as of December 31, 2022 credit. a. Not more than two x _______(See instructions) = 46 0 0 47 Other refundable credits (from Schedule CMS). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47 0 0 48 TOTAL REFUNDABLE CREDITS. Add lines 43 through 47. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 48 0 0 49 Excess Paid Family Leave withholding. See instructions. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49 0 0 50 TOTAL. Add lines 38 through 42 and lines 48 and 49. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 50 0 0 51 OVERPAYMENT. If line 37 is smaller than line 50, subtract line 37 from line 50. If line 37 is larger than line 50, go to line 54. If line 37 and line 50 are equal, enter 0 in line 53. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 51 0 0 52 Amount of overpayment you want APPLIED to your 2023 ESTIMATED TAX. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 52 0 0 53 THIS IS YOUR REFUND. Subtract line 52 from line 51. Mail to: Massachusetts DOR, PO Box 7000, Boston, MA 02204. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 53 R E F U N D 0 0

Direct deposit of refund. See instructions. Type of account (select one): Checking Routing number (first two digits must be 01 to 12 or 21 to 32) Account number

Savings

54 TAX DUE. Subtract line 50 from line 37. Pay in full online at mass.gov/masstaxconnect. . . . . . . . . . . . . . . . . . 54 0 0

Or pay by mail. Make check payable to Commonwealth of Massachusetts. Write Social Security number(s) in memo section of check and be sure to sign check. Mail to: Massachusetts DOR, PO Box 7003, Boston, MA 02204.

These amounts will affect your refund or tax due: Exception. Enclose Form M-2210.

Interest 0 0 Penalty 0 0 M-2210 amount 0 0 PRINT PAID PREPARER’S NAME PAID PREPARER’S SSN or PTIN PAID PREPARER’S PHONE DATE

/ / ( ) PAID PREPARER’S SIGNATURE PAID PREPARER’S EIN Fill in if self-employed

DOR may discuss this return with the preparer

I do not want my preparer to file my return electronically BE SURE TO SIGN RETURN ON PAGE 1 AND ENCLOSE SCHEDULE HC (IF APPLICABLE). FOR PRIVACY ACT NOTICE, SEE INSTRUCTIONS. 2022 FORM 1, PAGE 4

Schedule CB Circuit Breaker Credit. Enclose with Form 1 or Form 1-NR/PY. Do not cut or separate these schedules. 2022 FIRST NAME M.I. LAST NAME SOCIAL SECURITY NUMBER OF PROPRIETOR ADDRESS OF PRINCIPAL RESIDENCE IN MASSACHUSETTS (DO NOT ENTER PO BOX) CITY/TOWN STATE ZIP 1 Living quarters status during 2022: Homeowner If homeowner, fill in if multi-use or multi-family property (see instructions) Select one only. Renter (if you received any federal and/or state rent subsidy, or you rent from Note: If you moved during the year, see reverse. a tax-exempt entity, you do not qualify for the Circuit Breaker Credit; see instructions) 2 Homeowners only, enter assessed value of principal residence as of January 1, 2022. If over $912,000, you do not qualify for this credit. See instructions. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 0 0 INCOME CALCULATION 3 Massachusetts adjusted gross income (from line 20 of Schedule CB, line 3 worksheet on reverse). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 0 0 4 Full amount of Social Security benefits received before Medicare premiums (from Form 1099). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 0 0 5 Pensions/annuities/IRA/Keogh distributions not taxed on your Massachusetts tax return. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 0 0 6 Miscellaneous income, including cash public assistance. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 0 0 7 Massachusetts total income. Add lines 3 through 6. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 0 0 8 Combine Form 1, lines 2b through 2d or Form 1-NR/PY, lines 4b through 4d. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 0 0 9 Qualifying income. Subtract line 8 from line 7. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 0 0 You do not qualify for the Circuit Breaker Credit if you are filing as “Single,” and line 9 is greater than $64,000; or you are filing as “Head of household,” and line 9 is greater than $80,000; or you are filing as “Married filing jointly,” and line 9 is greater than $96,000. CREDIT CALCULATION. If you filled in “Homeowner” in line 1, complete lines 10–17; if “Renter,” skip to line 18. 10 Real estate taxes paid in calendar year 2022 for your principal residence (see instructions). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10 0 0 11 Adjustments to real estate taxes (from line 4 of Schedule CB, line 11 worksheet on reverse). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11 0 0 12 Subtract line 11 from line 10. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12 0 0 13 Enter 50% (.50) of water and sewer use charges paid in 2022. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13 0 0 14 Add lines 12 and 13. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14 0 0 15 Income threshold. Multiply line 9 by 10% (.10). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15 0 0 16 Subtract line 15 from line 14. If line 15 is equal to or greater than line 14, you do not qualify for this credit. . . . . . . . . . . . . . . . . . . . . . . . . 16 0 0 17 Enter the lesser of line 16 or $1,200 here and on Form 1, line 44 or Form 1-NR/PY, line 48. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17 0 0 18 Enter total amount of rent paid for your principal residence in 2022: a. 0 0 ÷ 4 =. . . . . . . . . . . . . . . . . . . . . . . . . 18 0 0 Landlord’s name and address_______________________________________________________________________ 19 Income threshold. Multiply line 9 by 10% (.10). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19 0 0 20 Subtract line 19 from line 18. If line 19 is equal to or greater than line 18, you do not qualify for this credit. . . . . . . . . . . . . . . . . . . . . . . . . 20 0 0 21 Enter the lesser of line 20 or $1,200 here and on Form 1, line 44 or Form 1-NR/PY, line 48. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21 0 0 You, or your spouse if married filing jointly, must be at least 65 years of age before January 1, 2023 to qualify for this credit. Also, you must file as single, married filing jointly or head of household to qualify for this credit. If married filing separately, you do not qualify for this credit.

Schedule CB Worksheets Schedule CB, Line 3 — Massachusetts Income Worksheet Part 1. Complete only if you only have 5.0% income reported on Form 1, line 10 or Form 1-NR/PY, line 12 or partnership, trust or S corporation income not reported on Form 1 or Form 1-NR/PY. Otherwise, enter 0 on line 6 and go to Part 2. Note: When calculating income for the Circuit Breaker Credit, do not exclude any amount on Schedule Y, line 9 that represents a deduction for unemployment compensation. 1. Enter your total 5.0% income from Form 1, line 10 or Form 1-NR/PY, line 12. Not less than 0* . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2. Enter the total of Schedule Y, lines 1 through 10 and line 18 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3. Subtract line 2 from line 1. Not less than 0. . . . . . . . . . . . 4. Enter total Massachusetts bank interest or the interest exemption amount, whichever is smaller, from Form 1, line 5a or line 5b or Form 1-NR/PY, line 7a or line 7b . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5. Enter any income from a partnership, trust or S corporation not reported on Form 1 or Form 1-NR/PY . . . . . . . . . . . . . . . . . . . . . . . . . Note: If Form 1, line 10 or Form 1-NR/PY, line 12 is a loss, do not complete line 4 above. Instead, combine Form 1, line 10 or Form 1-NR/PY, line 12 with the smaller amount of total Massachusetts bank interest or the interest exemption amount. Enter the result in line 4 above, unless the result is a loss. If the result is a loss, enter 0. 6. Add lines 3 through 5 . . . . . . . . . . . . . . . . . . . . . . . . . . . . Part 2. Complete only if you have interest income (including tax-exempt interest) other than from Massachusetts banks, dividend income, short­ term capital gains, long-term gains on collectibles and installment sales. Otherwise, enter 0 on line 11 and go to Part 3. 7. Enter the amount from Schedule B, line 9. If there is no entry in Schedule B, line 9, enter the amount from Form 1, line 20 or Form 1-NR/PY, line 24. . . . . . . . . . . . . . . . . . . . . . . . . . . . 8. Enter the amount from Schedule B, line 6. . . . . . . . . . . . . 9. Add lines 7 and 8. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10. Enter the amount from Schedule B, line 15 . . . . . . . . . . 11. Add lines 9 and 10. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Part 3. Complete only if you have long-term capital gains or capital gain distributions. Otherwise, enter 0 on line 18 and go to Part 4. 12. Enter any gains (not including any losses) included in U.S. Schedule D, lines 8a and 8b, col. h . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13. Enter any gains (not including any losses) included in U.S. Schedule D, line 9, col. h . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14. Enter any gains (not including any losses) included in U.S. Schedule D, line 10, col. h . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15. Enter any gains (not including any losses) included in U.S. Schedule D, line 11, col. h . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16. Enter any gains (not including any losses) included in U.S. Schedule D, line 12, col. h . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17. Enter any gains included in U.S. Schedule D, line 13, col. h. If U.S. Schedule D not filed, enter the amount from U.S. Form 1040, line 7 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18. Add lines 12 through 17 . . . . . . . . . . . . . . . . . . . . . . . . . Part 4. Massachusetts adjusted gross income. 19. Part-year residents, enter any income earned while a nonresident not included in lines 1 through 18 above. Not less than 0. . . . . . 20. Add lines 6, 11, 18 and 19. Enter the result here and on Schedule CB, line 3 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . *Add back any Abandoned Building Renovation deduction claimed on Schedule(s) C and/or E. Schedule CB, Line 11 — Adjustments to Real Estate Taxes Paid Worksheet 1. Enter the amount of any real estate tax abatement, including senior work program, or exemption received in 2022. Do not exclude amounts if they were already reflected on your tax bill and you did not pay them. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2. Enter any interest amount paid due to late real estate tax payments in 2022 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3. Enter the amount of any betterment or special assessment paid in 2022. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4. Add lines 1 through 3. Enter result here and on Schedule CB, line 11 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Note: If you moved during the year you may have to complete separate computations for each residence that would qualify for the credit. On Schedule CB you should complete separate computations for each residence for lines 10 through 14 and/or line 18. The income threshold (line 15 or 19) should be subtracted from the total of these computations to determine if you qualify for the credit.