*211111* 2021 Form M1, Individual Income Tax Do not use staples on anything you submit. From Your Federal Return (see instructions)

1 Federal adjusted gross income (from line 11 of federal Form 1040 and 1040-SR) . . . . . . . . . . . . . . . . . . . . . . . . . . 1

2 Additions to income from line 10 of Schedule M1M and line 9 of Schedule M1MB (see instructions) . . . . . . . . . 2

3 Add lines 1 and 2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 4 Itemized deductions (from Schedule M1SA) or your standard deduction (see instructions) . . . . . . . . . . . . . . . . . 4 5 Exemptions (determine from instructions) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5

6 State income tax refund from line 1 of federal Schedule 1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 7 Subtractions from line 32 of Schedule M1M and line 22 of Schedule M1MB (see instructions) . . . . . . . . . . . . . . 7

8 Total subtractions. Add lines 4 through 7 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

9 Minnesota taxable income. Subtract line 8 from line 3. If zero or less, leave blank. . . . . . . . . . . . . . . . . . . . . . . . 9 10 Tax from the table in the Form M1 instructions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10 9995 A. Wages, salaries, tips, etc. B. IRA, pensions, and annuities C. Unemployment D. Federal taxable income Your First Name and Initial Last Name Your Social Security Number Your Date of Birth (MM/DD/YYYY) If a Joint Return, Spouse’s First Name and Initial Spouse’s Last Name Spouse’s Social Security Number Spouse’s Date of Birth

Current Home Address Check if Address is: New Foreign City State ZIP Code 2021 Federal Filing Status (place an X in one box): (1) Single (2) Married Filing Jointly (3) Married Filing Separately (4) Head of Household (5) Qualifying Widow(er) Spouse Name Spouse SSN Dependents (see instructions): Dependent 1 First Name Dependent 1 Last Name Dependent 1 SSN Dependent 1 Relationship to You Dependent 2 First Name Dependent 2 Last Name Dependent 2 SSN Dependent 2 Relationship to You Dependent 3 First Name Dependent 3 Last Name Dependent 3 SSN Dependent 3 Relationship to You Your Code Spouse’s Code State Elections Campaign Fund To grant $5 to this fund, enter the code for the party of your choice. It will help candidates for state offices pay campaign expenses. This will not increase your tax or reduce your refund. Political Party Code Numbers: Republican . . . . . . . . . . . . . . . . 11 Democratic/Farmer-Labor . . . . 12 Independence . . . . . . . . . . . . . 13 Grassroots/Legalize Cannabis . 14 Libertarian . . . . . . . . . . . . . . . . 16 Legal Marijuana Now . . . . . . . . 17 General Campaign Fund . . . . . 99

11 Alternative minimum tax (enclose Schedule M1MT) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11

12 Add lines 10 and 11 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12 13 Full-year residents: Enter the amount from line 12 on line 13. Skip lines 13a and 13b.

Part-year residents and nonresidents: From Schedule M1NR, enter the amount from line 32 on

line 13, from line 28 on line 13a, and from line 29 on line 13b (enclose Schedule M1NR) . . . . . . . . . . . . . . . . . . 13

13a 13b

14 Other taxes, such as recapture amounts and the tax on lump-sum distributions (check appropriate boxes)

(a) Schedule M1HOME (b) Schedule M1529 (c) Schedule M1LS . . . . . . . . . . . . . . . . . . . . 14

15 Tax before credits. Add lines 13 and 14 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15

16 Amount from line 18 of Schedule M1C, Nonrefundable Credits (enclose Schedule M1C) . . . . . . . . . . . . . . . . . . 16

17 Subtract line 16 from line 15 (if result is zero or less, leave blank) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17

18 Nongame Wildlife Fund contribution (see instructions) This will reduce your refund or increase the amount you owe . . . . . . . . . . . . . . . . . . . . . . . . . . . 18

19 Add lines 17 and 18 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19 20 Minnesota income tax withheld. Complete and enclose Schedule M1W to report Minnesota withholding from Forms W-2, 1099, and W-2G (do not send) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20

21 Minnesota estimated tax and extension payments made for 2021 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21

22 Amount from line 11 of Schedule M1REF, Refundable Credits (see instructions; enclose Schedule M1REF) . . . 22

23 Total payments. Add lines 20 through 22 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23

24 REFUND. If line 23 is more than line 19, subtract line 19 from line 23 (see instructions).

For direct deposit, complete line 25 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24

25 Direct deposit of your refund (you must use an account not associated with a foreign bank):

Checking Savings

Routing Number Account Number 26 AMOUNT YOU OWE. If line 19 is more than line 23, subtract line 23 from line 19 (see instructions) . . . . . . . . 26

27 Penalty amount from Schedule M15 (see instructions). Also subtract

this amount from line 24 or add it to line 26 (enclose Schedule M15) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27

IF YOU PAY ESTIMATED TAX and want part of your refund credited to estimated tax, complete lines 28 and 29. 28 Amount from line 24 you want sent to you . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28

29 Amount from line 24 you want applied to your 2022 estimated tax . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29

Your Signature Spouse’s Signature (If Filing Jointly) Date (MM/DD/YYYY) Daytime Phone Email Address Taxpayer: I declare that this return is correct and complete to the best of my knowledge and belief. Include a copy of your 2021 federal return and schedules. Mail to: Minnesota Individual Income Tax, Mail Station 0010, 600 N. Robert St., St. Paul, MN 55145-0010 I authorize the Minnesota Department of Revenue to discuss this tax return with the preparer or the third-party designee indicated on my federal return. I do not want my paid preparer to file my return electronically. 2021 M1, page 2 Paid Preparer’s Signature Date (MM/DD/YYYY) PTIN or VITA/TCE # (required) Preparer’s Daytime Phone Preparer’s Email Address

9995 *211121*