1 Individual Income Tax Long Form Form MO-1040 2021 Tax Deadline is April 18. See page 3 for extensions. File Electronically Electronic filing is fast and easy. See page 2 for details. Complete a MO W-4 We encourage you to review and complete a new W-4 each year, especially if your filing status has changed. Request a W-4 from your employer or print it at dor.mo.gov/forms/. ! Sign up to Receive Return Status Updates Get text or email notifications each time the status of your return changes. See page 4 for more information. @

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Electronic Filing Options for Federal and State E-File - Missouri, in cooper­ ation with the Internal Revenue Service (IRS), offers a joint federal and state filing of individual income tax returns. There are two ways that you may e-file your federal and state income tax returns: 1) You can electronically file your federal and state returns

online from websites provided by approved software

providers. Many providers offer free filing if you meet certain

conditions. A list of approved providers can be found at

dor.mo.gov/taxation/individual/tax-types/income/. 2) You can have a tax preparer (if approved by the IRS) electronically file your federal and state returns for you, usually for a fee. A list of approved tax preparers can be found at dor.mo.gov/taxation/individual/tax-types/income/. BENEFITS OF ELECTRONIC FILING Convenience: You can electronically file 24 hours a day, 7 days a week. If you electronically file, DO NOT mail a copy of your return. Security: Your tax return information is encrypted and transmitted over secure lines to ensure confidentiality. Accuracy: Electronically filed returns have fewer errors than paper returns. Direct Deposit: You can have your refund directly deposited into your bank account. Proof of Filing: An acknowledgment is issued when your return is received and accepted. ASSISTANCE WITH PREPARING YOUR TAX RETURN There are a large number of volunteer groups in Missouri providing tax assistance to elderly or lower income taxpayers. To locate a volunteer group near you that offers return preparation assistance: call 800-906-9887, 888-227-7669 or visit irs.gov/individuals. You will find a larger volume of volunteer centers open during the filing season, which is typically January through April.

2-D BARCODE RETURNS If you plan to file a paper return, you should consider 2-D barcode filing. The software encodes all your tax information into a 2-D barcode, which allows your return to be processed with fewer errors compared to traditional paper returns. If you use software to prepare your return, check our website for approved 2-D barcode software companies. Also, check out the Department’s fill-in forms that automatically calculate and provide your return with a 2-D barcode. You can have your refund directly deposited into your bank account when you use the Department’s fill-in forms. If your form has a 2-D barcode, mail your return to the Department of Revenue address as indicated below: Refund returns: P.O. Box 3222, Jefferson City, MO 65105-3222 Balance due returns: P.O. Box 3370, Jefferson City, MO 65105-3370 Refund returns claiming a property tax credit: P.O. Box 3385, Jefferson City, MO 65105-3385 Balance due returns claiming a property tax credit: P.O. Box 3395, Jefferson City, MO 65105-3395 Visit our website at dor.mo.gov/personal/taxselector to use the Department’s form selector to obtain specific tax forms. DO YOU HAVE THE RIGHT FORM? The Individual Income Tax Return (Form MO-1040) is Missouri’s long form. It is a universal form that can be used by any individual taxpayer. If you do not have any of the special filing situations described below and you choose to file a paper tax return, try filing a short form. The short forms are less complicated and provide only the necessary information for specific tax filing situations. You must file Form MO-1040 if at least one of the following applies: 1. You or your spouse claim or file:

a. A pension, social security/social security disability, or

property tax credit and you also have other special filing

situations;

b. Miscellaneous Income Tax Credits (taken on Form MO-TC);

c. A credit for payment made with the filing of an Application

for Extension of Time to File (Form MO-60);

d. Income from another state;

e. An amended return;

f. A nonresident entertainer or a professional athlete;

g. A fiscal year return;

h. A nonresident military servicemember stationed in Missouri

and you or your spouse earned non-military income while in

Missouri;

i. A deduction for other federal tax (from Federal Form

1040, Federal Schedule 2, and Federal Schedule 3);

• Schedule 2, Part 1, Line 3

• Schedule 2, Part 2, Line 8 and 10

• Any recapture taxes included on Schedule 2, Part 2, Line 21

• Schedule 3, Part 1, Line 1;

j. A Health Care Sharing Ministry deduction;

k. Any Military income earned from:

*Active Duty

*Inactive Duty

l. The Bring Jobs Home tax deduction;

m. The Transportation Facilities deduction; or

n. First Time Home Buyers deduction. 2. You have any of the following Missouri modifications: a. Positive or negative adjustments from partnerships,

fiduciaries, S corporations, or other sources; b. Nonqualified distribution received from the Missouri for

Tuition Program (MOST), or other qualified 529 plan;

c. Nonqualified distribution received from or exempt

contributions made to Achieving a Better Life Experience

(ABLE) program;

d. Interest on federal exempt obligations;

e. Interest on state and local obligations;

f. Capital gain exclusion;

g. Exempt contributions made to (or earnings from) the

Missouri for Tuition Program (MOST), or other qualified 529

plans;

h. Enterprise zone or rural empowerment zone modification;

i. Negative adjustments related to bonus depreciation;

j. Net Operating Loss (NOL) carryback/carryforward;

k. Combat pay included in federal adjusted gross income;

l. Agriculture disaster relief income;

m. Employee Stock Ownership Plan (ESOP); or

n. Military retirement benefits. 3. You owe a penalty for underpayment of estimated tax. 4. You owe tax on a lump sum distribution included on Federal

Form 1040, U.S. Tax Return for Seniors (Federal Form

1040- SR), Line 16. 5. You owe recapture tax on low income housing credit.

3 WHAT’S INSIDE IMPORTANT FILING INFORMATION This information is for guidance only and does not state the complete law. FILING REQUIREMENTS

You do not have to file a Missouri return if you are not required to file a federal return. If you are required to file a federal return, you may not have to file a Missouri return if you:

a. are a resident and have less than $1,200 of Missouri

adjusted gross income;

b. are a nonresident with less than $600 of Missouri

income; or

c. have Missouri adjusted gross income less than the

amount of your standard deduction for your

filing status. Note: If you are not required to file a Mis­souri return, but you received a Wage and Tax Statement (Form W-2) stating you had Missouri tax withheld, file your Missouri return to claim a refund of your Missouri withholding. If you are not required to file a Missouri return and you do not anticipate an increase in income, you may change your Employee Withholding Allowance Certificate (Form MO W-4) to “exempt” so your employer will not withhold Missouri tax. Calendar year taxpayers must file no later than April 18, 2022. Late filing will subject taxpayers to charges for interest and addition to tax. Fiscal year filers must file no later than the 15th day of the fourth month following the close of their taxable year. EXTENSION OF TIME TO FILE You are not required to file an extension if you do not expect to owe additional income tax or if you anticipate re­ceiv­ing a refund. If you wish to file a Missouri extension, and do not expect to owe Missouri income tax, you may file an extension by filing Form MO-60. An auto­matic extension of time to file will be granted until October 17, 2022. If you receive an extension of time to file your federal income tax return, you will automatically be granted an extension of time to file your Missouri income tax return, provided you do not expect to owe any additional Missouri income tax. Select the box at the top of the Form MO-1040 indicating you have an approved federal extension and attach a copy of your Application for Automatic Extension of Time To File U.S. Individual Income Tax Return (Federal Form 4868) with your Missouri income tax return when you file. If you expect to owe Missouri income tax, file Form MO-60 with your payment by the original due date of the return. Remember: An extension of time to file does not extend the time to pay. A 5 percent addition to tax will apply if the tax is not paid by the original return’s due date. WHEN TO FILE Achieving a Better Life Experience (ABLE) . . . . . . . . . . . . . . . . . . . . 13, 15 Address Change . . . . . . . . . . . . . . . 5 Adjusted Gross Income Federal and Missouri . . . . . . . . . 6 Worksheet. . . . . . . . . . . . . . . . . . . 7 Agriculture Disaster Relief . . . . . . 16 Amended Return . . . . . . . . . . . 4, 10 Amount Due . . . . . . . . . . . . . . . . . . 12 Bring Jobs Home Deduction . . . 9 Business Income Deduction . . . . 16 Composite Return . . . . . . . . . . . . . 4 Consumer’s Use Tax . . . . . . . . . . . 6 Credit Card Payment . . . . . . . . . . 12 Domicile . . . . . . . . . . . . . . . . . . . . . . 4 Depreciation Adjustment . . . . . . . 15 Disabled, 100 Percent . . . . . . . . . . 6 Employee Stock Ownership Plan (ESOP) . . . . . . . . . . . . . . . . . . . 15 Enterprise or Rural Empowerment Zone Income Modification . . . . 9 Estimated Tax Declaration of . . . . . . . . . . . . . . . 5 Underpayment Penalty . . . . . . . 12 Extension . . . . . . . . . . . . . . . . 3, 6, 10 Federal Income Tax . . . . . . . . . . 7, 8 Filing Requirements . . . . . . . . . . . 3 Filing Status . . . . . . . . . . . . . . . 4, 5, 6 Fiscal Year Filers When to File . . . . . . . . . . . . . . . . 3

Form MO-1040 Instructions . . . . . . . . . . . . . . . 6-12 Healthcare Sharing Ministry . . . 8 Individual Medical Accounts . . 14 Interest Exempt Federal Obligations . . . . . . . . . . . . . 13, 14 State and Local Obligations . . . . . . . . . . . . . . . . 13 Itemized Deductions . . . . 5, 8, 16 Late Filing and Payment Addition and Interest . . . . . . . 4 Payment Options . . . . . . . 4, 12 1040V . . . . . . . . . . . . . . . . . 4, 46 Long-term Care Insurance . . . . . 8 Lump Sum Distribution . . . . . . 10 Mailing Addresses . . . . . . . . . . 2, 4 Active Duty Military Income Tax Deduction . . . . . . . . . . . . . . . . . . 8 Inactive Duty Military Income Tax Deduction . . . . . . . . . . . . . . . . 8, 9 Military Personnel . . . . . . . . . . . . . 5 Missouri Taxpayer Bill of Rights . . . . . . . . . . . . . . . . . . 50 Missouri Withholding Form 1099 . . . . . . . . . . . . . . . . 10 Form W-2 . . . . . . . . . . . 10, 16, 26 Modifications to Income . . . . . . . . . . . . . . . . 6, 12-16 MOST, Other Qualified 529 plans . . . . . . . . . . . . . . . . . . 12, 13, 15 Name, Address, or Deceased Taxpayer . . . . . . . . . 6 Net Operating Loss . . . . . . . 13, 14 Non-obligated Spouse . . . . . . . . 6 Nonresident Definition . . . . . . . . . . . . . . . . . . 4 Income Percentage . . . . . . . . . 9 Partner or S Corp Shareholder. . . . . . . . . . . . . . 10, 13 Nonresident Alien . . . . . . . . . . 4, 5 Part-year Resident . . . . . . . 5, 9-10 Pension Exemption . . . . . . . . . 7, 17 Property Tax Credit . . . . . 10, 17-20 Property Tax Credit Chart . 47-49 Qualified Health Insurance Premium Worksheet (Form 5695) . . . . . . . . . . . . . . . . 36 Railroad Retirement Benefits . . . . . . . . . . . . . . . . . 14, 18 Tax . . . . . . . . . . . . . . . . . . . . . . . . 16 Tier I and Tier II . . . . . . . . . . 14, 16 Recapture Tax . . . . . . . . . . . . . . . . 10 Refund . . . . . . . . . . . . . . . . . . . . 10-12 Return Inquiry Website . . . . . 4, 50 Resident (definition) . . . . . . . . . . 4 Resident Credit . . . . . . . . . . . . . . . 9 Self-employment Tax . . . . . . . . . 16 Signing Your Return . . . . . . . . . . 12 Standard Deduction . . . . . . . . . . 8 Tax Credits . . . . . . . . . . . . 10, 40-41 Tax Calculation Worksheet . . . . . . . . . . . . . . . . 26 FORMS MO-1040 . . . . . . . . . . . . . . . . . . 21-25 MO-A . . . . . . . . . . . . . . . . . . . . 27-30 MO-CR . . . . . . . . . . . . . . . . . . . . 31-32 MO-NRI . . . . . . . . . . . . . . . . . . 33-35 2021 Tax Chart . . . . . . . . . . . . . . . 26 Qualified Health Insurance Worksheet Form 5695 . . . . 36 MO-PTS . . . . . . . . . . . . . . . . . . 37, 38 MO-CRP . . . . . . . . . . . . . . . . . . . . 39 MO-TC . . . . . . . . . . . . . . . . . . . 40, 41 MO-2210 . . . . . . . . . . . . . . . . . 42-45 MO-1040V . . . . . . . . . . . . . . . . . . 46 Tax Chart . . . . . . . . . . . . . . . . . . . 26 Telephone Numbers . . . . . . . . . 50 Transportation Facilities Deduction . . . . . . . . . . . . . . . . . . . . 9 Trust Funds . . . . . . . . . . . . . . . . 11, 12 When to File . . . . . . . . . . . . . . . . . . 3

4 LATE FILING AND PAYMENT

Simple interest is charged on all delinquent taxes. The rate will be updated annually and can be found on our website at dor.mo.gov/taxation/statutory-interest-rates.html. For timely filed returns, an addition to tax of 5 percent (of the unpaid tax) is added if the tax is not paid by the return’s due date. For returns not filed by the due date, an addition to tax of 5 percent per month (of the unpaid tax) is added for each month the return is not filed. The addition to tax cannot exceed 25 percent. If you are unable to pay the tax owed in full on the due date, please visit dor.mo.gov for your payment options. If you are mailing a partial payment, please use the Individual Income Tax Payment Voucher (Form MO-1040V) found on page 46. WHERE TO MAIL YOUR RETURN

If you are due a refund or have no amount due, mail your return and all required attachments to: Department of Revenue, P.O. Box 500, Jefferson City, MO 65105-0500. If you have a balance due, mail your return, payment, and all re­quired attachments to: Department of Revenue, P.O. Box 329 Jefferson City, MO 65105-0329. All 2-D barcode returns, see page 2. DOLLARS AND CENTS

Rounding is required on your tax return. Zeros have been placed in the cents columns on your return. For 1 cent through 49 cents, round down to the previous whole dollar amount. For 50 cents through 99 cents, round up to the next whole dollar amount. Example: Round $32.49 down to $32.00

Round $32.50 up to $33.00 REPORT OF CHANGES IN FEDERAL TAXABLE INCOME

When your federal taxable income or federal tax liability is changed as a result of an audit or notification by the Internal Revenue Ser­vice, or if you file an amended federal in­come tax return, you must report such change by filing an amended Missouri income tax return with the Department of Revenue within 90 days of the change. Failure to notify the Department of Revenue within the 90 day period extends the statute of limitations to one year after the Department of Revenue be­comes aware of such determination. You will be subject to interest and addition to tax if you owe additional tax to Missouri. AMENDED RETURN

To file an amended individual income tax return, use Form MO-1040. Select the box at the top of the form. Complete Forms MO-1040 and the Individual Income Tax Adjustments (Form MO-A), pages 1-4 (pages 27-30 in the instructions), using corrected figures. Attach all schedules along with a copy of your federal changes and your Federal Form 1040X. If you are due a refund, mail to: Department of Revenue, P.O. Box 500, Jefferson City, MO 65105-0500. If you have an amount due, mail to Department of Revenue, P.O. Box 329, Jefferson City, MO 65105-0329. COMPOSITE RETURN

Businesses filing a composite return on behalf of their nonresident partners or shareholders should use Form MO-1040. Attach a schedule listing the name, address, identification number, and amount of each nonresident partner or shareholder’s income from Missouri sources to Form MO-1040. Select the composite return box at the top of Form MO-1040. Refer to Missouri Regulation 12 CSR 10-2.190 and the Instructions for Composite Individual Return for Nonresident Partners or Shareholders (Form 5677) at dor.mo.gov/ forms/ for complete filing instructions. Note: The tax rate for a composite return is 5.4 percent. FILL-IN FORMS THAT AUTOMATICALLY CALCULATE Visit dor.mo.gov/taxation/individual/tax-types/income/ to enter your tax information and let the auto calculation form complete the math for you. No calculation errors means faster processing. Just complete, print, sign, and mail the return. These forms contain a 2-D barcode at the top right portion of the form. This allows quicker processing of your return. MISSOURI RETURN INQUIRY To check the status of your 2018 through 2021 return 24 hours a day, please visit our website at dor.mo.gov/taxation/return-status/ or call our automated individual income tax inquiry line at (573) 526-8299. To check your return status, you must know the fol­lowing information:

1. the first social security number on the return;

2. the filing status shown on your return; and

3. the exact amount of the refund or balance due in

whole dollars. Once this information is validated using the Missouri Return Inquiry System on our website, you will be given the option to sign up for text or email notifications. This will allow you to be notified each time the status of your tax return changes as it is being processed by the Department of Revenue. RESIDENT

A resident is an individual who either:

1. maintained a domicile in Missouri or

2. did not maintain a domicile in Missouri but did have

permanent living quarters and spent more than 183

days of the taxable year in Missouri. Exception: An individual domiciled in Missouri who did not maintain permanent living quarters in Missouri, did maintain per­ma­nent living quarters elsewhere, and spent 30 days or less of the taxable year in Missouri is not a resident. Domicile: The place an individual intends to be his or her permanent home; a place that he or she intends to return to when absent. A domicile, once established, continues until the individual moves to a new location with the true intention of making his or her permanent home there. An individual can have only one domicile at a time. NONRESIDENT

A nonresident is an individual who does not meet the definition of resident. If required to file, nonresidents with income from an­other state must use the Missouri Income Percentage (Form MO-NRI) to determine income percentages. NONRESIDENT ALIEN SPECIAL FILING INSTRUCTIONS

If you do not have a social security number, enter your identifying number in the social security number space provided. Enter your federal adjusted gross income from U.S. Nonresident Alien Income Tax Return (Federal Form 1040NR), Line 11, on Form MO-1040, Line 1 Filing Status If you selected filing status Single on the Federal Form 1040NR, select Single as your filing status on Form MO-1040.

5 If you selected filing status Married filing separate and did not claim your spouse as an exemption on Federal Form 1040NR, select Married Filing Separate as your filing status on Form MO-1040. If you selected filing status Qualifying widow on Federal Form 1040NR, select Qualifying Widow as your filing status on Form MO-1040. Itemized Deductions Nonresident aliens who are required to itemize their deductions for federal purposes must also itemize deductions on their Missouri return. Visit dor.mo.gov/taxation/individual/tax-types/ income/ for more detailed information and Frequently Asked Questions. Federal Tax Deduction Enter on Form MO-1040, Line 9 the amount from the Form 1040NR, Line 22 less the amount from Line 17, as well as the net premium tax credit and health coverage tax credit (Federal Form 1040, Schedule 3, Part 2, Lines 9 and 13c). Enter on Form MO-1040, Line 10 the total amount from Federal Form 1040NR, Line 17; Schedule 3, Part 1, Line 1; Schedule 2, Part 2, Line 8 and Line 10; and any recapture taxes included on Schedule 2, Part 2, Line 21. For all other lines of Form MO-1040, see instructions beginning on page 6. PART-YEAR RESIDENT All income earned while living in Missouri is taxable to Missouri. A part-year resident may determine to be taxed as a resident for the entire year by using the Credit for Income Taxes Paid to Other States or Political Subdivisions (Form MO-CR) to claim a credit for taxes paid to another state on the income earned while living in Missouri. Or a part-year resident may use Missouri Income Percentage (Form MO-NRI) to determine their income based on the income earned while living in Missouri. MILITARY PERSONNEL The Servicemembers Civil Relief Act prevents military personnel from being taxed on military income by any state other than their home of record state. The Military Spouses Residency Relief Act prevents income earned by servicemembers’ spouses from being taxed by any state other than their state of residence. If you are a member of any component of the Armed Forces of the United States, or National Guard you may be eligible for an income deduction. See instructions for Line 17 and 18 on page 8 and 9 for more information or visit dor.mo.gov/military/. Missouri Home of Record If you entered the Armed Forces in Missouri, your home of record is presumed to be Missouri and you are presumed to be domiciled in Missouri. Missouri Home of Record (Stationed Outside Missouri) You are considered a nonresident for tax purposes if you:

a. maintained no permanent living quarters in Missouri

during the year;

b. maintained permanent living quarters elsewhere; and

c. did not spend more than 30 days of the year in Missouri Therefore, your military pay, interest & dividend income are not taxable to Missouri. Complete Form MO-NRI and attach to Form MO-1040. Note: If your spouse remains in Missouri more than 30 days while you are stationed outside Missouri, your total income, including your military pay, is taxable to Missouri. If you are the spouse of a military servicemember, are living outside of Missouri and Missouri is your state or residence, any income you earn is taxable to Missouri. If you earn more than $1,200 you must file Form MO-1040. Missouri Home of Record (Stationed in Missouri) If your home of record is Missouri and you are stationed in Missouri due to military orders, all of your income, including your military pay, is taxable to Missouri. Missouri Home of Record (Entering or Leaving the Military) If you are entering or leaving the military, Missouri is your home of record, and you spend more than 30 days in Missouri, your total income, including your military pay, is taxable to Missouri. Non-Missouri Home of Record (Stationed In Missouri) The military pay of a nonresident military personnel stationed in Missouri due to military orders is not taxable to Missouri. If you are a servicemember and earned only military income while stationed in Missouri, complete a No Return Required-Military Online Form by visiting mytax.mo.gov/rptp/portal/business/military-noreturn. If you are a military servicemember and earned $600 or more in Missouri in non-military income, this non-military income is taxable to Missouri and cannot be subtracted from your federal adjusted gross income on your Form MO-1040. If you are the spouse of a military servicemember, are in Missouri because the military servicemember is stationed in Missouri on military orders, and your state of residence is another state, any income earned by you is not taxable to Missouri. However, if you earn more than $600 you must file Form MO-1040 and provide verification of your state of residence. Acceptable verification may include any of the following from your state of residence: a copy of your 2021 state income tax return, 2021 property tax receipts, current driver license, vehicle registration or voter identification card. You must report the military pay of the servicemember and your income on Form MO-A, Part 1, Line 11, as a “Military (Non­ resident)” subtraction to your federal adjusted gross income. For additional information, visit dor.mo.gov/military/. OTHER STATE INCOME You must begin Form MO-1040 with your total federal adjusted gross income, as reported on your federal return. Lines 1 through 28 of the return are computed as if you are a full-year resident. Tax (Line 28) is computed on all your income, and may then be reduced by a resident credit (Line 29), or by a Missouri income percentage (Line 30). The result is a prorated Missouri tax liability based only on the income earned in Missouri. See page 9, Lines 29 and 30. DECLARATION OF ESTIMATED TAX Residents and nonresidents are required to make a declaration of estimated tax if their Missouri estimated tax is expected to be at least $100. If you are required to make estimated tax payments, you must do so by remitting your tax payment along with an Estimated Tax Declaration for Individuals (Form MO-1040ES). ADDRESS CHANGE

Visit dor.mo.gov/personal/individual/ to obtain an official address change form to change your address with the Department. Address change requests should be mailed to: Department of Revenue, P.O. Box 2200, Jefferson City, MO 65105-2200. This will help forward any refund check or correspondence to your new address. You may complete our online address change form by visiting dor.mo.gov/how-do-i/change-address-revenue-records.html.

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CONSUMER’S USE TAX Use tax is imposed on the storage, use or consumption of tangible personal property in this state. The state use tax rate is 4.225 percent. Cities and counties may impose an additional local use tax. Use tax does not apply if the purchase is subject to Missouri sales tax or otherwise exempt. A purchaser is required to file a use tax return if the cumulative purchase on which tax was not paid to the state exceeds $2,000 in a calendar year. You can use the Individual Consumer’s Use Tax Return (Form 4340). The due date for Form 4340 is April 18, 2022. FORM MO-1040 Important: Complete your federal return first. If you are filing a fiscal year return, indicate the beginning and ending dates on the line provided near the top of Form MO-1040. FEDERAL EXTENSION Select the box at the top of the form indicating you have an ap­ proved federal extension and attach a copy of your application for federal extension (Federal Form 4868) with your Missouri Income tax return when you file. Failure to check this box may result in disallowing the extension. FILING STATUS

Select the same filing status on your Missouri return as claimed on the federal return. If on your federal return you selected the checkbox “Someone can claim you as a dependent,” you will select “claimed as a dependent” on the Form MO-1040. If on your federal return you selected the checkbox “Someone can claim you as a dependent,” and your federal return status is Married Filing Jointly, you will select the filing status of “Married Filing Combined” on the Form MO-1040.

AGE 62 THROUGH 64 If you or your spouse were ages 62, 63, or 64 by December 31, 2021, select the appropriate box. AGE 65 OR OLDER OR BLIND If you or your spouse were age 65 or older or blind and qualified for these deductions on your 2021 federal return, select the appropriate boxes. 100 PERCENT DISABLED PERSON You may select the 100 percent disabled box if you or your spouse are unable to engage in any substantial gainful activity by reason of any medically determinable physical or mental impairment that can be expected to result in death or has lasted or can be expected to last for a continuous period of not less than 12 months. A claimant is not required to be gainfully employed prior to such disability to qualify for a property tax credit. Visit dor.mo.gov/taxation/individual/tax-types/property-tax- credit/ to learn more about the property tax credit form. NON-OBLIGATED SPOUSE You may select the non-obligated spouse box if your spouse owes the state of Missouri any child support payments, back taxes, student loans, etc., and you do not want your portion of the refund used to pay the amounts owed by your spouse. Debts owed to the Internal Revenue Service (IRS) are excluded from the non-obligated spouse apportionment. NAME AND ADDRESS Print or type your name(s), address, and social security number(s) in the spaces provided on the return. DECEASED TAXPAYER If the taxpayer or spouse passed away in 2021, select the appropriate box. If a refund is due to a deceased taxpayer, attach a copy of Statement of Person Claiming Refund Due a Deceased Taxpayer (Federal Form 1310) and death certificate. FIGURE YOUR MISSOURI ADJUSTED GROSS INCOME

Missouri requires the division of income between spouses. Taxpayers filing a combined return pay less tax by dividing the income between spouses and then determining the tax amount for each person’s income. You must begin your Missouri return with your total federal adjusted gross income, even if you have income from a state other than Missouri. LINE 1 - FEDERAL ADJUSTED GROSS INCOME

If your filing status is “married filing combined” and both spouses are reporting income, use the worksheet on page 7 to split income between you and your spouse. The combined income for you and your spouse must equal the total federal adjusted gross income you reported on your federal return. For all other filing statuses, use the chart below to determine your federal adjusted gross income. If you include loss(es) of $1,000 or more on Line 1, you must attach a copy of Federal Form 1040 or Federal Form 1040-SR (pages 1 and 2). Federal Form Line Numbers Line 11

Line 1 Federal Form 1040 or Federal Form 1040-SR Federal Form 1040X Missouri Modifications Before completing Lines 2, 3, and 4, read the Information to Complete Form MO-A, Part 1, pages 12 through 16. LINE 2 - TOTAL ADDITIONS

Enter the total additions amount from Form MO-A, Part 1, Line 7Y and 7S. LINE 4 - TOTAL SUBTRACTIONS

Enter the total subtractions amount from Form MO-A, Part 1, Lines 18Y and 18S. LINE 7 - INCOME PERCENTAGES

To calculate your income percentage for Line 7, complete the chart below if both spouses have income. Line 5Y Line 5S Line 6 Line 6 ÷ ÷ = = Spouse Yourself The total entered on Line 7 must equal 100 percent - round to the nearest percentage. For example, 84.3 percent would be shown as 84 percent and 97.5 percent would be shown as 98 percent. Lines 7Y and 7S must equal 100 percent.

7 Note: If one spouse has negative income and the other spouse has positive income (Ex: your income is -$15,000 and your spouse’s income is $30,000), enter zero percent on Line 7Y and 100 percent on Line 7S. If nothing is entered, the Department will consider this to be 100 percent. FIGURE YOUR TAXABLE INCOME LINE 8 - PENSION AND SOCIAL SECURITY/SOCIAL SECURITY DISABILITY If you or your spouse received a public, private, or social security or social security disability, complete Form MO-A, Part 3. Enter the amount from Form MO-A, Part 3, Total Exemption on MO-1040, Line 8. Attach a copy of your federal return (pages 1 and 2), Distributions From Pensions, Annuities, Retirement or Profit- Sharing Plans, IRAs, Insurance Contracts, etc. (Form 1099-R), and Social Security Benefit Statement (SSA-1099). LINE 9 - TAX FROM FEDERAL RETURN

Use the chart in next column to locate your tax on your federal return. Do not enter your federal income tax withheld as shown on your Form(s) W-2 or federal return. If you have an earned income credit, you must subtract the credit from the tax on your federal return. If a negative amount is calculated, enter “0”. If you used a method other than the federal tax table to determine your federal tax, attach the appropriate schedule. 1040 1040-SR Federal Forms Line Numbers • Federal Form 1040 or 1040-SR Line 22 less; • Federal Form 1040 or 1040-SR Line 27a and 29; • Schedule 2, Part 1, Line 3; • Schedule 3, Part 2, Line 9 and 13c. Line 8 less Lines 14 and 15, except amounts from Forms 2439 and 4136. 1040X Note: At the time the Department finalized their tax booklets, the Internal Revenue Service had not finalized the 2021 federal income tax forms. LINE 10 - OTHER FEDERAL TAX

Enter the total amount of: • Schedule 2, Part 1, Line 3; • Schedule 2, Part 2, Line 8 and 10; • Any recapture taxes included on Schedule 2, Part 2, Line 21; and • Schedule 3, Part 1, Line 1. For amended returns enter the other taxes reported on Line 10 of Federal Form 1040X except: do not include self-employment tax, FICA tax, or railroad retirement tax on this line. Attach a copy of your federal return (pages 1 and 2) and applicable schedules. Attach a copy of Federal Form(s) 4255, 8611, or 8828 if claiming recapture taxes.

Missouri law requires a combined return for married couples filing together. A combined return means taxpayers are required to split their total federal adjusted gross income (including other state income) between spouses when beginning the Missouri return.

Splitting the income can be as easy as adding up your separate Form(s) W-2 and Form 1099. Or it may require allocating to each spouse the percentage of ownership in jointly held property, such as businesses, farm operations, dividends, interest, rent, and capital gains or losses. State refunds should be split based on each spouse’s 2020 Missouri tax withheld, less each spouse’s 2020 tax liability. The result should be each spouse’s portion of the 2020 refund. Taxable social security benefits must be allocated by each spouse’s share of the benefits received for the year. The worksheet below lists income that is included on your federal return, along with federal line references. Find the lines that apply to your federal return, split the income between you and your spouse, and enter the amounts on the worksheet. When you have completed the worksheet, transfer the amounts from Line 18 to Form MO-1040, Lines 1Y and 1S. Note: Remember, the incomes listed separately on Line 18 of this worksheet must equal your total federal adjusted gross income when added together. Worksheet for Line 1 - Instructions for Completing the Adjusted Gross Income Worksheet Adjusted Gross Income Worksheet for Combined Return Y - Yourself S - Spouse 1. Wages, salaries, tips, etc. 2. Taxable interest income 3. Dividend income 4. State and local income tax refunds (from Schedule 1, Part 1) 5. Alimony received (from Schedule 1, Part 1) 6. Business income or loss (from Schedule 1, Part 1) 7. Capital gain or loss 8. Other gains or losses (from Schedule 1, Part 1) 9. Taxable IRA distributions 10. Taxable pensions and annuities 11. Rents, royalties, partnerships, S corporations, trusts, etc.

(from Schedule 1, Part 1) 12. Farm income or loss (from Schedule 1, Part 1) 13. Unemployment compensation (from Schedule 1, Part 1) 14. Taxable social security benefits 15. Other income (from Schedule 1, Part 1) 16. Total (add Lines 1 through 15) 17. Less: federal adjustments to income 18. Federal adjusted gross income (Line 16 less Line 17)

Enter amounts here and on Lines 1Y and 1S, Form MO-1040 00 00 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 Federal Form 1040 or Federal Form 1040-SR 1 2b 3b 1 2a 3 7 4 4b 5b 5 6 7 6b 9 10 11

8 LINE 12 - FEDERAL TAX PERCENTAGE This percentage is based on the Missouri Adjusted Gross Income reported on Line 6. See below examples:

Example 1: If Line 6 is $22,450, enter 35% on Line 12.

Example 2: If Line 6 is $58,750, enter 15% on line 12. $25,000 or less..............................................35% $25,001 to $50,000......................................25% $50,001 to $100,000...................................15% $100,001 to $125,000..................................5% $125,001 or more...........................................0% Missouri Adjusted Gross Income Range (Line 6): Federal Tax Percentage: LINE 13 - FEDERAL INCOME TAX DEDUCTION Multiply Line 11 by percentage on Line 12. If you selected any filing status other than married filing combined on the MO-1040, your federal tax deduction may not exceed $5,000. If you selected married filing combined, your federal tax cannot exceed $10,000.

LINE 14 - STANDARD OR ITEMIZED DEDUCTIONS Standard Deductions If you claimed the standard deduction on your federal return, enter the standard deduction amount for your filing status. The amounts are listed on Form MO-1040, Line 14. Federal Form Line Numbers Federal Form 1040 Federal Form 1040-SR Federal Form 1040X Line 12a Line 2 Itemized Deductions If you itemized on your federal return, you may want to itemize on your Missouri return or take the standard deduction, whichever results in a higher deduction. If you were required to itemize on your federal return, you must itemize on your Missouri return. To figure your itemized deductions, complete the Form MO-A, Part 2. Attach a copy of your federal return (pages 1 and 2) and Federal Schedule A. LINE 15 - LONG-TERM CARE INSURANCE DEDUCTION If you paid premiums for qualified long-term care insurance in 2021, you may be eligible for a deduction on your Missouri income tax return. Qualified long-term care insurance is defined as insurance coverage for at least 12 months for long-term care expenses should such care become necessary because of a chronic health condition or physical disability, including cognitive impairment or the loss of functional capacity, thus rendering an individual unable to care for themselves without the help of another person. Complete the worksheet in the right hand column only if you paid premiums for a qualified long-term care insurance policy; and the policy is for at least 12 months coverage. Note: You cannot claim a deduction for amounts paid toward death benefits or extended riders. A. Enter the amount paid for qualified long-term

care insurance policy . . . . . . . . . . . . . . . . . . . . A) $__________ If you itemized on your federal return and your federal itemized deductions included medical expenses, go to Line B. If not, skip to H. B. Enter the amount from Federal

Schedule A, Line 4 . . . . . . . . . . . . . . . . . . . . . . B) $__________ C. Enter the amount from Federal Schedule A, Line 1 . . . . . . . . . . . . . . . . . . . . . . . C) $__________ D. Enter the amount of qualified long-term care included on Line C . . . . . . . . D) $__________ E. Subtract Line D from Line C . . . . . . . . . . . . . . E) $__________ F. Subtract Line E from Line B (if the amount is less than zero, enter “0”) . . . . . . . . . . . . . . . F) $__________ G. Subtract Line F from Line A . . . . . . . . . . . . . . G) $__________ H. Enter Line G (or Line A if you did not

have to complete Lines B through G)

on Form MO-1040, Line 15 . . . . . . . . . . . . . . . H) $__________ Attach a copy of your Federal Form 1040 or 1040-SR (pages 1 and 2) and Federal Schedule A (if you itemized your deductions). Worksheet for Long-Term Care Insurance Deduction LINE 16 - HEALTH CARE SHARING MINISTRY

If you made contributions to a qualifying health care sharing ministry, enter the amounts you paid in 2021 on Line 16. Do not include amounts excluded from your federal taxable income. LINE 17 - ACTIVE DUTY MILITARY INCOME DEDUCTION

Enter the amount of military income earned as a member of any active duty component of the Armed Forces of the United States. This includes being ordered to federal active duty status under 10 USC or 32 USC, participating in Annual Training (typically two weeks a year), and participating in other active training or schools, except for Inactive Duty for Training. This amount may not include military income earned during State Active Duty. This amount must be included in your federal adjusted gross income and not previously taken as a deduction or subtraction. Please include copies of all your Leave and Earnings Statement(s) which validate how long you were on active duty for training or annual training and the amount you earned on active duty for training or on annual training. Failure to attach the requested documentation may result in the disallowance of this deduction. If you have additional questions about this deduction, you may contact the Department’s military liaison at military@dor.mo.gov. LINE 18 - RESERVES AND INACTIVE DUTY MILITARY DEDUCTION Military personnel may deduct a portion of their income earned from the following sources from their Missouri adjusted gross income: • National Guard Inactive Duty Training (IDT) • National Guard Annual Training (AT) • Reserve components of the Armed Forces. The following reflects the percentage of Military reserve or inactive duty income that may be deducted in each applicable tax year: 2020 20% 2021 40% 2022 60% 2023 80% 2024 100%

Year Percentage

9 Multiply the amount of inactive duty military income earned by 20% and enter this amount on Line 18. Example: $2,000 x 40% = $800. Please include copies of all your Leave and Earnings Statement(s) which validate how long you were on inactive duty for training or annual training and the amount you earned on inactive duty for training or on annual training. Failure to attach the requested documentation may result in the disallowance of this deduction. If you have additional questions about this deduction, you may contact the Department’s military liaison at military@dor.mo.gov. LINE 19 - BRING JOBS HOME DEDUCTION

If you or your spouse accrued expenses associated with relocating a business to Missouri, you may be eligible for this deduction (if approved by the Department of Economic Development). The deduction is equal to 50 percent of the eligible in-sourcing expenses and cannot exceed your Missouri adjusted gross income. For additional information, please visit ded.mo.gov or contact the Missouri Department of Economic Development at P.O. Box 118, Jefferson City MO 65102-0118. LINE 20 - TRANSPORTATION FACILITIES DEDUCTION Taxpayers must receive approval from the Missouri Department of Economic Development to claim one of the following Transportation Facilities deductions: A) Port Cargo Expansion, B) International Trade Facility; and C) Qualified Trade Activities. Select the appropriate deduction and enter the approved amount on Line 20. Note: The Qualified Trade Activities deduction cannot exceed 50 percent of the taxpayer’s Missouri adjusted gross income. LINE 21 - FIRST-TIME HOME BUYERS DEDUCTION You may deduct contributions to one or more first time home buyer account(s) and the interest accruing on these account(s). Complete a Missouri Form 5766 for each account and enter the applicable amount(s) on Lines 21a and 21b. Line 21a: Enter the amount of the contribution deduction to a first time home buyer account(s), not to exceed $800 ($1,600 for married filing combined returns) from Form(s) 5766, Deduction Section, Line A. Line 21b: Enter the amount of accrued interest on the first time home buyer account(s) from Form(s) 5766, Deduction Section, Line B. Line 21: Enter the sum of Lines 21a and 21b in Line 21. LINE 22 - LONG TERM DIGNITY SAVINGS ACCOUNT If the taxpayer made contributions to a Long Term Dignity Savings Account, the taxpayer may take a deduction of 100% of their contribution on their Missouri individual income tax return. Qualified contributions may not exceed the Missouri adjusted gross income and is limited to $4,000 per taxpayer ($8,000, if married filing combined). An affidavit must be filed with the income tax return to verify the amount claimed. LINE 24 - SUBTOTAL

Subtract Line 23 from Line 6. If less than zero, enter “0”. Do not enter a negative amount. LINE 26 - ENTERPRISE ZONE INCOME OR RURAL EMPOWERMENT ZONE MODIFICATION To claim the Enterprise Zone Income or Rural Empowerment Zone Modification, you must first receive notification of approval from the Department of Economic Development. Enterprise Zone Income Modification If you or your spouse have exempt income from a business facility located in an enterprise zone that has been approved by the Department of Economic Development, enter one-half of the Missouri taxable income attributed to the new business facility in the enterprise zone. Refer to the Worksheet for Calculating Business Facility Credit, Enterprise Zone Modification and Enterprise Zone Credit (Form 4354). Rural Empowerment Zone Modification If you or your spouse have exempt income from a new business facility located within a rural empowerment zone that has been approved by the Department of Economic Development, enter the Missouri taxable income attribute to a new business facility in a rural empowerment zone on Lines 26Y and 26S. Visit ded.mo.gov for additional information on either modification, or contact the Department of Economic Development, Incentives Section, P.O. Box 118, Jefferson City, MO 65102-0118. FIGURE YOUR TAX LINE 28 - MISSOURI TAX Calculate your tax by using your taxable income from Form MO-1040, Line 27Y and 27S, the Tax Rate Chart (page 26, Section A), and Tax Calculation Worksheet (page 26, Section B).

LINES 29 AND 30 - RESIDENT CREDIT OR MISSOURI INCOME PERCENTAGE A taxpayer filing as a resident who paid taxes to another state or political subdivision may take a credit for tax paid by using Form MO-CR. A taxpayer filing as a nonresident may calculate their Missouri income percentage by using the Form MO-NRI. A Form MO-CR and a Form MO-NRI may not be used by the same taxpayer on Form MO-1040. If filing a combined return, one spouse may use Form MO-NRI and the other spouse may elect to use Form MO-CR. See lines 29 and 30. For more information and examples, visit dor.mo.gov/taxation/individual/additional-resources/ non-residents.html. Attach a copy of your other state or political subdivision’s return. LINE 29 - MISSOURI RESIDENT(S) You should take the resident credit (Form MO-CR) if: a. you are a full-year Missouri resident; and b. you paid income tax to other state(s) or political subdivisions. LINE 30 - NONRESIDENT(S) You should de­ter­mine your Missouri income percentage (Form MO-NRI) if: a. you are a nonresident; and b. you had income from other state(s) or political subdivisions. The amount on Line 30 should be 100 percent unless you use Form MO-NRI and determine a lesser percentage. If you do not enter a percentage on Line 30, your tax will be based on all of your income, regardless of where it was earned. LINE 29 OR 30 - PART-YEAR RESIDENT(S) You may take either the resident credit or the Missouri income percentage. Com­plete both Forms MO-CR and MO-NRI and use

10 the one that is to your advantage. All income earned while living in Missouri is taxable to Missouri. Attach a copy of your other state or political subdivision’s return. LINE 32 - TAX ON LUMP SUM DISTRIBUTIONS AND RECAPTURE TAX ON MISSOURI LOW INCOME HOUSING CREDITS Lump Sum Distributions A taxpayer who receives a lump sum distribution may be required to file a Lump Sum Distribution (Federal Form 4972). Because this income is not included in your Missouri adjusted gross income, a separate calculation must be made to compute the Missouri tax on this distribution. You are subject to the tax if your state of legal residence was Missouri at the time you received the lump sum distribution. The amount of tax is 10 percent of your federal tax liability on the distribution received in 2021. You must compute this tax by multiplying the amount shown as tax on Federal Form 4972 by 10 percent. For example, if your Federal Form 1040, Line 16 includes $1,000 tax as a result of Federal Form 4972, the amount of tax on Form MO-1040 would be $100. Select the Lump Sum Dis­tri­bu­tion box on Line 32. Attach a copy of Federal Form 4972. Recapture Tax If you are required to re­capture a portion of any federal low income housing credits taken on a low income housing project, you are also re­quired to recapture a portion of any state credits taken. The state recapture amount is the proportion of the state credit that equals the proportion the federal recapture amount bears to the original federal low income housing credit amount. Attach a copy of your federal return (pages 1 and 2) and Federal Form 8611. FIGURE YOUR PAYMENTS AND CREDITS LINE 35 - MISSOURI WITHHOLDING

Include only Missouri withholding as shown on your Form(s) W-2, 1099, or 1099-R. Do not include withholding for federal taxes, local taxes, city earnings taxes, other state’s withholding, or payments submitted with a Statement of Income Tax Payments for Nonresident Individual Partners or S Corporation Shareholders (Form MO-2NR) or a Statement of Income Tax Payments for Nonresident Entertainers (Form MO-2ENT). Attach a copy of all Form(s) W-2 and 1099. See Diagram 1, Form W-2, on page 26. LINE 36 - ESTIMATED PAYMENTS Include any estimated tax payments made on your 2021 return and any overpayment applied from your 2020 Missouri return. LINE 37 - NONRESIDENT PARTNER OR S CORPORATION SHAREHOLDER TAX WITHHELD Include the payments from your distributive share by the partnership or S corporation, if you are a nonresident partner or S corporation shareholder as shown on Form(s) MO-2NR and the Nonresident Partnership Form (Form MO-NRP). Attach Form(s) MO-2NR and MO-NRP. LINE 38 - NONRESIDENT ENTERTAINER TAX WITHHOLDING Include your share of the payments from gross earn­ings as a nonresident entertainer, as shown on Form(s) MO-2ENT, Line 7. Attach a schedule showing the date(s) and place(s) of the per­formance(s), the nonresident entertainer entity’s name, and how your share of the amount paid was cal­culated. Attach Form(s) MO-2ENT. LINE 39 - EXTENSION OF TIME TO FILE If you filed for an extension of time to file, enter on Line 39 the amount you paid to the Department of Revenue with Form MO-60. LINE 40 - MISCELLANEOUS TAX CREDITS You may be eligible for certain tax credits. The total amount of tax credit is computed by completing Form MO-TC. Enter the total tax credit amount from Form MO-TC, Line 13 on Form MO-1040, Line 40. Attach Form MO-TC, along with any applicable sched­ules, certificates, and federal form(s). You can find a list of available credits and the agency to contact for information, forms, and approval to claim each credit on the Form MO-TC, located on page 41. LINE 41 - PROPERTY TAX CREDIT Complete the Property Tax Credit Schedule (Form MO-PTS) to determine the amount of your property tax credit. See information to complete Form MO-PTS on pages 17-19. LINE 43 - AMENDED RETURN ONLY: PAYMENT ON ORIGINAL RETURN Enter any payment(s) applied to your original filed return, including any penalties and interest. LINE 44 - AMENDED RETURN ONLY: OVERPAYMENT ON ORIGINAL RETURN Enter the overpayment claimed or adjusted on your original return including interest. INDICATE THE REASON FOR AMENDING YOUR RETURN: Select the box relating to why you are filing an amended return. • Select Box A (federal audit) if you have knowledge or have received a notice that your federal return you previously filed was incorrect, or if the Internal Revenue Service (IRS) adjusted your original return. You must attach a copy of your amended federal return or a copy of your revenue agent’s report. Enter the month, day, and year your audit was finalized. • Select Box B if you have a Net Operating Loss (NOL) carryback on your amended return. Indicate the year your loss occurred. • Select Box C if you have an investment tax credit carryback on your amended return. Indicate the year your credit occurred. • Select Box D if you are filing an amended Missouri return as a result of filing an amended federal return or a Missouri correction. Enter the month, day, and year you filed your amended federal return. FIGURE YOUR REFUND OR AMOUNT DUE LINE 46 - OVERPAYMENT If Line 42 is larger than Line 34, or on an amended return, Line 45 is larger than Line 34, enter the difference (overpayment) on Line 46. All or a portion of an overpayment can be refunded to you. LINE 47 - APPLY OVERPAYMENT TO NEXT YEAR’S TAXES

You may apply any portion of your refund to next year’s taxes.

11 LINE 48 - TRUST FUNDS You may donate part or all of your overpaid amount or contribute additional pay­ments to any of the trust funds listed on Form MO-1040 or any two additional trust funds. Children’s Trust Fund – Children’s Trust Fund, Missouri’s Foundation for Child Abuse Prevention, is a non-profit organization dedicated to the vision of children free to grow and reach their full potential in a nurturing and healthy environment free from child abuse and neglect. For more information please contact the Children’s Trust Fund ctf4kids.org or call 888-826-5437. (Minimum contribution: $2, or $4 if married filing combined.) Veterans Trust Fund – The Missouri Veterans Commission’s Veterans Trust Fund is a means by which individuals and corporations may donate money to expand and improve services to veterans in Missouri. Contributions may be made at any time directly to: Veterans Trust Fund c/o The Missouri Veterans Commission, P.O. Drawer 147, Jefferson City, MO 65102-0147 or call (573) 751-3779. (Minimum contribution: $2, or $4 if married filing combined.) Elderly Home Delivered Meals Trust Fund – The Elderly Home Delivered Meals Trust Fund supports the home delivered meals program for Missouri’s home-bound senior citizens, helping them to continue to live independently in their homes. The need for home delivered meals increases yearly as persons are living longer and may need assistance. Please visit health.mo.gov/seniors/ aaa/index.php for more information. (Minimum contribution $2, or $4 if married filing combined.) Missouri National Guard Trust Fund – The Missouri

National Guard Trust Fund expands the capability to provide and coordinate Military Funeral Honors Ceremonies for veterans of Missouri and veterans buried in Missouri who have served their country in an honorable manner. Contributions may be made at any time directly to Missouri National Guard Trust Fund, ATTN: JFMO-J1/ SSH, 2302 Militia Drive, Jefferson City, MO 65101-1203 or call (573) 638-9663. (Minimum contribution: $2, or $4 if married filing combined.) Workers’ Memorial Fund – This fund has been established to create a permanent memorial for all workers who suffered a job related death or injuries that resulted in a permanent disability while on the job in Missouri. Requests for information and contributions may be made at any time to: Workers’ Memorial Fund, Attn: Director’s Office, 412 E Dunklin St., Jefferson City, MO 65101. (Minimum contribution: $1, or $2 if married filing combined.) Childhood Lead Testing Fund – Activities supported by this fund ensure that Missouri children at risk for lead poisoning are tested and receive appropriate follow-up activities to protect their health and well being from the harmful effects of lead. For more information please contact the Missouri State Public Health Laboratory at (573) 751-3334, or e-mail labweb1@health.mo.gov. (Min­imum contribution: $1, or $2 if married filing combined.) Missouri Military Family Relief Fund – For more information, please contact: Missouri Military Family Relief Fund, 2302 Militia Drive, ATTN: JFMO-J1/SS, Jefferson City, MO 65201-1203. (Minimum contribution: $1, or $2 if married filing combined.) General Revenue Fund – Requests for information and contributions may be made at any time directly to General Revenue Fund, ATTN: Department of Revenue, P.O. Box 3022, Jefferson City, MO 65105-3022. (Minimum contribution: $1, or $2 if married filing combined.)

Organ Donor Program Fund – Contributions support organ and tissue donation education and registry operation. For more information, please contact: Missouri Department of Health and Senior Services, Organ and Tissue Donor Program, P.O. Box 570, Jefferson City, MO 65102-0570, or call 888-497-4564. (Minimum contribution: $2, or $4 if married filing combined.) Kansas City Regional Law Enforcement Memorial Foundation Fund - The Regional Law Enforcement Memorial Garden honors and celebrates the men and women who have laid down their lives in the line of duty. Donations can be made directly to Kansas City Regional Law Enforcement Memorial Foundation Fund at 527 W 39th Street Kansas City, MO 64111. (Minimum contribution: $1, or $2 if married filing combined.) Soldiers Memorial Military Museum in St. Louis Fund - Supports Soldiers Memorial Military Museum in honoring military service members, veterans, and their families, and sharing St. Louis’s involvement in the nation’s military history from the American Revolution through today. Donations can be made directly to Soldiers Memorial Military Museum Fund at P.O. Box 775460 1315 Chestnut St., St. Louis, MO, 63103. (Minimum contribution: $1, or $2 if married filing combined.) Additional Funds If you choose to give to additional funds, enter the two-digit additional fund code in the spaces provided on Line 48. If you want to give to more than two additional funds, please submit a contribution directly to the fund. For additional information visit dor.mo.gov/taxation/individual/trust-funds.html. Donations received from the following funds are designated specifically for Missouri residents. American Cancer Society Heartland Division, Inc., Fund (01) – For more information anytime, call toll free 1-800-ACS-2345 or visit cancer.org. Donations can be sent directly to the American Cancer Society at 1100 Pen­nsylvania Avenue, Kansas City, MO 64105. (Minimum irrevocable contribution: $1, not to exceed $200.) American Diabetes Asso­ci­a­tion Gateway Area Fund (02) – Requests for information may be made by calling (314) 822-5490 or contacting Gateway Area Diabetes Association Fund, 15455 Conway Road, Suite 360, Chesterfield, MO 63017. (Minimum irrevocable contribution: $1, not to exceed $200.) American Heart Association Fund (03) – For more information, please contact: American Heart Association, 460 N. Lindbergh Blvd., St. Louis, MO 63141-7808, or call (314) 692-5600. (Minimum irrevocable contribution: $1, not to exceed $200.) ALS Lou Gehrig’s Disease Fund (05) – Call 1-888-873- 8539 for patient services in Eastern Missouri and 1-800- 878-2062 for patient services in Western Missouri. (Minimum irrevocable contribution: $1, not to exceed $200.) Arthritis Foundation Fund (09) – Call (314) 991-9333 or visit arthritis.org. Contributions can be made at any time directly to the Arthritis Foundation, 9433 Olive Blvd., Suite 100, St. Louis, MO 63132. (Minimum irrevocable contribution: $1, not to exceed $200.) Foster Care and Adoptive Parents Recruitment and Retention Fund (14) – For more information please contact: Missouri Children’s Division, P.O. Box 88, Jefferson City, MO 65103- 0088 or call (573) 522-8024. (Minimum contribution: $1, or $2 if married filing combined.) March of Dimes Fund (08) – Send requests for

information and contributions directly to the March of Dimes Fund, 11829 Dorsett Road, Maryland Heights, MO 63043. (Minimum irrevocable contribution: $1, not to exceed $200.)

12 Muscular Dystrophy Asso­ci­a­tion Fund (07) – Requests for information and contributions may be made at any time directly to: Muscular Dystrophy Association, 222 South Riverside Plaza, Suite 1500, Chicago, IL 60606; (312) 260-5900. (Min­i­mum irrevocable contribution: $1, not to exceed $200.) National Multiple Sclero­sis Society Fund (10) – Visit nationalmssociety.org, call 1-800-FIGHTMS, or contact National Multiple Sclerosis Society Fund, 12125 Woodcrest Executive Drive, Suite 320, St. Louis, MO 63141 (Minimum irrevocable contribution: $1, not to exceed $200.) Pediatric Cancer Research Trust Fund (18) - CureSearch for Children’s Cancer raises funds to support children’s cancer research. For more information, visit curesearch.org or call (800) 458-6223. (Minimum contribution: $1, or $2 if married filing combined.) American Cancer Society Heartland Division, Inc. Fund . . . . . . 01 American Diabetes Association Gateway Area Fund . . . . . . . . . 02 American Heart Association Fund . . . . . . . . . . . . . . . . . . . . . . . . . 03 Amyotrophic Lateral Sclerosis (ALS - Lou Gehrig’s Disease) Fund . . . . . . . . . . . . . . . . . . . . . . . . . 05 Arthritis Foundation Fund. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 09 Foster Care and Adoptive Parents Recruitment and Retention Fund . . . . . . . . . . . . . . . . . . . . . . . . . . 14 March of Dimes Fund . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 08 Muscular Dystrophy Association Fund . . . . . . . . . . . . . . . . . . . . . 07 National Multiple Sclerosis Society Fund . . . . . . . . . . . . . . . . . . . 10 Pediatric Cancer Research Trust Fund . . . . . . . . . . . . . . . . . . . . . . 18 Funds

Codes LINE 49 - MISSOURI 529 EDUCATION PLAN DEPOSIT You can deposit all or a portion of your refund into a Missouri 529 Education Plan (MOST) account. To make this choice, there must be an open account and the total deposit must be a minimum of $25. Please complete and attach Missouri’s 529 Education Plan Direct Deposit Form (Form 5632). LINE 50 - REFUND Subtract Lines 47, 48 and 49 from Line 46 and enter on Line 50. If your refund is $100,000 or more, please consider filing electronically and receiving your refund by direct deposit to your bank account. For security purposes, all refunds over this amount must be electronically deposited. If you do not file electronically with direct deposit, the Department will contact you for your banking information, which may delay your refund. Note: If you have any other liability due the state of Missouri, such as child support payments, or a debt with the Internal Reve­nue Service, your income tax refund may be applied to that liability in accordance with Section 143.781, RSMo. Your property tax credit may be applied to any property tax credit or individual income tax liability pursuant to Section 143.782, RSMo. You will be notified if your refund is offset against any debt(s). LINE 52 - UNDERPAYMENT OF ESTIMATED TAX PENALTY If the total payments and credits amount on Line 42 less Line 39 or Line 45 less Line 39 is less than 90 percent (66-2/3 percent for farmers) of the amount on Line 34, or if your estimated tax payments were not paid timely, you may owe a penalty. Complete the Underpayment of Estimated Tax by Individuals (Form MO-2210), see pages 42-45. If you owe a penalty, enter the pen­alty amount on Line 52. If you have an overpayment on Line 46, the Department of Revenue will reduce your overpayment by the amount of the penalty. LINE 53 - AMOUNT DUE Payments must be postmarked by April 18, 2022, to avoid interest and late payment charges. The Department of Revenue offers several payment options.

• Check or money order: Attach a check or money order (U.S.

funds only), payable to Missouri Department of Revenue. By

submitting payment by check, you authorize the Department

of Revenue to process the check electronically upon receipt.

• Do not postdate. The Department of Revenue may

electronically resubmit checks returned for insufficient or

uncollected funds.

If you mail your payment after your return is filed, attach your

payment to the Form MO-1040V found on page 46.

• Electronic Bank Draft (E-Check): By entering your bank

routing number and check­ing account number, you can pay

on­line at dor.mo.gov or by calling (888) 929-0513.

There will be a convenience fee to use this service.

• Credit Card: The Department accepts MasterCard, Discover,

Visa, and American Express. To pay online visit our website or

call (888) 929-0513. The convenience fees listed below will be

charged to your ac­count for processing credit card payments: Amount of Tax Paid Convenience Fee $0.00 - $50.00 $1.25 $50.01 - $75.00 $1.75 $75.01 - $100.00 $2.15 $100.01 and up 2.15% Note: The convenience fees for credit card transactions are paid to the third party vendor, not to the Missouri Department of Revenue. By accessing this payment system, the user will be leaving Missouri’s website and connecting to the website of the third party vendor, which is a secure and confidential website. SIGN RETURN You must sign Form MO-1040. Both spouses must sign a combined return. If you use a paid preparer, the preparer must also sign the return. If you wish to authorize the Director of Revenue to release information regarding your tax account to your preparer or any member of your preparer’s firm, indicate by selecting the “yes” box below the signature line. For all tax years beginning on or after January 1, 2020, each and every income tax return or claim for a refund prepared by a paid tax return preparer shall be signed by the paid tax preparer and shall state the tax preparer’s Internal Revenue Service preparer tax identification number. Each failure by the paid tax return preparer to sign any income tax return or claim for refund, or failure of the tax return preparer to provide a preparer tax identification number, shall result in a penalty of $50 owed by the paid tax preparer for each separate failure. The total amount of penalties that may be assessed on any preparer with respect to returns or claims for refunds filed during a calendar year shall not exceed $25,000. INFORMATION TO COMPLETE FORM MO-A, PART 1 Missouri Modifications to Federal Adjusted Gross Income

13 Form MO-A, Part 1, computes Missouri modifications to federal adjusted gross income. Modifications on Lines 1 through 6 include income that is exempt from federal tax, but taxable for state tax purposes. Modifications on Lines 8 through 17 exclude income that is exempt from state tax, but taxable for federal tax purposes. If after reviewing the instructions for Part 1, you have no modifications, enter on Form MO-1040, Lines 3 and 5, the same amount(s) entered on Form MO-1040, Line 1. LINE 1 - INTEREST ON STATE AND LOCAL OBLIGATIONS If you received income from an obligation of a state or political subdivision other than Missouri, enter the amount of that in­come, reduced by the related expenses in­cur­red (management fees, trustee fees, interest, etc.) if the expenses are more than $500. LINE 2 - PARTNERSHIP, FIDUCIARY, S CORPORATION, OTHER Enter positive adjustments (additions) re­ported from partnerships, fiduciaries, S cor­por­ations, or other sources. The partnership, fiduciary, or S corporation must notify you of the amount of any such adjustment (addition) to which you are entitled. Select the boxes applicable on Line 2 and attach a copy of the notification received. Net Operating Loss (NOL) - Carryback/Carryforward In the year of your Net Operating Loss (NOL), enter on Form MO-A, Part 1, Line 2 the amount of your eligible NOL to be carried back or carried forward from the loss year. Enter the sum of the current year’s NOL (as a positive number), plus any unused NOL from prior years. If your federal adjusted gross income includes an NOL carryback that is also carried back or carried forward to another year, enter the unused amount as an addition. Please attach the calculation of your NOL carryback/carryforward, or your Federal Form 1045, Schedules A and B. Amended returns only: If your federal adjusted gross income includes an NOL (other than a farming loss) of more than two years, enter the loss amount as a positive number. Non-medical Withdrawal from Individual Medical Account (IMA) Any monies you withdraw from your Individual Medical Account (IMA) for non-medical purposes are taxable to Missouri. The interest earned on such monies is also taxable to Missouri. The amount subject to tax is reported on a statement provided by the administrator of the IMA. Business Interest Previously Subtracted Business Interest Expenses: Enter the amount of business interest expense included in your federal adjusted gross income, to the extent the amount was subtracted from federal adjusted gross income on the Form MO-A in a previous year. Non-qualified Withdrawal from Family Development Account Non-qualified Withdrawal from Family De­vel­op­ment Account: The amount of annual deposits previously subtracted must be added to your federal adjusted gross income if the withdrawal from the account was not for a qualified use. LINE 3 - NON-QUALIFIED DISTRIBUTION FROM A QUALIFIED 529 PLAN Any distribution made by the Missouri for Tuition Program (MOST), or any other qualified 529 plan, not used for qualified education expenses, must be added to federal adjusted gross income of the account owner. The amount of the distribution that must be added includes contributions previously exempt from state tax and earnings generated from the program (if the earn­ ings are not already included in federal adjusted gross income). If the account owner is deceased, the beneficiary of the account must add the non-qualified taxable distribution to federal adjust­ ed gross income on the Missouri income tax return. LINE 4 - FOOD PANTRY CONTRIBUTIONS INCLUDED ON SCHEDULE A If you are claiming the Food Pantry Tax Credit (Form MO-FPT) and you included your donations as an itemized deduction on your Federal Schedule A, enter the amount of your donations, as noted on Form MO-FPT. LINE 5 - NONRESIDENT PROPERTY TAX If you are a nonresident or part-year resident and you reported property taxes paid to another state or political subdivision on Line 5b and /or 5c of your Federal Schedule A, you must report an income modification on Line 5 of Form MO-A, unless that state or political subdivision allows a subtraction to income for Missouri property taxes. Visit dor.mo.gov/faq/taxation/individual/non-resident.html for a list of states that allow a subtraction for Missouri property taxes. If your state and local taxes from Federal Schedule A, Line 5d exceeds $10,000 (or $5,000 for married filing separate filers), use the following calculation to determine your income modification that must be added to federal adjusted gross income. Nonresident Property Tax Total State and Local Tax X $5,000 or $10,000 = Income Modification LINE 6 - NONQUALIFIED DISTRIBUTION FROM A QUALIFIED ACHIEVING A BETTER LIFE EXPERIENCE PROGRAM (ABLE) Any distribution made by the ABLE program administered by the Missouri Achieving a Better Life Experience board, not used for qualified disability expenses or not held for the minimum length of time established by the board must be added to the federal adjusted gross income of the account owner. The amount of the distribution that must be added includes contributions previously exempt from state tax and earnings generated from the program (if the earnings are not already included in federal adjusted gross income). LINE 7 - TOTAL ADDITIONS Add Lines 1 through 6. Enter the totals on Form MO-A, Part 1, Line 7 and on Form MO-1040, Line 2. LINE 8 - INTEREST ON EXEMPT FEDERAL OBLIGATIONS Interest from direct obligations of the U.S. Government, such as U.S. savings bonds, U.S. treasury bills, bonds, and notes is exempt from state taxation under the laws of the United States. Attach a detailed list or all Federal Forms 1099. Taxpayers who claim exclusion for interest from direct U.S. obligations must identify the specific securities owned, e.g., “U.S. savings bond”. A general description such as “interest on U.S. obligation” or “U.S. Government securities” is not acceptable. (See Missouri Regulation 12 CSR 10-2.150 for the taxability of various U.S. Government related obligations.) Failure to identify the specific security will result in the disallowance of the deduction. A federally taxed distribution received from a mutual fund investing exclusively in direct U.S. Government obligations is exempt. If the mutual fund invests in both exempt (direct) and non-exempt (indirect) federal obligations, the deduction allowed will be the distribution received from the mutual fund attributable to the interest on the direct U.S. Government obligations, as determined by the mutual fund. Attach a copy of the year-end statement received

14 from the mutual fund showing either the amount of money received or the percentage of funds received from direct U.S. Government obligations, or a summary statement received from the mutual fund which clearly identifies the exempt and non-exempt portions of the U.S. Government obligation interest. The statement does not need to list each obligation separately. Failure to attach the re­quested document will result in the dis­al­lowance of the deduction. Reduce the amount claimed by related expenses, if expenses were over $500. To arrive at the amount of related expenses, you may use actual expenses or a reasonable estimate. In general, you should use the same or similar method used to compute related expenses for federal income tax purposes, provided that the method reasonably reflects related expenses for Missouri-exempt income. If you fail to compute reasonable related expenses, the Director of Revenue will make an adjustment based on the best information available. If sufficient information is not available or if your records do not provide sufficient information, the Director of Revenue will use the fol­low­ing formula to compute related expenses: Exempt Income Total Income X Expense Items = Reduction to Exempt Income The principal expense item in this formula is interest expense; how­ever, the Direc­tor of Reve­nue may include other expense items because of their direct re­la­tionship to the production of exempt in­come. You may propose an alter­native method pro­vided that it properly reflects the amount of related expenses.

LINE 9 - STATE INCOME TAX REFUND Enter the amount of any state income tax refund included in your federal adjusted gross income on Form MO-1040, Line 1 (from Federal Form 1040 or Federal Form 1040-SR, Schedule 1, Part 1, Line 1). Attach a copy of Federal Form 1040 or 1040-SR (pages 1 and 2) and applicable schedules. LINE 10 - MILITARY RETIREMENT BENEFITS A military pension is a pension received for your service in a branch of the armed services of the United States, including the Missouri Army Reserve and Missouri National Guard. On Line 10, enter your total military retirement benefits reported on Federal Form 1040 or Federal Form 1040-SR, Line 5b. LINE 11 - PARTNERSHIP, FIDUCIARY, S CORPORATION, RAILROAD RETIREMENT BENEFITS, OTHER Enter subtractions, reported from partnerships, fiduciaries, and S corporations. The partnership, fiduciary, and S corporation must notify you of the amount of any such subtraction to which you are entitled. Enter amount on Line 11, select the boxes applicable on Line 11 and attach a copy of the notification received. Failure to attach a copy of the notification furnished to you will result in the disallowance of the subtraction. Railroad Retirement Benefits Administered by the Railroad Re­tire­ment Board, such as all Tier I and Tier II benefits and any railroad retirement sick pay, disability, and unemployment benefits, included in federal adjusted gross income (Form MO-1040, Line 1), are exempt from state taxation. Military Income of Nonresident Military Personnel. Enter the amount of any military income received by nonresident military personnel sta­tioned in Missouri. Nonresident active duty military service-members who are required to file a Missouri return may subtract the military income received from their federal adjusted gross income. Nonresident service-members’ spouses who are in Missouri due to as their state of residence may subtract their income from their federal adjusted gross income. Attach a copy of the Form(s) W-2 re­porting your military income. Combat Pay Included in Federal Adjusted Gross Income Earned by Military Personnel with a Missouri Home of Record. The IRS allows enlisted members, warrant officers and commissioned warrant officers to exclude their military pay received while serving in a combat zone, or while hospitalized as a result of in­juries incurred while serving in a com­bat zone. The exclusion of combat pay received by a commissioned officer, other than a commissioned warrant officer, is limited to the highest rate of enlisted pay Subtract all military income received while serving in a combat zone, which is included in Federal Adjusted Gross Income (FAGI) and is not otherwise excluded. In most cases combat pay is not included in Box 1, Wages, of Form W-2 and therefore is not included in FAGI. However if Box 1 includes combat pay, the por­tion consisting of combat pay may be taken as a subtraction for Missouri purposes.

Example 1: A resident of Missouri, is an enlisted member of

the military. He enters a combat zone in July and is there

through December. He earns $12,000 January through June,

and earns $20,000 July through December. Box 1 of his Form

W-2 should only indicate the $12,000 he received prior to

entering the combat zone. He is not entitled to a subtraction,

as his combat pay is not included in his FAGI.

Example 2: A resident of Missouri, is a high ranking commissioned

officer. He enters a combat zone in July and is there through

December. He earns $50,000 January through June, and earns

$70,000 July through December. The IRS limits his Form W-2 to

indicate $80,000. He is entitled to a subtraction of $30,000,

which represents the portion of Box 1 of Form W-2 attributable

to combat pay that is included in his FAGI. Build America Bonds and Recovery Zone Bonds Interest. Enter any interest received from Build America or Recovery Zone Bonds that is included in your federal adjusted gross income. Attach a copy of your Interest Income (Form 1099-INT) or any other applicable documentation. Missouri Public-Private Transportation Act. Enter any income received in connection with the Missouri Public Private Transportation Act, that is included in your federal adjusted gross income. Net Operating Loss (NOL). Any amount of Net Operating Loss deduction taken against federal taxable income but disallowed for Missouri income tax purposes after June 18, 2002, may be carried forward and taken against any income on the Missouri income tax return for a period of up to 20 years from the year of the initial loss. Attach a calculation of your Net Operating Loss carryback/ carryforward or a copy of your Federal Form 1045, Schedules A and B. Contributions into a Missouri In­divid­ual Medical Account (IMA). Con­tri­bu­tions that were made by your employer into an Individual Medical Account (IMA) and used to pay your health care expenses are exempt from Missouri income tax. The interest income earned on the IMA account is also exempt from Missouri income tax. The IMA contribution is identified in Box 14 of your Form W-2, Wage and Tax Statement. Reduce the amount of con­tributions by the amount of medical and dental expenses deducted on Federal Form 1040 or 1040-SR, and included in Missouri itemized deductions. Accumulation Distribution. If during the taxable year, you re­ceived a distribution as beneficiary of a trust that was made from accumulated earnings of prior years and you filed Tax on Accumulation Distribution of Trusts (Federal Form 4970), the amount of the distribution may be excluded from Missouri in­come to the extent that it was reported in your federal adjusted gross income. Capital Gain Exclusion on Sale of Low Income Housing. If during the taxable year, you sold a federally subsidized (HUD) low income housing project to a nonprofit or governmental organization, and at least 40 percent of the units are occupied by persons or families

15 having incomes of 60 percent or less of the median income, you may exclude 25 percent of the capital gain from Missouri tax. However, the buyer of the property must agree to preserve or increase the low income occupancy of the project. To use this exclusion, enter 25 percent of the capital gain reported on your Federal Form 1040 or 1040-SR. Attach a copy of your Federal Form 1040 or 1040-SR (pages 1 and 2) and Sales of Business Property (Federal Form 4797). Family Development Account. A family development account holder may subtract the amount of annual deposits made to the account (not to exceed $2,000). Approved withdrawals from the family development account are also exempt from state tax. Interest earned by a family development account is exempt from state taxation and may be subtracted from an account holder’s federal adjusted gross income. Any money withdrawn for an unapproved use is subject to tax. Attach proper certification and a copy of your Form 1099. Federally Taxable - Missouri Exempt Obligations. Income from any bond issued by the Missouri Higher Edu­ca­tion Loan Authority (MOHELA), in­clud­ing interest or proceeds resulting from the sale of the bond, is exempt from Missouri tax. Enter the amount of such income included in federal adjusted gross income on Line 10. Condemnation of Property. If you included in your Federal Adjusted Gross Income any gain arising from compulsory or involuntary conversion of property as a result of condemnation or the imminence thereof, you may exclude that gain from Missouri tax. Attach a copy of your Federal Form 1040 or 1040-SR, Schedule D, and Form 4797.

Employee Stock Ownership Plan (ESOP) Capital Gain Deduction. Enter 50 percent of the net capital gain from the sale or exchange of employer securities of a Missouri corporation to a qualified Missouri employee stock ownership plan if, upon completion of the transaction, the qualified Missouri employee stock ownership plan owns at least 30 percent of all outstanding employer securities issued by the Missouri corporation. Attach Form(s) 1099 and Beneficiary’s Share of Income, Deductions, Credits, etc. (Schedule K-1). Disallowed Business Income Expenses. If your deduction for business interest expenses were limited under Subsection 163(j) of the Internal Revenue Code, enter the disallowed amount. Attach a copy of your Federal Form 8990. (12-2021) Box 3. Benefits Paid in 2021 Box 4. Benefits Repaid to SSA in 2021 Box 5. Net Benefits Repaid for 2021 (Box 3 minus box 4) Benefits for 2021 $8,400.00 *Includes: $12.00 Paid in 2021 for 2020 2021 LINE 12 - EXEMPT CONTRIBUTIONS MADE TO A QUALIFIED 529 PLAN The state of Missouri allows a subtraction from federal adjusted gross income for the amount of annual contributions made to the Missouri Tuition Program (MOST), or any other qualified 529 plan. The maximum annual exempt contribution is $8,000 for single individuals or $16,000 for married couples filing a combined return. If you contributed to MOST, or any other qualified 529 plan and are claiming the subtraction on your Missouri income tax return, please attach one of the following with your return: • Statement from program manager showing contribution in the name of the individual claiming the subtraction, • Bank statements reporting/verifying the contribution date and contribution amount, • Copies of canceled checks, • Other supporting documentation verifying the name of the individual who contributed to the MOST 529 account, contribution dates, and contribution amounts. The documentation verifying contributions must be in the name of the individual claiming the subtraction. LINE 13 - QUALIFIED HEALTH INSURANCE PREMIUMS Enter the amount you paid for health insurance premiums, not to exceed your federal taxable income. Do not include any pre-tax premiums paid, any premiums excluded from federal taxable income, or any long term care insurance premiums. Use the worksheet on page 36 to determine your allowable subtraction. LINE 14 - DEPRECIATION ADJUSTMENT If you purchased an asset between July 1, 2002 and June 30, 2003, and you elected to use the 30 percent depreciation on your federal return, you may be able to subtract a portion of the depreciation. Enter the additional depreciation created by the Job Creation and Worker Assistance Act previously added back in prior years to the extent allowable by Section 143.121, RSMo. This amount is computed by figuring the allowable depreciation prior to the Job Creation and Worker Assistance Act less the depreciation taken on your federal return. If you have previously taken an addition modification for a qualifying property, but have sold or disposed of the property during the taxable year, select the box on Line 14 and take a subtraction for the amount not previously recovered. Visit dor.mo.gov/pdf/ depreciation_examples.pdf for more information and examples.

LINE 15 - EXEMPT CONTRIBUTION MADE TO A QUALIFIED ACHIEVING A BETTER LIFE EXPERIENCE PROGRAM (ABLE) The State of Missouri allows a subtraction from federal adjusted gross income for the amount of annual contributions made to the Achieving a Better Life Experience Program (ABLE). This plan is administered by the Missouri Achieving a Better Life Experience Board. The maximum annual exempt contribution is $8,000 for single individuals or $16,000 for married couples filing a combined return. If you contributed to ABLE and are claiming the subtraction on your Missouri income tax return, please attach one of the following with your return: • Statement from program manager showing contribution in

the name of the individual claiming the subtraction, • Bank statements reporting/verifying the contribution date

and contribution amount, • Copies of canceled checks, Federal From 5498-QA, or • Other supporting documentation verifying the name of the individual who contributed to the MOST 529 account, contribution dates, and contribution amounts. The documentation verifying contributions must be in the name of the individual claiming the subtraction.

16 LINE 16 - AGRICULTURE DISASTER RELIEF Enter the amount of payment received from a program that provides compensation to agricultural producers that have suffered a loss as a result of a disaster or emergency. This amount must be included in your Federal Adjusted Gross Income. Attach a copy of the Form 1099, as well as a Federal Schedule F and Federal Schedule K-1 if applicable, indicating the payment amount. LINE 17 - BUSINESS INCOME DEDUCTION The State of Missouri allows a subtraction from federal adjusted gross income in the amount of 10 percent for Missouri Source Business Deductions. Complete the worksheet below only if you have Missouri source income and are claiming a Business Income Deduction. Please provide the Federal Form 1040 or Federal Form 1040-SR and all applicable schedule(s) for verification.

Yourself Spouse 1. Missouri-source net profit from

Form 1040, Schedule(s) C, Line 31

that is included in federal adjusted

gross income. (Enter zero if negative.) 1Y ____ 2S ____ 2. Missouri-source net profit (loss) from

Form 1040 Schedule E, Part II, Line 32,

that is included in federal adjusted

gross income. 2Y ____ 2S ____ 3. Business income (Combine Line 1 and

Line 2; amount cannot be less than zero.) 3Y ____ 3S ____ 4. Business income deduction. Multiply

3 by 10%. Enter on Form MO-A, Part I,

Line 17. 4Y ____ 4S ____ Enter the amount from Line 4 from the worksheet above on Form MO-A, Line 17. Worksheet for Missouri Source Business Deduction LINE 18 - TOTAL SUBTRACTIONS Add Lines 8 through 17. Enter the total on Form MO-A, Part 1, Line 18 and on Form MO-1040, Line 4. Note: Do not include income earned in other states on Line 18. Com­plete Form MO-NRI or Form MO-CR. See Form MO-1040, Line 29 and Line 30.

PART 2 - MISSOURI ITEMIZED DEDUCTIONS You cannot itemize your Missouri deductions if you took the standard deduction on your federal return. See page 8, Line 14. You must itemize your Missouri deductions if you were re­quired to itemize on your federal return. LINE 1 - FEDERAL ITEMIZED DEDUCTIONS

Include your total federal itemized deductions from Federal Form 1040 or Federal Form 1040-SR, Line 12, and any approved cultural contributions (literary, musical, scholastic, or artistic) to a tax exempt agency or institution that is operated on a not-for-profit basis. Cash con­tributions do not qualify. LINES 2 AND 3 - SOCIAL SECURITY TAX Include the amount of the social security tax withheld from your Form(s) W-2. This amount cannot exceed $8,853. Enter the total on Line 2. Repeat for your spouse and enter the total on Line 3.

LINES 4 AND 5 - RAILROAD RETIREMENT TAX Include the amount of railroad retirement tax withheld from your wages, Tier I and Tier II, during 2021. This amount cannot exceed $14,057 (Tier I maximum of $8,853 and Tier II maximum of $5,204). Enter the total on Line 4. Repeat for your spouse and enter the total on Line 5. If you have both social security and Tier I railroad retirement tax, the maximum deduction allowed is the amount withheld as shown on the Form(s) W-2 less either the amount entered on Federal Form 1040 or Federal Form 1040-SR, Schedule 3, Part 2, Line 10, or, if only one employer, the amount refunded by the employer. LINE 6 - MEDICARE TAX Include the total amount of Medicare tax for yourself and spouse (combined). If you are not subject to “additional Medicare tax” on your federal return, enter the amount from your Form W-2. If you are subject to “additional Medicare tax” on your federal return, enter the amounts as calculated below. You must attach a copy of Additional Medicare Tax (Federal Form 8959). • Wage income: Form(s) W-2, Box 6, plus Line 7 of Federal

Form 8959, less Line 22 of Federal Form 8959;

• Railroad retirement compensation: Railroad retirement

Medicare tax withheld on Form(s) W-2, Box 14, plus Line 17

of Federal Form 8959, less Line 23 of Federal Form 8959. LINE 7 - SELF-EMPLOYMENT TAX Include the amount from Federal Form 1040, Federal Form 1040- SR, or Federal Form 1040-NR:

• Federal Schedule 2, Part 2, Line 4

• Less Federal Schedule 1, Part 2, Line 15

• Plus Federal Form 8959, Line 13 LINE 9 - STATE AND LOCAL INCOME TAXES Include the amount of income taxes from Federal Form 1040 or 1040-SR, Schedule A, Line 5. The overall limit on state and local income taxes plus property taxes, is $5,000 for married filing separately and $10,000 for all other taxpayers (single, married filing combined, head of household). If the sum of these deductions exceeds this limit, use the worksheet on MO-A, Part 2 to determine the state income tax portion of the state tax deduction. LINE 10 - EARNINGS TAXES If you entered an amount on Line 9 and you live or work in the Kansas City or St. Louis area, you may have included earnings taxes. Include on Line 10 the amount of earnings taxes withheld shown on Form(s) W-2. See page 26, Diagram 1, Box 19. LINE 12 - TOTAL MISSOURI ITEMIZED DEDUCTIONS If your total Missouri itemized deductions are less than your standard deduction (see page 8, Line 14), you should take the standard deduction on Form MO-1040, Line 14, unless you were re­quired to itemize your federal deductions.

17 PART 3 - PENSION AND SOCIAL SECURITY/ SOCIAL SECURITY DISABILITY If you are claiming a pension, social security, or social security disability, you must attach a copy of your federal return (pages 1 and 2), your Form(s) 1099-R, and SSA-1099. Failure to provide this information will result in your exemption being disallowed. Public Pension Calculation Public pensions are pensions received from any federal, state, or local government. If you have questions about whether your pension is a public or a private pension, contact your pension administrator. LINE 1 - MISSOURI ADJUSTED GROSS INCOME Include your Missouri adjusted gross income from Form MO-1040, Line 6. LINE 2 - TAXABLE SOCIAL SECURITY BENEFITS Include the taxable 2021 social security benefits for each spouse. This information can be found on Federal Form 1040 or Federal Form 1040-SR, Line 6b. LINE 6 - TAXABLE PUBLIC PENSION Include the taxable 2021 public pension(s) for each spouse. This information can be found on Federal Form 1040 or Federal Form 1040-SR, Line 5b. Do not include any payments from private pensions, social security benefits or railroad retirement payments on this line. (Exception: If you are 100 percent disabled, you may consider railroad retirement and military retirement benefits as taxable public pension.) Do not include military retirement benefits, this amount will be entered on MO-A, Part 1, Line 10. LINE 8 - SOCIAL SECURITY OR SOCIAL SECURITY DISABILITY EXEMPTION Include the amount from Lines 6Y and 6S from Part 3 of the MO-A, Section C (social security or social security disability calculation), unless you are a single individual with income greater than $85,000 or a married couple with income greater than $100,000. For single individuals with income greater than $85,000 enter the amount from Line 8 of Section C. For married couples with income greater than $100,000, multiply Line 8 by the percentages on Line 3Y and 3S of the Worksheet for Lines 4 and 5 (see right column), and enter those amounts here. If the social security or social security disability exemption, Section C, Line 8 is $0, enter $0 on Line 8 of the public pension calculation. Private Pension Calculation LINE 2 - TAXABLE SOCIAL SECURITY BENEFITS

Include the taxable 2021 social security benefits. This information can be found on Federal Form 1040 or Federal Form 1040-SR, Line 6b. LINE 6 - TAXABLE PENSION Include the taxable 2021 pension received from private sources for each spouse. This information can be found on Federal Form 1040 or Federal Form 1040-SR, Lines 4b and 5b. Do not include any payments from public pensions, social security benefits, or railroad retirement payments on this line.

Social Security or Social Security Disability Calculation LINE 4 - TAXABLE SOCIAL SECURITY BENEFITS To take the social security exemption, you must be age 62 or older. An individual that receives social security retirement benefits, partial benefits at age 62, full benefits at age 65 or older, or a disabled individual receiving Social Security Disability Income (SSDI), who reaches full retirement age during the taxable year and receives retirement benefits should include on Line 4, the amount of federal taxable benefits, which can be found on Federal Form 1040 or Federal Form 1040-SR, Line 6b. Taxable social security benefits must be allocated by each spouse’s share of the benefits received for the year. To determine each spouse’s portion of the taxable social security on Line 4, complete Worksheet for Lines 4 and 5 below. LINE 5 - TAXABLE SOCIAL SECURITY DISABILITY BENEFITS A disabled individual receiving Social Security Disability Income (SSDI) for the entire taxable year should enter on Line 5 the amount of federal taxable benefits, which can be found on Federal Form 1040 or Federal Form 1040-SR, Line 6b. Taxable social security disability benefits must be allocated by each spouse’s share of the benefits received for the year. To determine each spouse’s portion of the taxable social security disability on Line 5, complete the Worksheet for Lines 4 and 5 below. Note: A taxpayer filing single, head of household, qualifying widow(er), or married filing separate may not enter amounts on both Line 4, Taxable Social Security Benefits, and Line 5, Taxable Social Security Disability Benefits. Report only Social Security Benefits on Line 4 and Social Security Disability Benefits on Line 5. However, if you are married filing a combined return, one spouse may enter an amount on Line 4 and the other spouse may enter an amount on Line 5. 1. Total social security - Enter amount

from Federal Form 1040 or Federal

Form 1040-SR, Line 6a . . . . . . . . . . . . . 1) _________

Yourself Spouse 2. Enter each spouse’s portion of

the total social security. . . . . . . . . . . . . 2Y _____ 2S _____ 3. Divide Line 2Y and 2S by Line 1 . . . . . . 3Y ____% 3S ____% 4. Taxable social security - Enter

amount from Federal Form 1040

or Federal Form 1040-SR, Line 6b. . . 4) _________ 5. Multiply Line 4 by percentages on 3Y

and 3S and enter amounts here and

on Lines 4 or 5 of Part 3 of the MO-A,

Section C. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5Y _____ 5S _____ Worksheet for Lines 4 and 5

FORM MO-PTS Information to Complete Form MO-PTS If you qualify for the Property Tax Credit you must attach Form MO-PTS to your Form MO-1040 and mail to: Missouri Department of Revenue, P.O. Box 2800, Jefferson City, MO 65105-2800. Important: You must complete Form MO-1040, Line 1 through Line 40, before you complete Form MO-PTS.

18

• If your filing status on Form MO-1040 is head of household,

you will select single filing status on the Form MO-PTS.

• If your filing status on Form MO-1040 is married filing combined,

but you and your spouse lived at different addresses the entire

year, you may file a separate Property Tax Credit Claim (Form

MO-PTC). Do not include spouse name or social security

number if you selected married filing separate. (Example: One

spouse lives in a nursing home or residential care facility while

the other spouse remains in the home the entire year.) If filing a

separate Form MO-PTC, you cannot take the $2,000 or $4,000

deduction on Line 7 and you cannot calculate your Property Tax

Credit on Form MO-PTS. Qualifications

Select the applicable box to indicate under which qualification you are filing the Form MO-PTS. You must select a qualification box to be eligible for the credit. Select only one box. Attach the appropriate documentation to verify your qualification. (The required documentation is listed behind each qualification on Form MO-PTS.) Helpful Hints If you are married or lived together for any part of the year, you must file married filing combined and include all household income. LINE 2 - SOCIAL SECURITY BENEFITS Enter the amount of nontaxable 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. See below to deter­mine nontaxable benefits:

• Federal Form 1040 or Federal Form 1040-SR, Line 6a less Line 6b • Form(s) SSA-1099 and Payments by the Railroad Retirement

Board (Federal Form RRB-1099), total amount before

deductions (if you did not include an amount on Federal

Form 1040 or Federal Form 1040-SR). Lump sum distributions from Social Security Administration and other agencies must be claimed in the year in which they are received. Attach Form SSA-1099 or RRB-1099 (TIER I).

Helpful Hints

• Wait to file your return until you receive your Form

SSA-1099 in January 2022. This form will list your

benefits for the entire 2021 year. See the sample

Form SSA-1099 on page 15.

• If you are receiving railroad retirement benefits, you

should get two Forms RRB-1099. Form RRB-1099R

shows annuities and pensions. Form RRB-1099

shows your social security equivalent railroad

retirement benefits. Include the amount from Form

RRB-1099 that states social security equivalent

(usually Tier I benefits) on Line 2. LINE 3 - EXEMPT INTEREST AND PENSION INCOME Enter the amount of pensions, annuities, rental income, dividends, exempt unemployment compensation, or exempt interest income not included on Form MO-PTS, Line 1. (Do not include amount of excludable costs of pensions or annuities.) See the following to determine the amount of your pension or exempt interest:

• Form(s) 1099-R - Total amount before deduction not

included on Form MO-1040, Line 6 (Missouri adjusted

gross income).

• Form 1099-INT - Total amount not included on Form

MO-1040, Line 6 (Missouri adjusted gross in­come). Include

tax exempt interest from Form MO-A, Part 1, Line 8. If grants or long-term care benefits are made payable to a nursing facility, do not include as income or rent. LINE 4 - RAILROAD RETIREMENT BENEFITS Enter railroad retirement benefits before any deductions for medical premiums or withholdings of any kind from Form MO-A, Part 1, Line 11. Attach a copy of your Form RRB-1099-R. (Do not include social security equivalent railroad retirement included on Line 2.) LINE 5 - VETERAN BENEFITS If a veteran is 100 percent disabled not due to military service, payments and benefits must be included on line 5. Veteran payments and benefits include education and training allowances, disability compensation, grants, and insurance proceeds. If a veteran is 100 percent disabled as a result of military service, do not include veteran payments and benefits as household income on Form MO-PTS. If a veteran is less than 100 percent disabled, but is unable to engage in substantial gainful activity due to medical impairments(s) resulting entirely from military service, and such medical impairment(s) can be expected to result in death or has lasted or can be expected to last continuously for at least twelve months, do not include veteran payments and benefits as household income on Form MO-PTS. A letter from the Veterans Administration detailing the amount of benefits or confirming the disability is 100 percent from military service must be attached. Note: To request a copy of the letter, call the Veterans Administration at (800) 827-1000. If you are a surviving spouse receiving social security and your spouse was 100 percent disabled as a result of military service, all veteran payments and benefits must be included. LINE 6 - PUBLIC ASSISTANCE Include the amount of public assistance, Supplemental Security Income (SSI), child support, and Temporary Assistance payments re­ceived by you and your minor children. Tempo­rary Assistance payments include Temporary Assistance for Needy Families (TANF) payments. In Missouri, the program is referred to as Temporary Assistance (TA). This includes any payments received from the government. Do not include the value of commodity foods, food stamps, or heating and cooling assistance. Attach a letter from the Social Security Administration that includes the total amount of assistance received and Form 1099 from Employment Security, if applicable. Helpful Hints • Supplemental Security Income (SSI) is paid by the Social Security Ad­min­is­tration. You have to request an SSI form indicating total benefits received either through a My Social Security account at ssa.gov/myaccount/, by calling 1-800-772-1213, or contacting your local Social Security office. If you have minor children who receive SSI benefits, the children do not qualify for a credit. However, if you qualify for a credit, you must include the children’s SSI benefits on Line 6. • If you receive temporary assistance from the Children’s Division (CD) or Family Support Division (FSD), you must include all cash benefits re­ceived for your entire household. The Department of Revenue verifies this information and failure to in­clude total benefits may delay your refund.

19 LINE 7 - NONBUSINESS LOSS(ES) Complete Line 7 only if non­business losses reduced the amount reported on Form MO-PTS, Line 1. If Line 1 was reduced by nonbusiness losses, add back the amount of the loss on Line 7. A nonbusiness loss is a loss of income that did not result from a trade or business. (Losses from Federal Form 1040 or 1040-SR, Schedule F and Schedule C are considered business losses and should not be in­cluded here.) LINE 9 - FILING DEDUCTION If you are Single or Married Living Separate, enter $0 on Line 9. If you are Married and Filing Combined, see below to determine the amount to enter on Line 9.

• If you RENTED or DID NOT OWN your home for the entire

year, enter $2,000 on Line 9.

• If you OWNED and OCCUPIED your home for the entire

year, enter $4,000 on Line 9. LINE 10 - NET HOUSEHOLD INCOME Subtract Line 9 from Line 8 and enter amount on Line 10.

• If you RENTED or DID NOT OWN and occupy your home for

the entire year, the amount you enter on Line 10 cannot

exceed $27,200. If the amount of your net household income

on Line 10 is above $27,200, you are not eligible for the

credit. There is no need to complete and submit the form.

• If you OWNED and OCCUPIED your home for the entire

year, the amount you enter on Line 10 cannot exceed

$30,000. If the amount of your net household income

on Line 10 is above $30,000, you are not eligible for the

credit. There is no need to complete and submit the form. Note: Your home or dwelling is the place in which you reside in Missouri, whether owned or rented, and the surrounding land, not to exceed five acres, as is reasonably necessary for use of the dwelling as a home. A home may be part of a larger unit such as a farm or building partly rented or used for business. LINE 11 - OWN YOUR HOME If you owned and occupied your home, include the amount of real estate tax you paid for 2021 only, or $1,100, whichever is less. Do not include special assessments (sewer lateral), penalties, service charges, and interest listed on your tax receipt. You can only claim the taxes on your primary residence that you occupy. Secondary homes are not eligible for the credit. Attach a copy of paid real estate tax receipt(s) from the county and city collector’s offices. If you submit more than one receipt from a city or county for your residence, please submit a letter of explanation. If your home or farm has more than five acres or you own a mobile home that is classified as personal property, an Assessors Certification (Form 948) must be attached with a copy of your paid personal or real property tax receipt. If you own a mobile home, and it is classified as real property, a Form 948 is not needed. In such cases, you can claim property tax for the mobile home and rent for the lot. A credit will not be allowed on vehicles and other items listed on the personal property tax receipt. If you bought, sold, or shared your home, report only the portion of real-estate tax paid by you. If you use your home for business purposes, the percentage of your home that is used for business purposes must be subtracted from your real estate taxes paid. If you need to use a Form 948 to calculate the amount of real estate tax, you must subtract the percentage of your home that is used for business purposes from allowable real estate taxes paid. Example: Ruth has 10 acres surrounding her house. She needs to use a Form 948, because she is only entitled to receive credit for 5 acres. By her calculations, she enters $500 on Form 948, Line 6. Ruth also uses 15 percent of her house for her business. She will multiply $500 by 85 percent and enter this figure ($425) on Form MO-PTS, Line 11. LINE 12 - RENT YOUR HOME Complete one Cer­ti­fi­cation of Rent Paid (Form MO-CRP) for each rented home (including mobile home or lot) you occupied during 2021. You cannot claim returned check fees, late fees, security and cleaning deposits, or any other deposits. Add the totals from Line 9 on all Form(s) MO-CRP completed, and enter the amount on Line 12, or $750, whichever is less. Attach a completed Verification of Rent Paid (Form 5674), along with Form(s) MO-CRP. Forms may be obtained by visiting the Department’s website at: dor.mo.gov/forms/. If you have the same address as your landlord, please verify the number of occupants and living units. Helpful Hints If you receive low income housing assistance, the rent you claim may not exceed 40 percent of your income. Please claim only the amount of rent you paid or your refund will be delayed or denied. If you rent from a facility that does not pay real estate taxes, you are not eligible for a property tax credit. If your gross rent paid exceeds your household in­come, you must attach a detailed statement explaining how the additional rent was paid or the claim will be denied. LINE 13 - TOTAL REAL ESTATE TAX/RENT PAID Add amounts from Form MO-PTS, Lines 11 and 12 and enter amount on Line 13, or $1,100, whichever is less. Example: Ester owns her home for three months and pays $100 in property taxes. For nine months she rents an apartment and pays $4,000 in rent. The amount on Line 9 of the Form MO-CRP is $800 ($4,000 x 20 percent). Form MO-PTS, Line 11 is $100, Line 12 is $750 ($750 is the limit on Line 12) and Line 13 is $850.

Helpful Hints Real estate tax paid for a prior year cannot be claimed on this form. To claim real estate taxes for a prior year, you must file a claim for that year. Example: If you paid your 2020 real estate tax in calendar year 2021, you must file a 2020 Property Tax Credit Claim. If you own your home and other adults (other than spouse) live there and pay rent, the rent must be included in your federal adjusted gross income. LINE 14 - PROPERTY TAX CREDIT Apply Lines 10 and 13 to the Property Tax Credit Chart on pages 47 through 49 to determine the amount of your property tax credit. If you have another income tax or property tax credit liability, this property tax credit may be applied to that liability in accordance with Section 143.782, RSMo. You will be notified if your credit is offset against any debt.

20 INFORMATION TO COMPLETE FORM MO-CRP Form MO-CRP must be completed by taxpayers who rented their home and are submitting a Property Tax Credit Claim. If you rent from a tax exempt facility, you do not qualify. Step 1: Enter all information requested on Lines 1-5. If rent is paid

to a relative, the relationship to the landlord must be

indicated on Line 1. Your claim may be delayed if you fail

to enter all required information. Step 2: Enter on Line 6 the gross rent paid. Exclude rent paid

for any portion of your home used in the production of

income, and the rent paid for surrounding land with

attachments not necessary nor maintained for

homestead purposes. Also, exclude any rent paid to your

landlord on your behalf by any organization. Step 3: If you were a resident of a nursing home or boarding

home during 2021, use the applicable percentage on

Line 7. If you lived in a hotel and meals were included

in your rent payment, enter 50 percent; otherwise enter

100 percent. If two or more unmarried individuals over 18 years of age shared a residence and each paid part of the rent, enter the total rent on Form MO-CRP, Line 6 and select the appropriate percentage on box G of Line 7. If the rent receipt is for the total rent amount, then the percentage on box G of the Form MO-CRP must be used to determine your credit. If none of the reductions apply to you, enter 100

percent on Line 7. Step 4: Multiply Line 6 by the percentage on Line 7. Enter this amount on Form(s) MO-CRP, Line 8. Step 5: Multiply Line 8 by 20 percent and enter the result on Line 9. Add the totals from Line 9 on all completed Form(s) MO-CRP and enter the amount on Line 12 of Form MO-PTS.

Helpful Hints An apartment is a room or suite of rooms with separate facilities for cooking and other normal household functions. A boarding home is a house that provides meals, lodging, and the residents share common facilities. Federal Privacy Notice The Federal Privacy Act requires the Missouri Department of Revenue (Department) to inform taxpayers of the Department’s legal authority for requesting identifying information, including social security numbers, and to explain why the information is needed and how the information will be used. Chapter 143 of the Missouri Revised Statutes authorizes the Department to request information necessary to carry out the tax laws of the state of Missouri. Federal law 42 U.S.C. Section 405 (c)(2)(C) authorizes the states to require taxpayers to provide social security numbers. The Department uses your social security number to identify you and process your tax returns and other documents, to determine and collect the correct amount of tax, to ensure you are complying with the tax laws, and to exchange tax information with the Internal Revenue Service, other states, and the Multistate Tax Commission (Chapters 32 and 143, RSMo). In addition, statutorily provided non-tax uses are: (1) to provide information to the Department of Higher Education with respect to applicants for financial assistance under Chapter 173, RSMo and (2) to offset refunds against amounts due to a state agency by a person or entity (Chapter 143, RSMo). Information furnished to other agencies or persons shall be used solely for the purpose of administering tax laws or the specific laws administered by the person having the statutory right to obtain it [as indicated above]. In addition, information may be disclosed to the public regarding the name of a tax credit recipient and the amount issued to such recipient (Chapter 135, RSMo). (For the Department’s authority to prescribe forms and to require furnishing of social security numbers, see Chapters 135, 143, and 144, RSMo.) You are required to provide your social security number on your tax return. Failure to provide your social security number or providing a false social security number may result in criminal action against you.

21 For Calendar Year January 1 - December 31, 2021 2021 Individual Income Tax Return - Long Form Department Use Only Form MO-1040 Fiscal Year Beginning (MM/DD/YY) Fiscal Year Ending (MM/DD/YY) Age 62 through 64 Yourself Spouse Age 65 or Older Blind 100% Disabled Non-Obligated Spouse Yourself Spouse Yourself Spouse Yourself Spouse Yourself Spouse Amended Return Print in BLACK ink only and DO NOT STAPLE. Name Address If filing a fiscal year return enter the beginning and ending dates here. Composite Return Social Security Number Spouse’s Social Security Number - - M.I. In Care Of Name (Attorney, Executor, Personal Representative, etc.) County of Residence Present Address (Include Apartment Number or Rural Route) City, Town, or Post Office State ZIP Code Last Name in 2021 _ First Name Suffix Spouse’s Last Name Spouse’s First Name M.I. Suffix *21322010001* 21322010001 You may contribute to any one or all of the trust funds on Line 48. See pages 11-12 of the instructions for more trust fund information. Deceased Deceased in 2021 Name - - MO-1040 Page 1 0 Vendor Code 0 0 Single Married Filing Combined Married Filing Separately Head of Household Qualifying Widow(er) Claimed as a Dependent Filing Status (For use by S corporations or Partnerships) Federal Extension - Select this box if you have an approved federal extension. Attach a copy Federal Extension (Form 4868). Veterans Trust Fund Children’s Trust Fund Elderly Home Delivered Meals Trust Fund Missouri National Guard Trust Fund Workers Workers’ Memorial Fund LEAD Childhood Lead Testing Fund Missouri Military Family Relief Fund General Revenue General Revenue Fund Organ Donor Program Fund Soldiers Memorial Military Museum in St. Louis Fund Kansas City Regional Law Enforcement Memorial Foundation Fund

22 % 00 . % 6. Total Missouri adjusted gross income - Add columns 5Y and 5S . . . . . . . . . . . 7. Income percentages - Divide columns 5Y and 5S by total on Line 6. (Must equal 100%) . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7Y 7S 6 Exemptions and Deductions 00 . 8. Pension, Social Security and Social Security Disability exemption (from Form MO‑A, Part 3,

Section D) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 10. Other tax from federal return . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11. Total tax from federal return. Do not enter federal income tax withheld. 12. Federal tax percentage – Enter the percentage based on your 00 . 9 00 . 10 00 . 11 12 00 . 14 14. Missouri standard deduction or itemized deductions. (If itemizing, See Form MO-A, Part 2) • Single or Married Filing Separate-$12,550 • Head of Household-$18,800

*21322020001* 21322020001 Income Yourself (Y) Spouse (S) 1. Federal adjusted gross income from federal return (see worksheet on page 7 of the instructions) . . . . . . . . . . . . . 2. Total additions (from Form MO‑A, Part 1, Line 7) . . . . . . . . . . 3. Total income - Add Lines 1 and 2 . . . . . . . . . . . . . . . . . . . . . . 4. Total subtractions (from Form MO‑A, Part 1, Line 18) . . . . . . 5. Missouri adjusted gross income - Subtract Line 4 from Line 3 . 00 . 1S 00 . 1Y 00 . 5S 00 . 5Y 00 . 4S 00 . 4Y 00 . 3S 00 . 3Y 00 . 2S 00 . 2Y MO-1040 Page 2 9. Tax from federal return . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20. Transportation facilities deduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 00 . 20 19. Bring jobs home deduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 00 . 19 15. Long-term care insurance deduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 00 . 15 16. Health care sharing ministry deduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 00 . 16 17. Active Duty Military income deduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 00 . 17 A. Port Cargo Expansion B. International Trade Facility C. Qualified Trade Activities 00 . 13. Federal income tax deduction – Multiply Line 11 by the percentage on Line 12. Enter this amount not to exceed $5,000 for an individual or $10,000 for combined filers. . . . . . . . . . . . . . . 13 Missouri Adjusted Gross Income, Line 6. Use the chart below to Missouri Adjusted Gross Income Range, Line 6: Federal Tax Percentage: $25,000 or less.........................................................................35% $25,001 to $50,000..................................................................25% $50,001 to $100,000................................................................15% $100,001 to $125,000...............................................................5% $125,001 or more......................................................................0% find your percentage . . . . . . . . . . . . . . . . . . . . . . . . % 18. Inactive Duty Military income deduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 00 . 18 • Married Filing Combined or Qualifying Widow(er)-$25,100

23 *21322030001* 21322030001 Tax 00 . 27S 00 . 27Y 27. Taxable income - Subtract Line 26 from Line 25 . . . . . . . . . . . 00 . 28S 00 . 28Y 28. Tax (see tax chart on page 26 of the instructions) . . . . . . . . . . 00 . 29S 00 . 29Y

income tax return(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29. Resident credit - Attach Form MO‑CR and other states’

completing Form MO-NRI. Attach Form MO-NRI and a 30. Missouri income percentage - Enter 100% unless you are

copy of your federal return if less than 100% . . . . . . . . . . . . . 00 . 31S 00 . 31Y

multiply Line 28 by percentage on Line 30 . . . . . . . . . . . . . . . 31. Balance - Subtract Line 29 from Line 28; OR 00 . 32S 00 . 32Y 32. Other taxes - Select box and attach federal form indicated. Lump sum distribution (Form 4972) Recapture of low income housing credit (Form 8611) 00 . 33S 00 . 33Y 33. Subtotal - Add Lines 31 and 32 . . . . . . . . . . . . . . . . . . . . . . . 00 . 34 34. Total Tax - Add Lines 33Y and 33S . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Payments and Credits 35. MISSOURI tax withheld - Attach Forms W‑2 and 1099 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36. 2021 Missouri estimated tax payments - Include overpayment from 2020 applied to 2021 . . . . . . . . 37. Missouri tax payments for nonresident partners or S corporation shareholders - Attach Forms

MO-2NR and MO-NRP . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 00 . 35 00 . 36 00 . 37 30S % 30Y % MO-1040 Page 3 40. Miscellaneous tax credits (from Form MO-TC, Line 13) - Attach Form MO-TC . . . . . . . . . . . . . . . 00 . 40 41. Property tax credit - Attach Form MO-PTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 00 . 41 42. Total payments and credits - Add Lines 35 through 41 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 00 . 42 39. Amount paid with Missouri extension of time to file (Form MO-60) . . . . . . . . . . . . . . . . . . . . . . . . 00 . 39 38. Missouri tax payments for nonresident entertainers - Attach Form MO-2ENT . . . . . . . . . . . . . . . 00 . 38 00 . 22 22. Long Term Dignity Savings Account Deduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24. Subtotal - Subtract Line 23 from Line 6 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 00 . 24 00 . 26S 00 . 26Y 26. Enterprise zone or rural empowerment zone income

modification . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25. Multiply Line 24 by appropriate percentages (%) on 00 . 25S 00 . 25Y

Lines 7Y and 7S . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21. First Time Home Buyers deduction. A. B. 00 . 21 Deductions Continued 00 . 23 23. Total deductions - Add Lines 8 and 13 through 22 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

24 Refund 46. If Line 42, or if amended return, Line 45, is larger than Line 34, enter the difference. 00 . 46

Amount of OVERPAYMENT . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47. Amount of Line 46 to be applied to your 2022 estimated tax . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 00 . 47 48. Enter the amount of your donation in the trust fund boxes below. See instructions for additional trust fund codes. 49. Amount of Line 46 to be deposited into a Missouri 529 Education Plan (MOST) 00 . 49

account. Enter the total deposit amount from Form 5632 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . *21322040001* 21322040001 00 . 48

Skip Lines 43 through 45 if you are not filing an amended return. 43. Amount paid on original return . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 00 . 43 44. Overpayment as shown (or adjusted) on original return . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 00 . 44 D. Correction other than A, B, or C . . . . . . Indicate Reason for Amending A. Federal audit . . . . . . . . . . . . . . . . . . . . . B. Net Operating Loss carryback . . . . . . . . C. Investment tax credit carryback . . . . . . . 45. Amended return total payments and credits - Add Lines 42 and 43; subtract Line 44. 00 . 45

Enter on Line 45. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Enter date of federal amended return, if filed. (MM/DD/YY) Enter year of credit (YY) Enter year of loss (YY) Enter date of IRS report (MM/DD/YY)

Total Donation - Add amounts from Boxes 48a through 48m and enter here . . . . . . . . . . . . . . . . Amended Return MO-1040 Page 4 50. REFUND - Subtract Lines 47, 48, and 49 from Line 46 and enter here . . . . . . . . . . . . . . . . . . . . . 00 . 50 Reserved 00 . Children’s Trust Fund Veterans Trust Fund Elderly Home Delivered Meals Trust Fund 00 . 00 . Workers’ Memorial Fund Childhood Lead Testing Fund 00 . 00 . 00 . Organ Donor Program Fund 48a. 48b. 48c. 48e. 48f. 48i. 00 . 48l. Additional Fund Code Additional Fund Amount 00 . Kansas City Regional Law Enforcement Memorial Foundation Fund 48j. 00 . Soldiers Memorial Military Museum in St. Louis Fund 48k. 00 . Missouri National Guard Trust Fund 48d. 00 . 00 . General Revenue Fund Missouri Military Family Relief Fund 48g. 48h. 00 . 48m. Additional Fund Code Additional Fund Amount

25 Mail to: Balance Due: Refund or No Amount Due: Fax: (573) 522-1762

Missouri Department of Revenue Missouri Department of Revenue Email: income@dor.mo.gov

P.O. Box 329 P.O. Box 500

Jefferson City, MO 65105-0329 Jefferson City, MO 65105-0500

Phone: (573) 751-7200 Phone: (573) 751-3505

Ever served on active duty in the United States Armed Forces? If yes, visit dor.mo.gov/military/ to see the services and benefits we offer to all eligible military individuals. A list of all state agency resources and benefits can be found at veteranbenefits.mo.gov/state-benefits/. Yes No Preparer’s Telephone Signature Preparer’s Signature Spouse’s Signature (If filing combined, BOTH must sign) Daytime Telephone Date (MM/DD/YY) Preparer’s Address ZIP Code State I authorize the Director of Revenue or delegate to discuss my return and attachments with the preparer or any member of the preparer’s firm . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . E-mail Address Preparer’s FEIN, SSN, or PTIN Date (MM/DD/YY) Date (MM/DD/YY) *21322050001* 21322050001

electronically. Any returned check may be presented again electronically . . . . . . . . . . . . . . . . . . Amount Due 51. If Line 34 is larger than Line 42 or Line 45, enter the difference. 00 . 51

Amount of UNDERPAYMENT . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 52. Underpayment of estimated tax penalty - Attach Form MO-2210. Enter penalty amount here . . . 00 . 52 53. AMOUNT DUE - Add Lines 51 and 52. 00 . 53

If you pay by check, you authorize the Department of Revenue to process the check Signature FA E10 A DE Department Use Only F Select this box if you are a farmer exempt from the underpayment of estimated tax penalty. . MO-1040 Page 5

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. By signing or entering my name in the “Signature” field(s) below, I am providing

the Department of Revenue with my signature as required under Section 143.561, RSMo. Declaration of preparer (other than taxpayer) is

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.

based on all information of which he or she has 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 Yes No Did you pay a tax return preparer to complete your return, but the preparer failed to sign the return or provide an Internal Revenue Service preparer tax identification number? If you marked yes, please insert the preparer’s name, address, and phone number in the applicable sections of the signature block above. . . . . . . Visit dor.mo.gov/taxation/individual/tax-types/income/ for additional information. Form MO-1040 (Revised 12-2021)

26 2021 Tax Chart To identify your tax, use your Missouri taxable income from Form MO-1040, Line 27Y and 27S and the tax chart in Section A below. A separate tax must be computed for you and your spouse. Calculate your Missouri tax using the online tax calculator at dor.mo.gov/personal/individual/ or by using the worksheet in Section B below. Round to the nearest whole dollar and enter on Form MO-1040, Line 28Y and 28S. Section B Section A Tax Rate Chart Tax Calculation Worksheet

Yourself Spouse Example A Example B 1. Missouri taxable income (Form MO-1040, Lines 27Y and 27S) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ ______________ ______________ $ 3,090 $ 12,000 2. Enter the minimum taxable income for your tax bracket (see Section A above). If below $1,088 enter $0 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . - $ ______________ ______________ - $ 2,176 $ 8,704 3. Difference - Subtract Line 2 from Line 1 . . . . . . . . . = $ ______________ ______________ = $ 914 $ 3,296 4. Enter the percent for your tax bracket (see Section A above) . . . . . . . . . . . . . . . . . . . . . . . . . . X ______________ % ______________ % X 2.5%

5.4% 5. Multiply Line 3 by the percent on Line 4 . . . . . . . . . = $ ______________ ______________ = $ 22.85 $ 177.98 6. Enter the tax from your tax bracket - before applying the percent (see Section A above) . . . . . . + $ ______________ ______________ + $ 38 $ 283 7. Total Missouri Tax - Add Line 5 and 6. Enter here and on Form MO-1040, Lines 28Y and 28S . . . . . . = $ ______________ ______________ = $ 61 $ 461 ($60.85 rounded to the nearest dollar) ($460.98 rounded to the nearest dollar) 2021 Missouri Taxes Withheld Earnings Tax Diagram 1: Form W-2

If the Missouri taxable income is: The tax is: $0 to $108 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $0 At least $109 but not over $1,088 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.5% of the Missouri taxable income Over $1,088 but not over $2,176 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $16 plus 2.0% of excess over $1,088 Over $2,176 but not over $3,264 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $38 plus 2.5% of excess over $2,176 Over $3,264 but not over $4,352 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $65 plus 3.0% of excess over $3,264 Over $4,352 but not over $5,440 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $98 plus 3.5% of excess over $4,352 Over $5,440 but not over $6,528 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $136 plus 4.0% of excess over $5,440 Over $6,528 but not over $7,616 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $180 plus 4.5% of excess over $6,528 Over $7,616 but not over $8,704 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $229 plus 5.0% of excess over $7,616 Over $8,704 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $283 plus 5.4% of excess over $8,704

27 MO Public-Private Transportation Act *21340010001* 21340010001 Department Use Only (MM/DD/YY) 1. Interest on state and local obligations other than Missouri source . . . Other (description) 4. Food Pantry contributions included on Federal Schedule A . . . . . . . . Part 1 - Missouri Modifications to Federal Adjusted Gross Income Attach to Form MO‑1040. Attach your federal return. See information beginning on page 12 to assist you in completing this form. Additions 3. Nonqualified distribution received from a qualified 529 plan not used for

qualified expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6. Nonqualified distribution received from a qualified Achieving a Better

Life Experience Program (ABLE) not used for qualified expenses . . . . 7. Total Additions - Add Lines 1 through 6. Enter here and on Form Subtractions 8. Interest from exempt federal obligations included in federal adjusted

gross income - Attach a detailed list or all Federal Form(s) 1099 . . . . . 9. Any state income tax refund included in federal adjusted gross income. Other (description) 12. Exempt contributions made to a qualified 529 plan . . . . . . . . . . . . . . . 2. Partnership Fiduciary S Corporation Net Operating Loss (Carryback/Carryforward) 00 . 2Y 00 . 2S 00 . 1Y 00 . 1S 5. Nonresident Property Tax . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Partnership Fiduciary S Corporation 11. Build America and Recovery Zone Bond Interest Railroad Retirement Benefits Net Operating Loss Military (nonresident) Combat Pay 00 . 3Y 00 . 3S 00 . 4Y 00 . 4S 00 . 5Y 00 . 5S 00 . 6Y 00 . 6S 00 . 7Y 00 . 7S 00 . 8Y 00 . 8S 00 . 9Y 00 . 9S 00 . 11Y 00 . 11S 00 . 12Y 00 . 12S Social Security Number Spouse’s Social Security Number M.I. Last Name First Name Suffix Spouse’s Last Name Spouse’s First Name M.I. Suffix Name

MO-1040, Line 2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13. Qualified Health Insurance Premiums - Attach the Qualified Health 00 . 13Y 00 . 13S

Insurance Premiums Worksheet (Form 5695) and supporting - - - - Spouse (S) Yourself (Y) For Privacy Notice, see instructions.

documentation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . MO-A Page 1 Form MO-A 2021 Individual Income Tax Adjustments Business Interest Business Interest 10. Military Retirement Benefits (see Instructions on page 14) . . . . . . . . . . . 00 . 10Y 00 . 10S

28

Form MO-1040, Line 4 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . *21340020001* 21340020001 MO-A Page 2 Part 2 - Missouri Itemized Deductions 1. Total federal itemized deductions from Federal Form 1040 or Federal Form 1040-SR, Line 12a . . . . . . . . . . 3. 2021 Social security tax - (Spouse). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4. 2021 Railroad retirement tax - Tier I and Tier II (Yourself) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5. 2021 Railroad retirement tax - Tier I and Tier II (Spouse) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6. 2021 Medicare tax - Yourself and Spouse (see instructions on page 16) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7. 2021 Self-employment tax (see instructions on page 16) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8. Total - Add Lines 1 through 7 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9. State and local income taxes from Federal Schedule A, Line 5 or enter . 10. Earnings taxes included in Line 9. . . . . . . . . . . . . . . . . . . . . . . . . . . . 11. Net state income taxes - Subtract Line 10 from Line 9 or enter Line 7 from worksheet below . . . . . . . . . . . . . 12. Missouri Itemized Deductions - Subtract Line 11 from Line 8. Enter here and on Form MO-1040, Line 14 . . . 00 . 00 . 00 . 00 . 00 . 00 . 00 . 00 . 00 . 00 . 00 . 00 . Part 1 Continued 2. 2021 Social security tax - (Yourself). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 2 3 4 5 6 7 8 9 10 11 12

Complete this section only if you itemize deductions on your federal return. Attach your Federal Form 1040 (pages 1 and 2) and Federal Schedule A. 17. Business Income Deduction – see worksheet on page 16 . . . . . . . . .

16. Agriculture Disaster Relief . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Sold or disposed property previously taken as addition modification 14. Missouri depreciation adjustment (Section 143.121, RSMo.) 15. Exempt contributions made to a qualified Achieving a Better Life 00 . 14Y 00 . 14S 00 . 15Y 00 15S 00 . 16Y 00 16S 00 . 17Y 00 17S . . .

$0 if completing worksheet below . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Experience Program (ABLE) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18. Total Subtractions - Add Lines 8 through 17. Enter here and on 00 . 18Y 00 18S . 2. State and local income taxes from Federal Form 1040 or Federal Form 1040-SR, Schedule A, Line 5a. . . . . . . . 2 3. Earnings taxes included on Federal Form 1040 or Federal Form 1040-SR, Schedule A, Line 5a. . . . . . . . . 3 4. Subtract Line 3 from Line 2.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 5. Divide Line 4 by Line 1. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 % 6. Enter $10,000 ($5,000 if married filing separately). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 7. Multiply Line 6 by percentage on Line 5. Enter here and on Missouri Itemized Deductions, . . . . . . . . . 00 . 00 . 00 . 00 . 00 . Complete this worksheet only if your total state and local taxes included in your federal itemized deductions (Federal Schedule A, Line 5d) exceeds $10,000 (or $5,000 for married filing separate filers). Part 2 Worksheet - Net State Income Taxes, Line 11

Line 11, above. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 1. Enter the sum of your state and local taxes on Federal Form 1040 or Federal Form 1040-SR, 00 .

Schedule A, Line 5d. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

29

1 through 8 of Section C, and enter the amount(s) from Line(s) 6Y 5. Subtract Line 4 from Line 3 and enter on Line 5. If Line 4 is greater than Line 3, enter $0 . . . . . . . . . . . . . . . . 6. Taxable pension for each spouse from public sources from Federal 7. Amount from Line 6 or $39,365 (maximum social security benefit), Private Pension Calculation - Annuities, pensions, IRAs, and 401(k) plans funded by a private source. 8. If you received taxable social security, complete Form MO-A, Lines

and 6S. See instructions if Line 3 of Section C is more than $0 . . . . . 9. Subtract Line 8 from Line 7. If Line 8 is greater than Line 7, enter $0. . 10. Add amounts on Lines 9Y and 9S . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11. Total public pension, subtract Line 5 from Line 10. If Line 5 is greater than Line 10, enter $0 . . . . . . . . . . . . . Part 3 - Section B 1. Missouri adjusted gross income from Form MO-1040, Line 6 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2. Taxable social security benefits from Federal Form 1040 or Federal Form 1040-SR, Line 6b . . . . . . . . . . . . . 3. Subtract Line 2 from Line 1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4. Select the appropriate filing status and enter the amount on Line 4.

• Married Filing Combined (joint federal) - $32,000 5. Subtract Line 4 from Line 3. If Line 4 is greater than Line 3, enter $0 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7. Amounts from Line 6Y and 6S or $6,000, whichever is less . . . . . . . . 8. Add Lines 7Y and 7S . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9. Total private pension, subtract Line 5 from Line 8. If Line 5 is greater than Line 8, enter $0 . . . . . . . . . . . . . . *21340030001* 21340030001 00 . 00 . 00 . 00 . 00 . 00 . 00 . 00 . 00 .

Form 1040 or Federal Form 1040-SR, Line 5b . . . . . . . . . . . . . . . . .

whichever is less . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 00 . Public Pension Calculation - Pensions received from any federal, state, or local government. Part 3 - Pension and Social Security/Social Security Disability Part 3 - Section A 1. Missouri adjusted gross income from Form MO-1040, Line 6 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2. Taxable social security benefits from Federal Form 1040 or Federal Form 1040-SR, Line 6b . . . . . . . . . . . . . 3. Subtract Line 2 from Line 1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 00 . 00 . 00 . 00 . 1 2 3 4 5 10 11 1 2 3 4 5 8 9 6. Taxable pension for each spouse from private sources from

Federal Form 1040 or Federal Form 1040-SR, Line 4b and 5b . . . . . 00 . 6Y 00 . 6S 00 . 7Y 00 . 7S 00 . 8Y 00 . 8S 00 . 9Y 00 . 9S 00 . 6Y 00 . 6S 00 . 7Y 00 . 7S

• Single, Head of Household, and Qualifying Widow(er) - $25,000

• Married Filing Separate - $16,000 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4. Select the appropriate filing status and enter amount on Line 4.

• Married Filing Combined (joint federal) - $100,000

• Single, Head of Household, Married Filing Separate, and Qualifying Widow(er) - $85,000 . . . . . . . . . . . . MO-A Page 3

30 Enter total amount here and on Form MO-1040, Line 8. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Total Pension and Social Security/Social Security Disability Part 3 - Section D Add Line 11 (Section A), Line 9 (Section B), and Line 8 (Section C) from Form MO-A. *21340040001* 21340040001 00 . Part 3 - Section C 1. Missouri adjusted gross income from Form MO-1040, Line 6 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2. Select the appropriate filing status and enter the amount on Line 2.

• Married Filing Combined (joint federal) - $100,000 3. Subtract Line 2 from Line 1 and enter on Line 3. If Line 2 is greater than Line 1, enter $0 . . . . . . . . . . . . . . . . 4. Taxable social security benefits for each spouse from 5. Taxable social security disability benefits for each spouse from 6. Amount from Line(s) 4Y or 5Y, and 4S or 5S . . . . . . . . . . . . . . . . . . . 7. Add Lines 6Y and 6S . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8. Total social security/social security disability, subtract Line 3 from Line 7. If Line 3 is greater than Line 7, 00 . 00 . 00 . 00 . 00 .

enter $0 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Federal Form1040 or Federal Form 1040-SR, Line 6b . . . . . . . . . . .

Federal Form 1040 or 1040-SR, Line 6b . . . . . . . . . . . . . . . . . . . . . . . 1 2 3 7 8

Social Security or Social Security Disability Calculation - To be eligible for social security deduction you must be 62 years of age by 00 . 4Y 00 . 4S 00 . 5Y 00 . 5S 00 . 6Y 00 . 6S

• Single, Head of Household, Married Filing Separate, and Qualifying Widow(er) - $85,000 . . . . . . . . . . . .

December 31 and have selected the 62 and older box on page 1 of Form MO-1040. Age limit does not apply to social security disability deduction. Attach to Form MO‑1040. Attach your federal return. Instructions for Part 2 and 3 begin on page 16. MO-A Page 4 (Revised 12-2021) Ever served on active duty in the United States Armed Forces? If yes, visit dor.mo.gov/military/ to see the services and benefits we offer to all eligible military individuals. A list of all state agency resources and benefits can be found at veteranbenefits.mo.gov/state-benefits/. Note: Beginning with tax year 2021, there is no longer a calculation for computing a military pension exemption since 100% of military retirement benefits can be subtracted from federal adjusted gross income. (The military retirement benefits must be included on your federal return, Line 5b). Please use MO-A, Part 1, Line 10 to claim your military subtraction.

31 For Privacy Notice, see Instructions. Name Spouse’s Name Yourself (Y) Spouse (S) 1. Claimant’s total adjusted gross income (Form MO-1040, Line 5Y 2. Claimant’s Missouri income tax (Form MO-1040, Line 28Y and 3. Wages and commissions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5. Total - Add Lines 3 and 4 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6. Less, related adjustments (Federal Form 1040 or 1040-SR, . . .

Line 10) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7. Net amounts - Subtract Line 6 from Line 5 . . . . . . . . . . . . . . . . . . 28S). Use the two letter abbreviation for the state or name of 8. Percentage of your income taxed - Divide Line 7 by Line 1 . . . . . 9. Maximum credit - Multiply Line 2 by percentage on Line 8 . . . . . . 10. Income tax you paid to another state or political subdivision.

before entering on Form MO-1040 . . . . . . . . . . . . . . . . . . . . . . . . Attach Form MO-CR and all income tax returns for each state or political subdivision to Form MO-1040. Complete this form if you or your spouse have income from another state or political subdivision. If you had multiple credits, complete a separate form for each state or political subdivision. State of: State of: Form MO-CR (Revised 12-2021) 4. Other income (Describe nature ________________________ ) . . Social Security Number Spouse’s Social Security Number - - - - 00 . 11S 00 . 11Y % % 11. Credit - Enter the smaller amount of Line 9 or Line 10 here and

credits, add the amounts on Line 11 from each Form MO-CR

on Form MO-1040, Line 29Y or Line 29S. If you have multiple

all credits, except withholding and estimated tax . . . . . . . . . . . . .

This is not income tax withheld. The income tax is reduced by 00 . 10S 00 . 10Y 00 . 9S 00 . 9Y 00 . 8S 00 . 8Y 7S 7Y 00 . 6S 00 . 6Y 00 . 5S 00 . 5Y 00 . 4S 00 . 4Y 00 . 3S 00 . 3Y ________________________________________________ abbreviation, or enter the name of the political subdivision below. political subdivision. See the table on back for the two letter 00 . 2S 00 . 2Y

and Line 5S) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 00 . 1S 00 . 1Y 2021 Credit for Income Taxes Paid To Other States or Political Subdivisions Form MO-CR

32 Two Letter Abbreviations for States Complete this form if you are a Missouri resident, resident estate, or resident trust with income from another state(s). A part-year resident may elect to use this form to determine his or her tax as if he or she were a resident for the entire taxable year. If you pay tax to more than one state, you must complete a separate Form MO-CR for each state. Before you begin:

• Complete your Missouri return, Form MO-1040 (Lines 1 through 28).

• Complete the other state’s return(s) to determine the amount of income tax you paid to the other state(s). Line 1 - Enter the amount from Form MO-1040, Line 5Y and 5S. Line 2 - Enter the amount from Form MO-1040, Line 28Y and 28S. Lines 3 and 4 - Enter the total amount of wages, commissions, and other income you or your spouse received from the other

state(s), as reported on the other state(s) return. Line 5 - Add Lines 3 and 4; enter the total on Line 5. Line 6 - Enter any federal adjustments from:

• Federal Form 1040 or 1040-SR, Line 10 Line 7 - Subtract Line 6 from Line 5. Enter the difference on Line 7. Line 8 - Divide Line 7 by Line 1. If greater than 100 percent, enter 100 percent. Round in whole percent, such as 91 percent

instead of 90.5 percent. If percentage is less than 0.5 percent, use exact percentage. Enter percentage on Line 8. Line 9 - Multiply Line 2 by percentage on Line 8. Enter amount on Line 9. Line 10 - Enter your income tax liability as reported on the other state(s) income tax return. This is not income tax withheld. The

income tax entered must be reduced by all credits, except withholding and estimated tax. If both you and your spouse

paid income tax to the other state(s), each must claim his or her own portion of the tax liability. Line 11 - Enter the smaller amount from Form MO-CR, Line 9 or Line 10. This is your Missouri resident credit. Enter the amount

on Form MO-1040, Line 29Y and 29S. (If you have multiple credits, add the amounts on Line 11 from each MO-CR).

Your total credit cannot exceed the tax paid or the percent of tax due to Missouri on that part of your income. Information to complete Form MO-CR AL - Alabama AK - Alaska AZ - Arizona AR - Arkansas CA - California CO - Colorado CT - Connecticut DC - District of Columbia DE - Delaware FL - Florida GA - Georgia HI - Hawaii ID - Idaho IL - Illinois IN - Indiana IA - Iowa KS - Kansas KY - Kentucky LA - Louisiana ME - Maine MD - Maryland MA - Massachusetts MI - Michigan MN - Minnesota MS - Mississippi MT - Montana NE - Nebraska NV - Nevada NH - New Hampshire NJ - New Jersey NM - New Mexico NY - New York NC - North Carolina ND - North Dakota OH - Ohio OK - Oklahoma OR - Oregon PA - Pennsylvania RI - Rhode Island SC - South Carolina SD - South Dakota TN - Tennessee TX - Texas UT - Utah VT - Vermont VA - Virginia WA - Washington WV - West Virginia WI - Wisconsin WY - Wyoming Ever served on active duty in the United States Armed Forces? If yes, visit dor.mo.gov/military/ to see the services and benefits we offer to all eligible military individuals. A list of all state agency resources and benefits can be found at veteranbenefits.mo.gov/state-benefits/.

33 Attach Federal Return. See instructions and diagram on page 3 of Form MO-NRI. Part A Resident/Nonresident Status - Select your status in the appropriate box below. Name Address City, State, ZIP Code Social Security Number - - Spouse’s Name Address City, State, ZIP Code Spouse’s Social Security Number - - 1. Nonresident of Missouri

State of residence during 2021 _____________________ 2. Part-Year Missouri Resident Indicate the dates you were a Missouri Resident in 2021. A. Date From: ________________ Date To: ______________ B. Indicate the other state of residence Based on the Military Spouse’s Residency Relief Act, if you are the spouse of a military servicemember residing outside of Missouri solely because your spouse is there on military orders, and Missouri is your state of residence, any income you earn is taxable to Missouri. Do not complete Form MO-NRI. You must report 100% on Line 30 of Form MO-1040. 3. Military/Nonresident Tax Status - Indicate your tax status Missouri Home of Record

below and complete Part C - Missouri Income Percentage. I did not at any time during the tax year 2021 maintain a permanent place of abode in Missouri, nor did I spend more than 30 days in Missouri during the year. I did maintain a permanent place of abode in the state of ______________ . Non-Missouri Home of Record I resided in Missouri during 2021 solely because my spouse or I was stationed at ______________________________ on military orders. My home of record is in the state of

and dates you resided there __________________________ For Privacy Notice, see Instructions.

Date From: ________________ Date To: ______________ ______________ . 3. Military/Nonresident Tax Status - Indicate your tax status Missouri Home of Record

below and complete Part C - Missouri Income Percentage. I did not at any time during the tax year 2021 maintain a permanent place of abode in Missouri, nor did I spend more than 30 days in Missouri during the year. I did maintain a permanent place of abode in the state of ______________ . Non-Missouri Home of Record I resided in Missouri during 2021 solely because my spouse or I was stationed at ______________________________ on military orders. My home of record is in the state of ______________ . MO-NRI Page 1 2021 Missouri Income Percentage Form MO-NRI Remote Work (See instructions on Form MO-NRI, page 3) Remote Work (See instructions on Form MO-NRI, page 3) 1. Nonresident of Missouri

State of residence during 2021 _____________________ 2. Part-Year Missouri Resident Indicate the dates you were a Missouri Resident in 2021. A. Date From: ________________ Date To: ______________ B. Indicate the other state of residence

and dates you resided there __________________________

Date From: ________________ Date To: ______________ Remote Work (See instructions on Form MO-NRI, page 3) Remote Work (See instructions on Form MO-NRI, page 3)

34 2a 00 Q 00 00 00 Part B Worksheet for Missouri Source Income Adjusted Gross Income Computations A. Wages, salaries, tips, etc. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . B. Taxable interest income . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . C. Dividend income . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . D. State and local income tax refunds (from schedule 1, part 1) . . . . . . . E. Alimony received (from schedule 1, part 1) . . . . . . . . . . . . . . . . . . . . F. Business income or (loss) (from schedule 1, part 1) . . . . . . . . . . . . . . G. Capital gain or (loss) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . H. Other gains or (losses) (from schedule 1, part 1) . . . . . . . . . . . . . . . . . A . A I. Taxable IRA distributions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . J. Taxable pensions and annuities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . K. Rents, royalties, partnerships, S corporations, etc. (from schedule 1, part 1) L. Farm income or (loss) (from schedule 1, part 1) . . . . . . . . . . . . . . . . . M. Unemployment compensation (from schedule 1, part 1) . . . . . . . . . . . N. Taxable social security benefits . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . O. Other income (from schedule 1, part 1) . . . . . . . . . . . . . . . . . . . . . . . . P. Total - Add Lines A through O . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Q. Less: federal adjustments to income . . . . . . . . . . . . . . . . . . . . . . . . . . R. SUBTOTAL (Line P - Line Q) If no modifications to income, S. Missouri modifications - additions to federal adjusted gross income T. Missouri modifications - subtractions from federal adjusted gross income

enter this amount on Part C, Line 1 . . . . . . . . . . . . . . . . . . . . . . . . . . .

(Missouri source from Form MO-1040, Line 2) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

(Missouri source from Form MO-1040, Line 4) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . U. MISSOURI INCOME (Missouri sources) Line R plus Line S, less

Line T. Enter this amount on Part C, Line 1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yourself or One Income Filer Spouse (On A Combined Return) Missouri Sources Missouri Sources Federal Form 1040 or Federal Form 1040-SR Line No. . 00 T . 00 T . 00 S . 00 S . 00 R . 00 R Q P P O O N N M M L L K K J J I I H H G G F F E E D D C C B B . 00 U . 00 U 11 10 9 6b 7 6 5 5b 4b 4 7 3 1 1 3b 2b Part C Missouri Income Percentage 1. Missouri Income - Enter wages, salaries, etc. from Missouri. (You must

file a Missouri return if the amount on this line is more than $600) . . . . . . . . . 2. Taxpayer’s total adjusted gross income (from Form MO-1040, Lines 5Y

and 5S or from your federal form if you are a military nonresident and you

are not required to file a Missouri return) . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3. Missouri Income Percentage - Divide Line 1 by Line 2. If greater than

100%, enter 100%. (Round to a whole percent such as 91% instead of

90.5% and 90% instead of 90.4%. However, if percentage is less than

0.5%, use the exact percentage.) Enter percentage here and on Form 3Y % Yourself or One Income Filer Spouse (On A Combined Return) Signature Under penalties of perjury, I declare that I have examined this form and to the best of my knowledge and believe it is true, correct, and complete. Declaration of preparer (other than taxpayer) is based on all information of which he/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. Signature Date (MM/DD/YY) Spouse’s Signature (if filing combined, BOTH must sign) Date (MM/DD/YY) 1S 00 . 1Y 00 . 2S 00 . 2Y 00 .

MO-1040, Lines 30Y and 30S . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 . . . . . . . . . . . . . . . . . 00 . 00 . 00 . 00 . 00 . 00 . 00 . 00 . 00 . 00 . 00 . 00 . 00 . 00 . . 3S % MO-NRI Page 2 Ever served on active duty in the United States Armed Forces? If yes, visit dor.mo.gov/military/ to see the services and benefits we offer to all eligible military individuals. A list of all state agency resources and benefits can be found at veteranbenefits.mo.gov/state-benefits/.

35 Instructions - MO-NRI, Part A Part A, Line 1: Nonresidents of Missouri If you are a Missouri nonresident and had Missouri source income, complete Part A, Line 1, Part B, and Part C. Attach a copy of your federal return, Form(s) W-2 and 1099 and this form to your Missouri return. If you performed ‘remote work’ for a Missouri employer outside of Missouri during 2021, this income is not taxable to Missouri. Check the Remote Work box under Part A, Line 1, and complete Part B and C. Part A, Line 2: Part-Year Resident If you were a Missouri part-year resident with Missouri source income and income from another state, you may use Form MO-NRI or Form MO-CR, whichever is to your benefit. When using Form MO-NRI, complete Part A, Line 2, Part B, and Part C. Missouri source income includes any income (pensions, annuities, etc.) that you received while living in Missouri. Attach a copy of your federal return, Form(s) W-2 and 1099 and this form to your Missouri return. If you performed ‘remote work’ for a Missouri employer outside of Missouri during 2021, the portion of income earned while working outside Missouri is not taxable to Missouri. Check the Remote Work box under Part A, Line 2, and complete Part B and C. Part A, Line 3: Military Nonresident Tax Status Missouri Home of Record - If you have a Missouri home of record and you: a) Did not have any Missouri income other than military income, were not in Missouri for more than 30 days, did not maintain a

home in Missouri during the year, but did maintain living quarters elsewhere, you qualify as a nonresident for tax purposes.

Complete Part A, Line 3 and enter “0” on Part C, Line 1. b) Did have Missouri income other than military income, were in Missouri for more than 30 days or maintained a home in Missouri during the year, you cannot use this form. You must file Form MO-1040 because 100 percent of your income is taxable, including your military income. Do not complete this form. c) Did not have Missouri income other than military income but spent more than 30 days in Missouri or maintained a home in Missouri during the year, you must file Form MO-1040 because 100 percent of your income is taxable, including your military income. Do not complete this form. d) Are married to a Missouri resident, who is not in the military, but lives with you outside of Missouri on military orders, you may use Form MO-NRI to calculate your Missouri income percentage. However, any income earned by your spouse is taxable to Missouri. Your spouse is not eligible to complete Form MO-NRI. Military Nonresident Stationed in Missouri - If you are a military nonresident, stationed in Missouri and you: a) Earned non-military income while in Missouri - You must file Form MO-1040. Complete Part A, Line 3, Part B and Part C. The nonresident military pay should be subtracted from your federal adjusted gross income using Form MO-A, Part 1, Line 11, as a “Military (nonresident)” subtraction. b) Only had military income while in Missouri - You may complete a Military - No Return Required Form online at

mytax.mo.gov/rptp/portal/business/military-noreturn. Note: If you file a joint federal return, you must file a combined Missouri return (regardless of whom earned the income).

Complete each column of Part B and Part C of this form. Do not combine incomes for you and your spouse. 1. Did you maintain a permanent place of residency in Missouri? 2. Did you spend more than 30 days in Missouri? You are a Resident. Did you maintain a permanent place of residency elsewhere? 1. Did you maintain a permanent place of residency in Missouri? 2. Did you spend more than 183 days in Missouri? Are you domiciled* in Missouri? NO YES NO to both YES to either You are a Nonresident (for tax purposes). You are a Resident. You are a Nonresident. You are a Resident. NO to either YES to both NO YES Use this diagram to determine if you or your spouse are a RESIDENT OR NONRESIDENT *Domicile (Home of Record) - The place an individual intends to be his or her permanent home; a place that he or she intends to return whenever absent. A domicile, once established, continues until the individual moves to a new location with the true intention of making his or her permanent home there. An individual can only have one domicile at a time. MO-NRI Page 3

36 Yourself (Y) Spouse (S) 1. Enter the amount from Federal Form 1040 or Federal Form 1040-SR, Line 6a. If $0, skip to Line 6 and enter

your total health insurance premiums paid . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 00 . 1 Complete this worksheet and attach it, along with proof of premiums paid, to Form MO-1040 if you included health insurance premiums paid as an itemized deduction or had health insurance premiums withheld from your social security benefits. If you had premiums withheld from your social security benefits, complete Lines 1 through 4 to determine your taxable percentage of social security 2. Enter amount from Federal Form 1040 or Federal Form 1040-SR, Line 6b. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 00 . 4S 00 . 4Y 3. Divide Line 2 by Line 1. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 00 . 2 3 4. Enter the health insurance premiums withheld from your social

security income . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5. Multiply the amounts on Line 4Y and 4S by the percentage on Line 3. . . . 6. Enter the total of all other health insurance premiums paid, which

were not included on 4Y or 4S . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7. Add the amounts from Lines 5 and 6 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 00 . 5S 00 . 5Y 00 . 6S 00 . 6Y 00 . 7S 00 . 7Y 8. Add the amounts from Lines 7Y and 7S . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 00 . 8 9. Divide Line 7Y and 7S by the total found on Line 8. If you itemized 9S 9Y

on your federal return and your federal itemized deductions included

health insurance premiums as medical expenses, go to Line 10.

If not, go to Line 15 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10. Enter the amount from Federal Schedule A, Line 1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 00 . 10 11. Enter the amount from Federal Schedule A, Line 4. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 00 . 11 12. Divide Line 11 by Line 10 (round to full percent) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12 % 13. Multiply Line 8 by percent on Line 12 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 00 . 13 14. Subtract Line 13 from Line 8 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 00 . 14 15. Enter your federal taxable income from Federal Form 1040 or Federal Form 1040-SR, Line 15 . . . . . . . . . . . . 00 . 15 16. If you itemized on your federal return and completed Lines 10 through 14 above, enter the amount from 00 . 16

Line 14 or Line 15, whichever is less. If not, enter the amount from Line 8 or Line 15, whichever is less . . . . . . 17. Multiply Line 16 by the percentage on Line 9Y and Line 9S.

Enter the amounts on Line 17Y and 17S of this worksheet on Line 13 Form 5695 (Revised 04-2022) income and the corresponding taxable portion of your health insurance premiums included in your taxable income.

of Form MO-A . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 00 . 17S 00 . 17Y % % % Social Security Number - - Spouse’s Social Security Number - - Form 5695 Qualified Health Insurance Premiums Worksheet for MO-A Ever served on active duty in the United States Armed Forces? If yes, visit dor.mo.gov/military/ to see the services and benefits we offer to all eligible military individuals. A list of all state agency resources and benefits can be found at veteranbenefits.mo.gov/state-benefits/.

37 For Privacy Notice, see Instructions. MO-PTS Page 1 This form must be attached to Form MO-1040. *21323010001* 21323010001 Department Use Only (MM/DD/YY) Social Security Number Spouse’s Social Security Number Date of Birth (MM/DD/YYYY) Spouse’s Date of Birth (MM/DD/YYYY) Select only one qualification. Copies of letters, forms, etc., must be included with claim. A. 65 years of age or older - You must be a full year resident. (Attach Form SSA-1099.) B. 100% Disabled Veteran as a result of military service (Attach letter from Department of Veterans Affairs - see instructions.) C. 100% Disabled (Attach letter from Social Security Administration or Form SSA-1099.) D. 60 years of age or older and received surviving spouse benefits (Attach Form SSA-1099.) Qualifications Select only one filing status. If your filing status on Form MO-1040 is head of household, you will select single filing status below. If married filing combined, you must report both incomes. 1. Enter the amount of income from Form MO-1040, Line 6. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2. Enter the amount of nontaxable 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 Form(s) SSA-1099 or RRB-1099 (TIER I) . . . . . . . . . . . . . . . . . . . . . 3. Enter the total amount of pensions, annuities, dividends, rental income, unemployment compensation, or interest income not included in Line 1. Include tax exempt interest from MO-A, Part 1, Line 8 (if filing 4. Enter the amount of railroad retirement benefits (not included in Line 2) before any deductions. Attach Form RRB-1099-R (Tier II). If filing Form MO-1040, refer to MO-A, Part 1, Line 11 . . . . . Attach letter from Veterans Affairs. See instructions, MO-1040. . . . . . . . . . . . . . . . . . . . . . . . . . . . . Filing Status Form MO-1040). Attach Form(s) W-2, 1099, 1099-G, 1099-R, 1099-MISC, 1099-INT, 1099-DIV, etc 1 2 3 4 5 Income 00 . 00 . 00 . 00 . 00 . 5. Enter the amount of veterans payments or benefits before any deductions. Single Married - Filing Combined Married - Living Separate for Entire Year M.I. Last Name First Name M.I. Last Name Spouse’s First Name - - - - Failure to provide the required attachment(s) will result in the delay or denial of your return. 2021 Property Tax Credit Schedule Form MO-PTS

38 *21323020001* 21323020001 9. Enter the appropriate amount from the options below . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10. Net household income - Subtract Line 9 from Line 8 and enter the amount here . . . . . . . . . . . . . • If you rented or did not own and occupy your home for the entire year and Line 10 is

greater than $27,200 , you are not eligible to file this claim. • If you owned and occupied your home for the entire year and Line 10 is greater

than $30,000, you are not eligible to file this claim. 11. 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 the 12. If you rented, enter the total amount from Certification of Rent Paid (Form(s) MO-CRP), Line 9

or $750, whichever is less. Attach a completed Verification of Rent Paid (Form 5674).

Note: If you rent from a facility that does not pay property tax, you are not eligible for a 13. Enter the total of Lines 11 and 12, or $1,100, whichever is less . . . . . . . . . . . . . . . . . . . . . . . . . . 14. Apply Lines 10 and 13 to the chart in the instructions for MO-1040, pages 47-49 to figure your

Property Tax Credit. You must use the chart to see how much credit you are allowed.

Enter this amount on Form MO-1040, Line 41. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . This form must be attached to Form MO-1040. 11 12 14 13 Income (continued) Real Estate or Rent Credit 8. Total household income - Add Lines 1 through 7 and enter the total here . . . . . . . . . . . . . . . . . 8 00 . 9 00 . 10 00 . 00 . 00 . 00 . 00 .

Assessor’s Certification (Form 948) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7. Enter the amount of nonbusiness loss(es). You must include nonbusiness loss(es) in your household income (as a positive amount) here. (Include capital loss from Federal Form 1040 or 7 00 . 6. Enter the total amount received by you, your spouse, and your minor children from: public assistance, SSI, child support, or Temporary Assistance payments (TA and TANF). Attach a letter from the Social Security Administration that includes the total amount of assistance received if applicable . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 00 . • Single or Married Living Separate - Enter $0 • Married and Filing Combined - rented or did not own your home for the entire year - Enter $2,000 • Married and Filing Combined - owned and occupied your home for the entire year - Enter $4,000 K R A U Department Use Only

Property Tax Credit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1040-SR) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Ever served on active duty in the United States Armed Forces? If yes, visit dor.mo.gov/military/ to see the services and benefits we offer to all eligible military individuals. A list of all state agency resources and benefits can be found at veteranbenefits.mo.gov/state-benefits/.

39 For Privacy Notice, see instructions. 2021 Certification of Rent Paid Form MO-CRP 1. Social Security Number Form MO-CRP (Revised 12-2021) *21315010001* 21315010001 Spouse’s Social Security Number 5. Rental Period During Year From: (MM/DD/YY) To: (MM/DD/YY) 8. Net rent paid - Multiply Line 6 by the percentage on Line 7 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9. Multiply Line 8 by 20%. Enter amount here and on Line 10 of Form MO-PTC or Line 12 of Form MO-PTS . . . . . . . 00 . Taxation Division Attach to Form MO-PTC or MO-PTS and mail to the Missouri Department of Revenue. 00 . 7. Select the appropriate box below and enter the corresponding percentage on Line 7 . . . . . . . . . . . . . . . . . . . . . . . . A. Apartment, House, Mobile Home, or Duplex - 100% F. Low Income Housing - 100% (Rent cannot exceed 40% of total B. Mobile Home Lot - 100% C. Boarding Home or Residential Care - 50% G. Shared Residence – If you shared your rent with relatives or friends D. Skilled or Intermediate Care Nursing Home - 45% E. Hotel - 100%; if meals are included - 50% Select this box if related to your landlord. If so, explain. 2. Name (First, Last) Physical Address of Rental Unit (P.O. Box Not Allowed) Apartment Number 3. Landlord’s Name (First, Last) Landlord’s Street Address (Must be completed) 4. Landlord’s Phone Number (Must be completed) City State ZIP Code 1 (50%) 2 (33%) 3 (25%) 8 9 One Form MO-CRP must be provided for each rental location in which you resided. Failure to provide landlord information will result in denial or delay of your claim.

household income.)

(other than your spouse or children under 18), select the appropriate

box based on the additional person(s) sharing rent: City State ZIP Code - - - - Apartment Number %

you are not eligible for a Property Tax Credit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

assistance, enter the amount of rent you paid. Note: If you rent from a facility that does not pay property tax, 6. Enter your gross rent paid. Attach a completed Verification of Rent Paid (Form 5674). If you received housing 00 . 6 7 Ever served on active duty in the United States Armed Forces? If yes, visit dor.mo.gov/military/ to see the services and benefits we offer to all eligible military individuals. A list of all state agency resources and benefits can be found at veteranbenefits.mo.gov/state-benefits/. 2021 2021

40 For Privacy Notice, see instructions. Missouri Tax I.D. Number Federal Employer I.D. Number Form MO-TC (Revised 12-2021) Social Security Number Name (Last, First) Spouse’s Social Security Number Spouse’s Name (Last, First) Use Column 1 if you are filing: • An individual income tax return with a single type filing status; • A fiduciary return; or, • A corporation income tax return. I 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. I also declare that if I am a business entity, I participate in a federal work authorization program with respect to the employees working in connection with any contracted services and I do not knowingly employ any person who is an unauthorized alien in connection with any contracted services. Instructions *21306010001* 21306010001 Charter Number Corporation Name Department Use Only (MM/DD/YY) 1. 1. 00 00 2. 2. 00 00 3. 3. 00 00 4. 4. 00 00 5. 5. 00 00 6. 6. 00 00 7. 7. 00 00 8. 8. 00 00 9. 9. 00 00 10. 10. 00 00 11. Subtotals - add Lines 1 through 10.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11. 00 00 12. Enter the amount of the tax liability from Form MO-1040, Line 33Y for yourself and Line 33S for your spouse,

or Form MO‑1120, Line 17 or Form MO‑1041, Line 15.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12. 00 00 13. Total Credits - add amounts from Line 11, Columns 1 and 2. (Enter here and on Form MO‑1120, Line 18; Form MO‑1040, Line 40; or Form MO‑1041, Line 16.) Line 13 cannot exceed the amount on Line 12, unless the credit is refundable.. . . . . . . . . 13. 00 • Yourself • Corporation Income • Fiduciary • Spouse (on a combined return)

Column 1 Column 2 Alpha Code (3 characters) from the next page Benefit Number (See example above) Credit Name Each credit will apply against your tax liability in the order they appear below. If you are a shareholder or partner claiming a credit, attach a copy of the shareholder listing or Federal Schedule K-1, specifying your percentage and the corporation’s percentage of ownership. If you are filing a combined return and both you and your spouse have income: • Use Column 1 for yourself and Column 2 for spouse. • Both names must be on the credit certificate. Use this form to claim income tax credits on Form MO‑1040, MO‑1120, or MO‑1041. Attach to Form MO‑1040, MO‑1120, or MO‑1041. 2021 Miscellaneous Income Tax Credits Form MO-TC • Benefit Number - The number is the last six (6) digits of the number located on your Certificate of Eligibility. Example: For benefit, ABC-2018-12345-123456, enter 123456, on Form MO-TC. • Alpha code - The three (3) character code located on the next page of this form. Each credit is assigned an alpha code to ensure proper processing of the credit claimed.

• If you are claiming more than 10 credits, attach additional MO-TC(s) • The sum of the tax credits claimed in Column 1 or Column 2 cannot

exceed the applicable tax liability, unless the credit is refundable.

41 * Must be approved by the issuing agency Individuals with speech or hearing impairments may call TTY (800) 735-2966 or fax (573) 522-1762. Miscellaneous tax credits are administered by various agencies. For more information, forms, and approval to claim these credits, contact the following Departments. Visit dor.mo.gov/tax-credits/ for a description of each credit and more contact information for agencies administering each credit. Missouri Department of Economic Development Missouri Department of Revenue Form MO-TC (Revised 12-2021) *21000000001* 21000000001 Form MO-TC (Revised 12-2021) Ever served on active duty in the United States Armed Forces? If yes, visit dor.mo.gov/military/ to see the services and benefits we offer to all eligible military individuals. A list of all state agency resources and benefits can be found at veteranbenefits.mo.gov/state-benefits/. P.O. Box 2200, Jefferson City, MO 65105-2200 dor.mo.gov • (573) 751-3220 Alpha Attach to Code Name of Credit Form MO-TC ATC Special Needs Adoption Form ATC, and

Federal Form 8839 BFT Bank Franchise Tax Form INT-2, INT-2-1 BTC Bank Tax Credit for S Corporation Form BTC, and Form

Shareholders INT-3,

2823, INT-2, Fed. K-1 CFC Champion for Children Contribution

Verification from

Issuing Agency DAC Disabled Access Federal Form 8826 and Form MO-8826 DAT Residential Dwelling Accessibility Form MO-DAT FPT Food Pantry Tax Form MO-FPT SHC Self-Employed Health Insurance Form MO-SHC SSC Public Safety Officer Surviving Spouse Form MO-SSC Missouri Agricultural and Small Business Development Authority P.O. Box 630, Jefferson City, MO 65102-0630 agriculture.mo.gov • (573) 751-2129 Alpha Attach to Code Name of Credit Form MO-TC APU Agricultural Product Utilization Contributor Certificate* FFC Family Farms Act Certificate* MPF Meat Processing Facility Investment Tax Credit Certificate* NGC New Generation Cooperative Incentive Certificate* QBC Qualified Beef Certificate* Missouri Department of Natural Resources Jefferson City, MO 65105 dnr.mo.gov Alpha Attach to Code Name of Credit and Phone Number Form MO-TC CPC Charcoal Producers - (573) 751-4817 Certificate* Missouri Department of Social Services Jefferson City, MO 65109 dss.mo.gov/dfas/taxcredit/index.htm • (573) 751-7533 Alpha Attach to Code Name of Credit Form MO-TC DBC Diaper Bank Certificate* DDC Developmental Disability Care Provider Certificate* DVC Shelter for Victims of Domestic Violence Certificate* MHC Maternity Home Certificate* PRC Pregnancy Resource Certificate* RTA Residential Treatment Agency Certificate* SCH School Children Health and Hunger Certificate* P.O. Box 118, Jefferson City, MO 65102‑0118 ded.mo.gov Alpha Attach to Code Name of Credit and Phone Number Form MO-TC BFC New or Expanded Business Facility - (573) 522-2790 Schedule 150,

Fed. K-1, Form 4354 BJI Brownfield “Jobs and Investment” - (573) 522-8004 Certificate* CCA Capitol Complex - Artifact Donation - (573)751-5798 Certificate* CCM Capitol Complex - Monetary Donation -(573)751-5798 Certificate* DPC Development Tax Credit - (573) 526-3285 Certificate* FDA Family Development Account - (573) 751-4539 Certificate* FPC Film Production - (573) 751-9048 Certificate* HPC Historic Preservation - (573) 522-8004 Certificate* ICT Innovation Campus Tax Credit - (573) 751-4539 Certificate* MQJ Missouri Quality Jobs - (573) 526-3285 Certificate* MWC Missouri Works Credit - (573) 526-3285 Certificate* NAC Neighborhood Assistance - (573) 751-4539 Certificate* NEZ New Enhanced Enterprise Zone - (573) 526-3285 Certificate* NMC New Market Tax Credit - (573) 522-8004 Certificate* RCC Rebuilding Communities - (573) 526-3285 Certificate* RCN Rebuilding Communities and Neighborhood

Preservation Act - (573) 522-8004 Certificate* REC Qualified Research Expense - (573) 526-0124 Certificate* RTC Remediation - (573) 522-8004 Certificate* SBI Small Business Incubator - (573) 751-4539 Certificate* SEC Sporting Event Credit - (573) 522-8004 Certificate* SPC Sporting Contribution Credit - (573) 522-8004 Certificate* WEC Processed Wood Energy - (573) 526-1723 Certificate* WGC Wine and Grape Production - (573) 751-9048 Certificate* YOC Youth Opportunities - (573) 751-4539 Certificate* Missouri Development Finance Board P.O. Box 567, Jefferson City, MO 65102-0567 mdfb.org • (573) 751-8479 Alpha Attach to Code Name of Credit Form MO-TC BEC Bond Enhancement Certificate* BUC Missouri Business Use Incentives for Large Certificate*

Scale Development (BUILD) DRC Development Reserve Contribution Credit Certificate* EFC Export Finance Certificate* IDC Infrastructure Development Certificate* Missouri Housing Development Commission 3435 Broadway, Kansas City, MO 64111 mhdc.com Alpha Attach to Code Name of Credit and Phone Number Form MO-TC AHC Affordable Housing Assistance - (816) 759-6878 Certificate* LHC Missouri Low Income Housing - (816) 759-6878 Eligibility Statement, Fed. K-1, 8609A, 8609 (first year) Missouri Department of Health Division of Senior Services P.O. Box 570, Jefferson City, MO 65102-0570 health.mo.gov Alpha Attach to Code Name of Credit and Phone Number Form MO-TC SCT Shared Care - (573) 751-4842 Must Register Each Year With Division of Senior and Disability Services - Attach Form MO-SCC

42 Address, City, State, and ZIP Code Part I - Required Annual Payment Part II - Short Method Department Use Only (MM/DD/YY) Social Security Number Spouse’s Social Security Number Taxpayer Name Spouse’s Name - - - - 1. Enter your 2021 tax after credits (Form MO‑1040, Line 34 less approved credits from Line 40;

Property Tax Credit from Line 41). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 2. Multiply Line 1 by 90% (66 2/3% for qualified farmers) . . . . . . . . . . . . . . . . . . . . 2 3. Withholding Taxes - Do not include any estimated tax payments on this line . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 4. Subtract Line 3 from Line 1. If less than $500, stop here; do not complete or file this form.

You do not owe the penalty. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 5. Enter the tax shown on your 2020 tax return. If you did not file a 2020 Missouri return or only filed a Property

Tax Credit Claim, skip line 5 and enter the amount from Line 2 on Line 6. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 6. Required Annual Payment - Enter the smaller of Line 2 or Line 5 (Note: If Line 3 is equal to or more than

Line 6, stop here; you do not owe the penalty. Do not file Form MO-2210). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 7. Enter the amount, if any, from Line 3 above . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 8. Enter the total amount, if any, of 2021 estimated tax payments you made . . . . . 8 9. Add Lines 7 and 8 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 10. Total Underpayment for Year - Subtract Line 9 from Line 6. If zero or less, stop here; you do not owe the

penalty. Do not file Form MO-2210 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10 11. Multiply Line 10 by .01995 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11 12. If the amount on Line 10 was paid on or after 04/15/22, enter 0 (zero). If the amount on Line 10 was paid

before 04/15/22, make the following computation to find the amount to enter on Line 12.

Amount on

Number of days paid

Line 10 X before 04/15/22 X .0000822 . . . . . . . . . . . . . . . . . . . 12 13. Penalty - Subtract Line 12 from Line 11. Enter result here and on Form MO-1040, Line 52 . . . . . . . . . . . . . . . . . 13 Part II Instructions - Short Method A. Purpose of the Form - Use this form to determine whether your income tax was sufficiently paid throughout the year by withholding or by estimated

tax payments. If it is not, you may owe a penalty on the underpaid amount. B. Short Method - You may qualify for the Short Method to calculate your penalty if all withholding and estimated tax payments were made equally

throughout the year and you do not annualize your income.

If you do not qualify to use the Short Method, you must use the Regular Method. 2021 Underpayment of Estimated Tax By Individuals Form MO-2210 You may qualify for the Short Method to calculate your penalty. You may use the Short Method if:

a. All withholding and estimated tax payments were made equally throughout the year and

b. You do not annualize your income. If both (a) and (b) apply to you, complete Part I, Required Annual Payment and Part II, Short Method. Otherwise, complete Part I, Required Annual Payment and Part III, Regular Method.

43 25. Amount of underpayment . . . . . . . . . . . . . . . . . . . . . . . . . . . 26. Date of payment, due date of installment, or April 15, 2022,

whichever is earlier . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27a. Number of days between the due date of installment, and

either date of payment, the due date of the next

installment, or December 31, 2021, whichever is earlier . . . . 27b. Number of days from January 1, 2022 or installment date

to date of payment or April 15, 2022 . . . . . . . . . . . . . . . . . . . 28a. Multiply the 3% annual interest rate times the amount on

Line 25 for the number of days shown on Line 27a . . . . . . . . 28b. Multiply the 3% annual interest rate times the amount on

Line 25 for the number of days shown on Line 27b . . . . . . . . 28c. Total Penalty (Line 28a plus Line 28b) . . . . . . . . . . . . . . . . . 29. Total amount on Line 28c. Show this amount on Line 52 of Form MO-1040 as “Underpayment of Estimated Tax

Penalty”. If you have an underpayment on Line 51 of Form MO-1040, enclose your check or money order for payment in

the amount equal to the total of Line 51 and the penalty amount on Line 52. If you have an overpayment on Line 50, the

Department of Revenue will reduce your overpayment by the amount of penalty . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Complete Lines 14 through 19. If you meet any of the exceptions (see instruction D) to the penalty for all quarters, omit Lines 14 through 19 and go directly to Line 20. Part III - Regular Method 20. Total amount paid and withheld from January 1 through

the installment date indicated . . . . . . . . . . . . . . . . . . . . . . . . 21. Exception No. 1 - prior year’s tax

2020 tax . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22. Exception No. 2 - tax on prior year’s income using 2021

rates and exemptions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23. Exception No. 3 - tax on annualized 2021 income . . . . . . . . . 24. Exception No. 4 - tax on 2021 income (See Instructions) . . . Section A - Figure Your Underpayment 14. Required annual payment (Enter payment as computed on Part I, Line 6) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14 Due Dates of Installments April 15, 2021 June 15, 2021 Sept. 15, 2021 Jan. 15, 2022 15. Required installment payments (See Instructions) . . . . . . . . 16. Estimated tax paid . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17. Overpayment of previous installments . . . . . . . . . . . . . . . . . . 18. Total payments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19. Underpayment of current installment . . . . . . . . . . . . . . . . . . . 19a. Overpayment of current installment . . . . . . . . . . . . . . . . . . . . 19b. Underpayment of previous installments . . . . . . . . . . . . . . . . 19c. Total overpayment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19d. Total underpayment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . See instruction D - For special exceptions see instruction I for service in a “combat zone”, and instruction J for farmers. 25% of 2020 Tax 50% of 2020 Tax 75% of 2020 Tax 100% of 2020 Tax 25% of Tax 50% of Tax 75% of Tax 100% of Tax 22.5% of Tax 45% of Tax 67.5% of Tax 90% of Tax 90% of Tax 90% of Tax Section B - Exceptions To The Penalty Section C - Figure the Penalty Complete Lines 25 through 29 Note: If this form is not filed with Form MO‑1040, attach check or money order payable to “Department of Revenue” and mail. Taxation Division E-mail: income@dor.mo.gov P.O. Box 329 Jefferson City, MO 65107-0329 Ever served on active duty in the United States Armed Forces? If yes, visit dor.mo.gov/military/ to see the services and benefits we offer to all eligible military individuals. A list of all state agency resources and benefits can be found at veteranbenefits.mo.gov/state-benefits/.

44 Part III Instructions - Regular Method A. Purpose of the Form - Use this form to determine whether your income tax was sufficiently paid throughout the year by withholding or by estimated

tax payments. If it is not, you may owe a penalty on the underpaid amount. B. Filing an Estimated Tax Payment and Paying the Tax for Calendar Year Taxpayers -If you file returns on a calendar year basis and are required to

file Form MO‑1040ES, you are generally required to file an estimated tax payment by April 15, and to pay the tax in four installments. If you are not

required to file an estimated tax payment until later in the year because of a change in your income or exemptions, you may be required to pay fewer

installments. The chart below shows the due date for the estimated tax payments and the maximum number of installments required for each.

Period Requirements First Met Due Date of Estimated Tax Payments Maximum Number of Installments Required

Between Jan. 1 and Apr. 1 April 15 4

Between Apr. 2 and Jun. 1 June 15 3

Between Jun. 2 and Sept.1 Sept. 15 2

After Sept. 1 Jan. 15 1

When the due date falls on a Saturday, Sunday, or legal holiday, the estimated tax payment will be considered timely if filed on the next business day. C. Fiscal Year Taxpayers - Fiscal year taxpayers should substitute for the due dates above, the 15th day of the first and last months of the second

quarter of your fiscal year; the 15th day of the last month of the third quarter; and the 15th day of the first month of your next fiscal year. D. Exception to the Penalty - You will not be liable for a penalty if your 2021 tax payments (amounts shown on Line 20) equal or exceed any amount determined for the same period under the following exception provisions. You may apply a different exception to each underpayment. Please

enclose a separate computation page for each payment. If one of the exceptions apply, complete Lines 15 through Line 29.

The percentages shown on Lines 21, 22, and 23, for the April 15, June 15, and Sept. 15 installment dates, are for calendar year taxpayers required

to pay installments on four dates.

Exception 1 - Prior Year’s Tax - This exception applies if your 2021 tax payments equal or exceed the tax shown on your 2020 tax return. The 2020

return must cover a period of 12 months and show a tax liability.

Exception 2 - Tax on Prior Year’s Income using 2021 Rates and Exemptions - This exception applies if your 2021 tax withheld and estimated tax

payments equal or exceed the tax that would have been due on your 2020 income if you had computed it at 2021 rates. To determine if you qualify

for this exception, use the other facts and law applicable to your 2020 return.

Exception 3 - Tax on Annualized 2021 Income - This exception applies if your 2021 tax payments equal or exceed 90 percent of the tax on your

annualized taxable income for periods from the first of the year to the end of the month preceding that month in which an installment is due.

To annualize your taxable income, follow these four steps.