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 Reset Form Print Form

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

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

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.