1 For Calendar Year January 1 - December 31, 2023 2023 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 2023 _ First Name Suffix Spouse’s Last Name Spouse’s First Name M.I. Suffix *23322010006* 23322010006 You may contribute to any one or all of the trust funds on Line 51. See pages 11-12 of the instructions for more trust fund information. Deceased Deceased in 2023 Name - - MO-1040 Page 1 0 Vendor Code 0 6 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 Missouri Medal of Honor Fund Department of Social Services Application of Eligibility form attached. Federal return attached. View instructions Print Form Reset Form Calculate 006 SELECT COUNTY For Privacy Notice CLICK HERE

2 13 % 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-$13,850 • Head of Household-$20,800

*23322020006* 23322020006 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 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21. Farmland sold, rented, leased, or crop-shared to a beginning farmer deduction. Enter the sum

of Lines 21A, 21B, and 21C on Line 21 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 00 . 21 20. Bring jobs home deduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 00 . 20 16. Long-term care insurance deduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 00 . 16 17. Health care sharing ministry deduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 00 . 17 18. Active Duty Military income deduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 00 . 18 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. . . . . . . . . . . . . . . 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 . . . . . . . . . . . . . . . . . . . . . . . . % 19. Inactive Duty Military income deduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 00 . 19 • Married Filing Combined or Qualifying Widow(er)-$27,700 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 00 . 15 15. Additional Exemption for Head of Household and Qualifying Widow(er) . . . . . . . . . . . . . . . . . . 21A. Sold 21C. Crop-

Share 00 . $ 00 . $ 00 . $ 21B. Rented/

Leased Worksheet Line 1 MO-A 0 0 Line 2 0 0 MO-A 0 0 Line 4 0 0 0 0 0 Line 7 MO-A 0 Line 8 Line 9 Line 10 0 0 Line 13 Itemized Deductions Worksheet 0 Line 14 0 Long-term Care Worksheet 0 Line 16 Line 17 Line 18 Line 20 Line 21

3 00 . 44 35. Subtotal - Add Lines 33 and 34 . . . . . . . . . . . . . . . . . . . . . . . *23322030006* 23322030006 Tax 00 . 29S 00 . 29Y 29. Taxable income - Subtract Line 28 from Line 27 . . . . . . . . . . . 00 . 30S 00 . 30Y 30. Tax (see tax chart on page 26 of the instructions) . . . . . . . . . . 00 . 31S 00 . 31Y

income tax return(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31. Resident credit - Attach Form MO‑CR and other states’

Form MO-NRI. Attach Form MO-NRI and federal return if applicable. 32. Missouri income percentage - Enter 100% if not completing 00 . 33S 00 . 33Y

multiply Line 30 by percentage on Line 32 . . . . . . . . . . . . . . . 33. Balance - Subtract Line 31 from Line 30; OR 00 . 34S 00 . 34Y 34. Other taxes - Select box and attach federal form indicated. Lump sum distribution (Form 4972) Recapture of low income housing credit (Form 8611) 00 . 35S 00 . 35Y 00 . 36 36. Total Tax - Add Lines 35Y and 35S . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Payments and Credits 37. MISSOURI tax withheld - Attach Forms W‑2 and 1099 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 38. 2023 Missouri estimated tax payments - Include overpayment from 2022 applied to 2023 . . . . . . . . 39. Missouri tax payments for nonresident partners or S corporation shareholders - Attach Forms

MO-2NR and MO-NRP . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 00 . 37 00 . 38 00 . 39 32S % 32Y % MO-1040 Page 3 42. Miscellaneous tax credits (from Form MO-TC, Line 13) - Attach Form MO-TC . . . . . . . . . . . . . . . 00 . 42 43. Property tax credit - Attach Form MO-PTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 00 . 43 44. Missouri Working Family Tax Credit (Attach Form MO-WFTC and federal return) . . . . . . . . . . . . 41. Amount paid with Missouri extension of time to file (Form MO-60) . . . . . . . . . . . . . . . . . . . . . . . . 00 . 41 40. Missouri tax payments for nonresident entertainers - Attach Form MO-2ENT . . . . . . . . . . . . . . . 00 . 40 00 . 23 23. Long term dignity savings account deduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25. Total deductions - Add Lines 8 and 13 through 24 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 00 . 25 00 . 28S 00 . 28Y 28. Enterprise zone or rural empowerment zone income

modification . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27. Multiply Line 26 by appropriate percentages (%) on 00 . 27S 00 . 27Y

Lines 7Y and 7S . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 00 . 24 24. Foster parent tax deduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26. Subtotal - Subtract Line 25 from Line 6 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 00 . 26 Deductions Continued 00 . 45 45. Total payments and credits - Add Lines 37 through 44 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22. First time home buyers deduction. A. B. 00 . 22 First Time Home Buyers Worksheet 0 0 0 0 0 Line 26 0 0 Line 28 0 0 0 0 Line 30 MO-CR 0 0 Line 31 MO-NRI 100 100 Line 32 0 0 Line 34 0 0 0 Line 37 Line 38 Line 39 Line 40 Line 41 MO-TC 0 Line 42 MO-PTS 0 Line 43 0

4 Refund 49. If Line 45, or if amended return, Line 48, is larger than Line 36, enter the difference. 00 . 49

Amount of OVERPAYMENT . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 50. Amount of Line 49 to be applied to your 2024 estimated tax . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 00 . 50 51. Enter the amount of your donation in the trust fund boxes below. See instructions for additional trust fund codes. 52. Amount of Line 49 to be deposited into a Missouri 529 Education Plan (MOST) 00 . 52

account. Enter the total deposit amount from Form 5632 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . *23322040006* 23322040006 00 . 51

Skip Lines 46 through 48 if you are not filing an amended return. 46. Amount paid on original return . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 00 . 46 47. Overpayment as shown (or adjusted) on original return . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 00 . 47 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 . . . . . . . 48. Amended return total payments and credits - Add Lines 45 and 46; subtract Line 47. 00 . 48

Enter on Line 48. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 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 51a through 51n and enter here . . . . . . . . . . . . . . . . . Amended Return MO-1040 Page 4 53. REFUND - Subtract Lines 50, 51, and 52 from Line 49 and enter here . . . . . . . . . . . . . . . . . . . . . 00 . 53 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 51a. 51b. 51c. 51e. 51f. 51i. 00 . 51m. Additional Fund Code Additional Fund Amount 00 . Kansas City Regional Law Enforcement Memorial Foundation Fund 51j. 00 . Soldiers Memorial Military Museum in St. Louis Fund 51k. 00 . Missouri National Guard Trust Fund 51d. 00 . 00 . General Revenue Fund Missouri Military Family Relief Fund 51g. 51h. 00 . 51n. Additional Fund Code Additional Fund Amount 00 . MIssouri Medal of Honor Fund 51l. a. Routing

Number b. Account c. Savings Checking

Number Line 46 Line 47 These fields are locked. To unlock them, Click on the "amended" check box on page 1 of this form (top left). 0 Line 49 0 Line 50 0 Line 51 51 Part 2 MOST 0 Line 53

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

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

P.O. Box 3370 P.O. Box 3222 Submission of Individual Income Tax Returns

Jefferson City, MO 65105-3370 Jefferson City, MO 65105-3222 Email: income@dor.mo.gov

Phone: (573) 751-7200 Phone: (573) 751-3505 Inquiry and correspondence

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) *23322050006* 23322050006

electronically. Any returned check may be presented again electronically . . . . . . . . . . . . . . . . . . Amount Due 54. If Line 36 is larger than Line 45 or Line 48, enter the difference. 00 . 54

Amount of UNDERPAYMENT . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 55. Underpayment of estimated tax penalty - Attach Form MO-2210. Enter penalty amount here . . . 00 . 55 56. AMOUNT DUE - Add Lines 54 and 55. 00 . 56

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. I am aware of any applicable reporting requirements of Section 135.805, RSMo, and the penalty provisions of Section 135.810,

RSMo.

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 12-2023) 0 Line 55 0 Line 56 Click here to finish

26 2023 Tax Chart To identify your tax, use your Missouri taxable income from Form MO-1040, Line 29Y and 29S 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 30Y and 30S. Section B Section A Tax Rate Chart Tax Calculation Worksheet

Yourself Spouse Example A Example B 1. Missouri taxable income (Form MO-1040, Lines 29Y and 29S) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ ______________ ______________ $ 3,090 $ 12,000 2. Enter the minimum taxable income for your tax bracket (see Section A above). If below $1,207 enter $0 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . - $ ______________ ______________ - $ 2,414 $ 8,449 3. Difference - Subtract Line 2 from Line 1 . . . . . . . . . = $ ______________ ______________ = $ 676 $ 3,551 4. Enter the percent for your tax bracket (see Section A above) . . . . . . . . . . . . . . . . . . . . . . . . . . X ______________ % ______________ % X 2.5%

4.95% 5. Multiply Line 3 by the percent on Line 4 . . . . . . . . . = $ ______________ ______________ = $ 16.90 $ 175.77 6. Enter the tax from your tax bracket - before applying the percent (see Section A above) . . . . . . + $ ______________ ______________ + $ 24 $ 234 7. Total Missouri Tax - Add Line 5 and 6. Enter here and on Form MO-1040, Lines 30Y and 30S . . . . . . = $ ______________ ______________ = $ 41 $ 410 ($40.90 rounded to the nearest dollar) ($409.77 rounded to the nearest dollar) 2023 Missouri Taxes Withheld Earnings Tax Diagram 1: Form W-2

If the Missouri taxable income is: The tax is: $0 to $1,207 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $0 Over $1,207 but not over $2,414 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.00% of excess over $1,207 Over $2,414 but not over $3,621 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $24 plus 2.50% of excess over $2,414 Over $3,621 but not over $4,828 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $54 plus 3.00% of excess over $3,621 Over $4,828 but not over $6,035 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $90 plus 3.50% of excess over $4,828 Over $6,035 but not over $7,242 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $132 plus 4.00% of excess over $6,035 Over $7,242 but not over $8,449 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $180 plus 4.50% of excess over $7,242 Over $8,449 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $234 plus 4.95% of excess over $8,449

0 0 0 0 0 0 0.00 0.00 0.00 0.00 0 0 0 0 For Privacy Notice CLICK HERE

1 MO Public-Private Transportation Act *23340010001* 23340010001 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 13 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 2023 Individual Income Tax Adjustments Business Interest Business Interest 10. Military Retirement Benefits (see Instructions on page 14) . . . . . . . . . . . 00 . 10Y 00 . 10S Line 1 Line 2 Line 3 Line 4 Line 5 Line 6 0 0 Line 7 Back to 1040 Page 2 Line 8 Line 9 Line 11 Line 12 Qualified Health Insurance Premiums Worksheet 0 0 Line 13 For Privacy Notice CLICK HERE

2

Form MO-1040, Line 4 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . *23340020001* 23340020001 MO-A Page 2 Part 2 - Missouri Itemized Deductions 1. Total federal itemized deductions from Federal Form 1040 or Federal Form 1040-SR, Line 12 . . . . . . . . . . . 3. 2023 Social security tax - (Spouse). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4. 2023 Railroad retirement tax - Tier I and Tier II (Yourself) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5. 2023 Railroad retirement tax - Tier I and Tier II (Spouse) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6. 2023 Medicare tax - Yourself and Spouse (see instructions on page 16) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7. 2023 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. 2023 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 Line 14 Line 15 Line 16 Line 17 0 0 Line 18 Back to 1040 Page 2 Line 1 Line 2 Line 3 Line 4 Line 5 Line 6 Line 7 0 Line 9 Line 10 0 0 Line 12 Carry amount to 1040 Line 14 0 10,000 0 Use data from worksheet Reset Worksheet For Privacy Notice CLICK HERE

3

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 $44,683 (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 . . . . . . . . . . . . . . *23340030001* 23340030001 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 0 Line 1 0 85,000 0 0 0 0 0 Line 8 0 0 0 0 0 Line 2 0 25,000 0 Line 6 0 0 0 0 For Privacy Notice CLICK HERE

4 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. *23340040001* 23340040001 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 12-2023) 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: 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. 0 85,000 0 Line 4 Line 5 0 0 0 0 0 Back to MO-1040, page 2 For Privacy Notice CLICK HERE

1 Name Spouse’s Name Yourself (Y) Spouse (S) 1. Claimant’s total adjusted gross income (Form MO-1040, 2. Claimant’s Missouri income tax (Form MO-1040, Line 30Y and 3. Wages and commissions . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5. Total - Add Lines 3 and 4 . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6. Minus, related adjustments (Federal Form 1040 or 1040-SR,

Line 10). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7. Net amounts - Subtract Line 6 from Line 5 . . . . . . . . . . . . . . . 30S). 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 imposed by another state or political 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. Attach Form MO-CR and all income tax returns for each state or political subdivision to Form MO-1040. State of: State of: 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 on Form MO-1040, Line 31Y or Line 31S . . . . . . . . . . . .

must generally be reduced by all credits, except withholding

subdivision. This is not income tax withheld. The income tax 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

Line 5Y and Line 5S) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 00 1S 00 . 1Y 2023 Credit for Income Taxes Paid to Other States or Political Subdivisions Form MO-CR If you are claiming a resident credit as a shareholder of an S corporation with income earned in a non-taxed jurisdiction, complete MO-CR, Schedule 1 and see Instructions.

and estimated tax. (See instructions.) . . . . . . . . . . . . . . . . . . . Form MO-CR

Note: If you have completed Form MO-CR for credits in multiple states, add the amounts on Line 11 from each Form MO-CR

and the amounts on Line 5, from each Form MO-CR, Schedule 1, before entering on Form MO-1040. The cumulative amount

of credit reported on MO-1040, Line 31Y and 31S cannot exceed the Missouri tax liability. For Privacy Notice, see Instructions. Form MO-CR (Revised 12-2023)

0 0 Line 1 0 0 Line 2 Line 3 Line 4 0 0 Line 5 Line 6 0 0 Line 7 0 0 Line 8 0 0 Line 9 Line 10 0 0 Line 11 Back to MO-1040, page 3 For Privacy Notice CLICK HERE

1 Name Spouse’s Name Yourself (Y) Spouse (S) 1. Claimant’s total adjusted gross income (Form MO-1040, 2. Claimant’s Missouri income tax (Form MO-1040, Line 30Y and 3. Wages and commissions . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5. Total - Add Lines 3 and 4 . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6. Minus, related adjustments (Federal Form 1040 or 1040-SR,

Line 10). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7. Net amounts - Subtract Line 6 from Line 5 . . . . . . . . . . . . . . . 30S). 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 imposed by another state or political 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. Attach Form MO-CR and all income tax returns for each state or political subdivision to Form MO-1040. State of: State of: 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 on Form MO-1040, Line 31Y or Line 31S . . . . . . . . . . . .

must generally be reduced by all credits, except withholding

subdivision. This is not income tax withheld. The income tax 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

Line 5Y and Line 5S) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 00 1S 00 . 1Y 2023 Credit for Income Taxes Paid to Other States or Political Subdivisions Form MO-CR If you are claiming a resident credit as a shareholder of an S corporation with income earned in a non-taxed jurisdiction, complete MO-CR, Schedule 1 and see Instructions.

and estimated tax. (See instructions.) . . . . . . . . . . . . . . . . . . . Form MO-CR

Note: If you have completed Form MO-CR for credits in multiple states, add the amounts on Line 11 from each Form MO-CR

and the amounts on Line 5, from each Form MO-CR, Schedule 1, before entering on Form MO-1040. The cumulative amount

of credit reported on MO-1040, Line 31Y and 31S cannot exceed the Missouri tax liability. For Privacy Notice, see Instructions. Form MO-CR (Revised 12-2023)

0 0 Line 1 0 0 Line 2 Line 3 Line 4 0 0 Line 5 Line 6 0 0 Line 7 0 0 Line 8 0 0 Line 9 Line 10 0 0 Line 11 Back to MO-1040, page 3 For Privacy Notice CLICK HERE

2 Form MO-CR (Revised 12-2023) For Privacy Notice, see Instructions. Resident Credit For Tax on Pro Rata Share of S Corporation Income Earned From a Non-Taxed Jurisdiction 1. Claimant’s federal adjusted gross income (Form 1040, Line 1Y 3. Divide Line 2 by Line 1. Enter as a percent. If greater than 100%,

enter 100% . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5. Multiply Line 4 by the percentage on Line 3. Enter here and 4. Claimant’s Missouri income tax (Form MO-1040, Line 30Y and 30S) 2. Income earned from an S corporation in a non-taxed jurisdiction . . % % 00 . 4S 00 . 4Y 3S 3Y 00 . 2S 00 . 2Y 00 . 1S 00 . 1Y

and Line 1S) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yourself (Y) Spouse (S) 00 . 5S 00 . 5Y

include on Form MO-1040, Line 31Y or 31S . . . . . . . . . . . . . . . . MO-CR Schedule 1 Form Complete Form MO-CR, Schedule 1, if you are a Missouri resident S corporation shareholder who has S corporation income from sources in another state(s) or the District of Columbia that is not subject to an income tax imposed in that jurisdiction. State abbreviation - List all states from which the non-taxed S corporation income is sourced: Name Spouse’s Name Social Security Number Spouse’s Social Security Number - - - - Note: If you have completed Form MO-CR, Schedule 1 for credits in multiple states, add the amounts on Line 11 from each Form MO-CR and the amounts on Line 5, from each Form MO-CR, Schedule 1, before entering on Form MO-1040. The cumulative amount of credit reported on MO-1040, Line 31Y and 31S cannot exceed the Missouri tax liability.

0 0 0 0 0 0 0 0 Back to MO-1040, page 3 For Privacy Notice CLICK HERE

3 Form MO-CR (Revised 12-2023) Complete this form if you are a:

• Missouri resident, resident estate, or resident trust with income from another state(s) within the United States, political

subdivision therein, or District of Columbia, or

• Missouri resident who is a direct or indirect member in a partnership or S corporation (pass-through entity), which

voluntarily elected to be subject to and pay an income tax at the pass-through entity level in another state through a

program substantially similar to the Missouri SALT Parity Act (Section 143.436 of the Missouri Revised Statutes). A

pass-through entity level tax program of another state or the District of Columbia is substantially similar to the Missouri

SALT Parity Act if:

- The partnership or S corporation only pays the tax if it voluntarily elects to be subject to that pass-through entity level tax;

- The tax is imposed directly on the income of the partnership or S corporation;

- The partner or shareholder receives an individual income tax credit for all or part of the partner or shareholder’s pro

rata share of the tax paid by the partnership or S corporation; and

- The tax is not the mere payment, withholding, or composite payment of an income tax imposed on the partners or

shareholders of the partnership or S corporation. 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 or your S Corporation or partnership referenced above 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 30).

• Complete the other state’s return(s) to determine the amount of income tax you paid to the other state(s). Line-By-Line Instructions Note: If you are claiming a resident credit as a shareholder of an S corporation with income earned in a non-taxed jurisdiction, complete Form MO-CR, Schedule 1 and see Instructions. Compute the Missouri Resident Credit as follows: Line 1 - Enter the amount from Form MO-1040, Line 5Y and 5S. Line 2 - Enter the amount from Form MO-1040, Line 30Y and 30S. Lines 3 & 4 - Enter the total amount of wages, commissions, and other income you or your spouse received from the other

state(s) or District of Columbia, 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. Your

income tax liability must be reduced by all credits, except withholding and estimated tax. If the other state allows

Missouri residents to take a credit against that state’s income tax for the amount of Missouri income tax prior to the

application of all tax credits, then you do not need to reduce your tax liability by all credits for that state. If both you and

your spouse paid income tax to the other state(s) or District of Columbia, each must claim his or her own portion of the

tax liability. Also add on this line the following item:

• You and your spouse’s pro rata share of pass-through entity level income tax actually paid to another state of the

United States or the District of Columbia through a program substantially similar to the Missouri SALT Parity Act.

• If you or your spouse are a resident S corporation shareholder, you or your spouse’s pro rata share of net income

tax actually paid by your S corporation to the other state, but only if that other state does not measure the income

of S corporation shareholders by reference to the income of the S corporation. Note: If an amount or share of the

S corporation’s income is included in the shareholder’s taxable income in that state, then that state measures the

income of S corporation shareholders by reference to the S corporation’s income.

• If you or your spouse are a resident S corporation shareholder and your S corporation is an out-of-state bank, see

Section 143.081.4 of the Missouri Revised Statutes to determine the pro rata share of the net tax actually paid by

the bank to include on Line 10. 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 31Y and 31S. (If you have multiple credits, add the amounts on Line 11 from each MO-CR).

Your total credit cannot exceed the percent of tax due to Missouri on that part of your income, and also cannot exceed

the income tax imposed by the other jurisdiction(s). Information to Complete Form MO-CR

4 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/. Form MO-CR (Revised 12-2023) 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 Complete Form MO-CR, Schedule 1, if you are a Missouri resident S corporation shareholder who has S corporation income from sources in another state(s) or the District of Columbia not subject to an income tax imposed on you or the S corporation in that jurisdiction or the political subdivision of that jurisdiction from which the income was derived. If you received S corporation income, which meets this description, from multiple non-taxing states, you may include all non-taxed S corporation income on one Schedule 1. Attach Form MO-CR, Schedule 1 and supporting documentation, including Federal K-1 and a statement detailing the calculation of your share of the income earned in the state(s) with no taxing jurisdiction for each state or political subdivision, to Form MO- 1040 to instead say “in the state(s) that are non-taxing jurisdictions for each state (or D.C.), to Form MO-1040.” State abbreviation - Use the two letter abbreviation for each state or the District of Columbia. If you have S corporation income from multiple non-taxing states, enter an abbreviation for each state. See the table below for the two letter abbreviations. Line 1 – Enter the amount from Form MO-1040, Line 1Y and 1S. Line 2 – Enter pro rata share of S corporation income that was derived from the non-taxed jurisdiction. Line 3 – Enter the amount from Line 2 divided by the amount from Line 1. Enter as a percentage. Round in whole percent, such

as 91 percent instead of 90.5 percent. If percentage is less than 0.5 percent, use exact percentage. Line 4 – Enter your and your spouse’s Missouri income tax from Form MO-1040, Line 30Y and 30S. Line 5 – Multiply Line 4 by the percentage on Line 3; enter the amount on Line 5. Information to Complete Form MO-CR, Schedule 1 State Abbreviations

1 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 2023 _____________________ 2. Part-Year Missouri Resident Indicate the dates you were a Missouri Resident in 2023. 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 32 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 2023 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 2023 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 2023 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 2023 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 2023 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 2023 _____________________ 2. Part-Year Missouri Resident Indicate the dates you were a Missouri Resident in 2023. 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)

Line 1 Line 2 Line 3 For Privacy Notice CLICK HERE

2 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. Minus: 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, minus

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 1z 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 32Y and 32S . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 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/. 0 0 0 0 0 0 Use worksheet values in NRI, Part C, Line 1 Reset 0 0 Check boxes to carry amount to MO-1040 with values below CHECK to fill Line 32Y CHECK to fill Line 32S 0 0 Back to MO-1040, page 3 For Privacy Notice CLICK HERE

3 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 2023, 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 2023, 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 For Privacy Notice CLICK HERE

1 Missouri Tax I.D. Number Federal Employer I.D. Number Social Security Number Name (Last, First) Spouse’s Social Security Number Spouse’s Name (Last, First) 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 35Y for yourself and Line 35S for your spouse, or

Form MO-1120, Line 16, Form MO-1041, Line 15 or Form MO-PTE, Line 10. . . . . . . . . . . . . . . . . . . . . . . . . . . 12. 00 00 13. Total Credits - add amounts from Line 11, Columns 1 and 2. (Enter here and on Form MO-1120, Line 17; Form MO-1040,

Line 42; or Form MO-1041, Line 16; or Form MO-PTE, Line 11.) 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. 2023 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. For Privacy Notice, see instructions. Form MO-TC (Revised 12-2023) *23306010001* 23306010001 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. 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. I am aware of any applicable reporting requirements of Section 135.805 RSMo and the penalty provisions of Section 135.810 RSMo. Signature Taxpayer’s Signature Printed Name Date (MM/DD/YYYY) Spouse’s Signature Printed Name Date (MM/DD/YYYY) __ __ / __ __ / __ __ __ __ __ __ / __ __ / __ __ __ __ 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/. , , For Privacy Notice CLICK HERE 0 0 0 0 0 Back to MO-1040, page 3

2 * 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 12-2023) *23000000001* 23000000001 Pursuant to Section 105.1500, RSMo, the Department of Revenue is prohibited from requir­ ing any entity exempt from federal income tax under Section 501(c) of the Internal Revenue Code, or any individual, to provide the Department with any list, record, register, registry, roll, roster, or other compilation of data of any kind that directly or indirectly identifies a person as a member, supporter, volunteer of, or donor of financial or nonfinancial support to, any entity exempt from federal income tax under Section 501(c) of the Internal Revenue Code. Nothing in this form should be read or understood as a requirement that you provide any such information. Notwithstanding any publication, webpage, form, instruction, regulation, or statement shared by the Department, you are not required to include such information on this form. If you encounter any technical difficulty in submitting this form without including information that you believe is protected by Section 105.1500, RSMo, feel free to contact the Department by email at corporate@dor.mo.gov or by phone at 573-751-4541. Use Column 1 if you are filing: • An individual income tax return with a single type filing status; or • A corporation income tax or fiduciary return. Instructions 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. 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) 526-0308 Certificate* BJI Brownfield “Jobs and Investment” - (573) 522-8004 Certificate* CCA Capitol Complex - Artifact Donation - (573) 522-4216 Certificate* CCM Capitol Complex - Monetary Donation -(573) 522-4216 Certificate* FDA Family Development Account - (573) 522-4216 Certificate* FPC Show-Mo Act/Motion Media - (573)526-2102 Certificate* HPC Historic Preservation - (573) 522-8004 Certificate* MQJ Missouri Quality Jobs - (573) 526-3285 Certificate* MWC Missouri Works Credit - (573) 526-0308 Certificate* NAC Neighborhood Assistance - (573) 522-4216 Certificate* NEZ New Enhanced Enterprise Zone - (573) 526-3285 Certificate* RCN Rebuilding Communities and Neighborhood

Preservation Act - (573) 522-8004 Certificate* REC Qualified Research Expense - (573) 526-3285 Certificate* RTC Remediation - (573) 522-8004 Certificate* SBI Small Business Incubator - (573) 526-6708 Certificate* SEC Sporting Event Credit - (573) 522-8004 Certificate* SPC Sporting Contribution Credit - (573) 522-8004 Certificate* YOC Youth Opportunities - (573) 522-4216 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 920 Main Street, Suite 1400, Kansas City, MO 64105 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 Allocation Schedule

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 P.O. Box 2200, Jefferson City, MO 65105-2200 taxcredit@dor.mo.gov • (573) 751-3220 Alpha Attach to Code Name of Credit Form MO-TC ATC Adoption Tax Credit Form ATC, and

Federal Form 8839 BFT Bank Franchise Tax Form INT-2, INT-2-1 BPT Biodiesel Producer Form 5875 BRD Biodiesel Retailer and Distributor Form 5879 BTC Bank Tax Credit for S Corporation Form BTC, INT-3, 2823, INT-2, Fed. K-1 CFC Champion for Children Form CFC DAC Disabled Access Federal Form 8826 and Form MO-8826 DAT Residential Dwelling Accessibility Form MO-DAT ERD Ethanol Retailer and Distributor Form 5885 FPT Food Pantry Tax Form MO-FPT SHC Self-Employed Health Insurance Form MO-SHC SSC Public Safety Officer Surviving Spouse Form MO-SSC SPA SALT Parity Pass Through Entity

Report 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* SAC Specialty Agriculture Crops Loan Certificate* UFT Urban Farms Certificate* Missouri Department of Natural Resources P.O. Box 176, Jefferson City, MO 65102-0176 dnr.mo.gov Alpha Attach to Code Name of Credit and Phone Number Form MO-TC WEC Processed Wood Energy - (573) 751-6981 Certificate* Missouri Department of Social Services P.O. Box 1082, Jefferson City, MO 65102-1082 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* MPT Medical Preceptorship Certificate* PRC Pregnancy Resource Certificate* RTA Residential Treatment Agency Certificate* SCH School Children Health and Hunger Certificate* Missouri State Treasurer’s Office P.O. Box 210, Jefferson City, MO 65101 mo.scholars@treasurer.mo.gov • (573) 751-8533 Alpha

Attach to Code Name of Credit Form MO-TC MES MO Scholars Receipt For Privacy Notice CLICK HERE

7 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 2022 Missouri tax withheld, minus each spouse’s 2022 tax liability. The result should be each spouse’s portion of the 2022 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. Subtract: federal adjustments to income 18. Federal adjusted gross income (Line 16 minus 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 1z 2b 3b 1 2a 3 7 4 4b 5b 5 6 7 6b 9 10 11 0 0 0 0 Carry amounts to MO-1040, Line 1Y and 1S. Back to MO-1040, page 2

1 For Privacy Notice, see Instructions. MO-PTS Page 1 This form must be attached to Form MO-1040. *23323010001* 23323010001 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.

4. Enter the amount of railroad retirement benefits (not included in Line 2) before any deductions. Attach Form RRB-1099-R (Tier II). Refer to MO-A, Part 1, Line 11 . . . . . . . . . . . . . . . . . . . . . . . Attach letter from Veterans Affairs. See instructions, MO-1040. . . . . . . . . . . . . . . . . . . . . . . . . . . . . Filing Status 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. 2023 Property Tax Credit Schedule Form MO-PTS 0 Line 2 Line 3 Line 4 Line 5 For Privacy Notice CLICK HERE

2 *23323020001* 23323020001 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, minus

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 49-51 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 43. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 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, Supplemental Security Income (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/. Line 6 Line 7 0 0 Line 9 Check if you owned and occupied your home for the entire year 0 Line 10 Line 11 Go to MO-CRP 0 Line 12 0 Line 13 0 Line 14 Back to MO-1040, page 3 For Privacy Notice CLICK HERE

For Privacy Notice, see instructions. 2023 Certification of Rent Paid Form MO-CRP 1. Social Security Number Form MO-CRP (Revised 12-2023) *23315010001* 23315010001 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/. Line 1 2023 2023 Line 6 Line 7 0 Line 8 0 Line 9 Back to MO-PTS For Privacy Notice CLICK HERE

For Privacy Notice, see instructions. 2023 Certification of Rent Paid Form MO-CRP 1. Social Security Number Form MO-CRP (Revised 12-2023) *23315010001* 23315010001 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/. Line 1 2023 2023 Line 6 Line 7 0 Line 8 0 Line 9 Back to MO-PTS For Privacy Notice CLICK HERE

For Privacy Notice, see instructions. 2023 Certification of Rent Paid Form MO-CRP 1. Social Security Number Form MO-CRP (Revised 12-2023) *23315010001* 23315010001 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/. Line 1 2023 2023 Line 6 Line 7 0 Line 8 0 Line 9 Back to MO-PTS For Privacy Notice CLICK HERE

For Privacy Notice, see instructions. 2023 Certification of Rent Paid Form MO-CRP 1. Social Security Number Form MO-CRP (Revised 12-2023) *23315010001* 23315010001 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/. Line 1 2023 2023 Line 6 Line 7 0 Line 8 0 Line 9 Back to MO-PTS For Privacy Notice CLICK HERE

For Privacy Notice, see instructions. 2023 Certification of Rent Paid Form MO-CRP 1. Social Security Number Form MO-CRP (Revised 12-2023) *23315010001* 23315010001 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/. Line 1 2023 2023 Line 6 Line 7 0 Line 8 0 Line 9 Back to MO-PTS For Privacy Notice CLICK HERE

1 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 16 . . . . . . . . . . . . . . . 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 0 0 0 Back to MO-1040, page 2

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 12-2023) 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/. 0 0 0 0 0 0 0 0 0 0 0 0 0 Back to MO-A, Line 12 For Privacy Notice CLICK HERE

Taxpayer *23348010001* 23348010001 MOST-Missouri’s 529 Education Plan Form 5632 (Revised 12-2023) If you wish to deposit all or a portion of your refund into a Missouri MOST 529 Education Plan, you must include this form with your Taxation Division Add the amounts from Line A through Line D and enter the total deposit amount here Requirements If you want to deposit your refund as a contribution to one or more Missouri MOST 529 Education Plan accounts: • You must have an open Missouri MOST 529 Education Plan account that is administered by the Missouri Education Program. See the contact information below. • Your total deposit must be at least $25. • If your overpayment is adjusted and the amount you requested to deposit exceeds your available refund, the Department will • If your refund is offset to pay another debt, the Department will cancel your deposit. cancel your deposit and issue a refund to you. Enter the 11-digit MOST 529 account number and the amount you want contributed to each account. (You may contribute to a maximum of four accounts.) 529 Account A) Account Number B) Account Number C) Account Number D) Account Number Total Deposit and on Form MO-1040, Line 52 or Form MO-1040A, Line 17. . . . . . . . . . . . . . . . . . . . . . . Contact Information - A) Amount B) Amount C) Amount D) Amount Missouri Individual Income Tax Return. E-mail: most529@missourimost.org Telephone: (888) 414-6678 missourimost.org 00 . - - - M.I. Last Name First Name Suffix Spouse’s Last Name Spouse’s First Name M.I. Suffix 00 . 00 . 00 . 00 . Social Security Number Spouse’s Social Security Number - - - - Department Use Only (MM/DD/YY) Form 5632 2023 MOST - Missouri’s 529 Education Plan Direct Deposit Form - Individual Income Tax 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/. Back to MO-1040, page 4

Form 5766 First-Time Home Buyers Bank Worksheet Military Date (MM/DD/YYYY) Description Expenses Military servicemember with home of record outside of Missouri __ __ / __ __ / __ __ __ __ __ __ / __ __ / __ __ __ __ __ __ / __ __ / __ __ __ __ 00 00 00 Account Holder’s Address City State ZIP Code Account Holder Information Department Use Only (MM/DD/YY) Account Number Social Security Number Spouse Social Security Number Name Name Spouse Account Holder Beneficiary Information Name Beneficiary Beneficiary Social Security Number Beneficiary Address City State ZIP Code Financial Institution Financial Institution Name Account Balance December 31 00 . 00 . Total Account Withdrawals 00 .

Interest Earned Account Balance January 1 00 . 00 . Total Account Deposits Amount Form 5766 (Revised 12-2023) First-Time Home Buyer A. Contribution Deduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 00 . A B. Accrued Interest . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 00 . B Address of Residence Purchased City State ZIP Code Deduction Enter this amount on Form MO-1040, Line 22 Enter this amount on Form MO-1040, Line 22

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