State of Rhode Island Division of Taxation 2021 RI Schedule M - page 1 RI Modifications to Federal AGI Elective deduction for new research and development facilities under RIGL §44-32-1................................. 1c c Railroad Retirement benefits paid by the Railroad Retirement Board............................................................ 1d d Qualifying investment in a certified venture capital partnership under RIGL §44-43-2.................................. 1e e 1f Family Education Accounts under RIGL §44-30-25....................................................................................... 1g f Tuition Saving Program contributions (section 529 accounts) under RIGL §44-30-12. Not to exceed $500 ($1,000 if joint return)..................................................................................................... 1h g Exemptions from tax on profit or gain for writers, composers and artists under RIGL §44-30-1.1................. 1i h Bonus depreciation taken on the Federal return that has not yet been subtracted from Rhode Island income under RIGL §44-61-1......................................................................................................................... 1j i Section 179 depreciation taken on the Federal return that has not yet been subtracted from Rhode Island under RIGL §44-61-1.1.................................................................................................................................. 1k j Modification for performance based compensation realized by an eligible employee under the Jobs Growth Act under RIGL §42-64.11-4.............................................................................................................. 1l k Modification for exclusion for qualifying option under RIGL §44-39.3 AND modification for exclusion for quali- fying securities or investment under RIGL §44-43-8.............................................................................................. l Modification for Tax Incentives for Employers under RIGL §44-55-4.1.......................................................... 1m m Tax Credit income reported on Federal return exempt for Rhode Island purposes (see instructions for eligible credits)................................................................................................................................................................... 1n n Active duty military pay of Nonresidents stationed in Rhode Island and income for services performed in Rhode Island by the servicemember’s spouse............................................................................................... 1o o 1p Scituate Medical Savings Account contributions taxable on the Federal Return but exempt from Rhode Island under RIGL §44-30-25.1(d)(3)(i).................................................................................................................................. 1q p Amounts of insurance benefits for dependents and domestic partners included in Federal AGI pursuant to chapter 12 of title 36 or other coverage plan under RIGL §44-30-12(c)(6)................................................... 1r q Modification for Organ Transplantation for specific unreimbursed expenses incurred by Rhode Island Resident pursuant to RIGL §44-30-12(c)(7).................................................................................................. r Name Social security number MODIFICATIONS DECREASING FEDERAL AGI Income from obligations of the US government included in Federal AGI but exempt from state income taxes reduced by investment interest on the obligations taken as a federal itemized deduction................................... 1a 1a Rhode Island fiduciary adjustment as beneficiary of an estate or trust under RIGL §44-30-17..................... 1b b 1s Modification for Rhode Island Resident business owner in certified enterprise zone under RIGL §42-64.3-7 1t s 1u t u 1v v CASH BASIS ONLY - Deduction for Pass-Through Entity Tax claimed in Prior Year (See Instructions)............... NOTE: For each modification being claimed you must enter the modification amount on the corresponding modification line and attach documentation supporting your modification. Otherwise, the processing of your return may be delayed. Refer to the instructions for more information on each modification. If a modification is not listed below, it is not valid and, therefore, not allowable. Revised 03/2021 1w Total modifications DECREASING Federal AGI. Add lines 1a through 1v and enter as a negative amount......... w Modification for taxable Social Security income under RIGL §44-30-12(c)(8)

/ / Primary Date of Birth (Required) Spouse Date of Birth (Required) Primary Date of Birth (Required) Spouse Date of Birth (Required)

/ / Modification for taxable Retirement in- come from certain pension plans or an- nuities under RIGL §44-30-12(c)(9)

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/ / 21100999990101

State of Rhode Island Division of Taxation 2021 RI Schedule M - page 2 RI Modifications to Federal AGI MODIFICATIONS INCREASING FEDERAL AGI Income from obligations of any state or its political subdivisions, other than Rhode Island under RIGL §44-30-12(1) and RIGL §44-30-12(2)............................................................................................................ 2a 2a 2b Rhode Island fiduciary adjustment as beneficiary of an estate or trust under RIGL §44-30-17..................... 2c b Recapture of Family Education Account modifications under RIGL §44-30-25(g)......................................... 2d c Bonus depreciation taken for federal purposes that must be added back to Rhode Island income under RIGL §44-61-1................................................................................................................................................ 2e d Recapture of Tuition Saving Program modifications (section 529 accounts) under RIGL §44-30-12(4).............. 2f e Recapture of tax credit income previously claimed as a modification decreasing Federal AGI (see instruc- tions for more information)............................................................................................................................. 2g f Recapture of Scituate Medical Savings Account modifications under RIGL §44-30-25.1(d)(3)(i).......................... 2i g Pass-through Entity Tax Elected to be Paid under RIGL §44-11-2.3............................................................. i Name Social security number NOTE: For each modification being claimed you must enter the modification amount on the corresponding modification line and attach documentation supporting your modification. Otherwise, the processing of your return may be delayed. Refer to the instructions for RI Schedule M for more detailed information on each of the modifications listed below. If a modification is not listed, it is not an allowable Rhode Island adjustment to Federal AGI. NET MODIFICATIONS TO FEDERAL AGI: 1 Total modifications DECREASING Federal AGI. Enter the amount from Schedule M, page 1, line 1w........ 2 1 Total modifications INCREASING Federal AGI. Enter the amount from line 2l above......................................... 2 3 COMBINE lines 1 and 2. Enter here and on RI-1040 or RI-1040NR, page 1, line 2......................................... 3 Taxable portion of Paycheck Protection Program Loan amount under RIGL §44-30-12(b)(8) (See Instructions). 2j j Unemployment compensation received but not included in federal adjusted gross income under RIGL §44-30- 12(b)(6)................................................................................................................................................................... 2h h Total modifications INCREASING Federal AGI. Add lines 2a through 2k..................................................... k 2k .........................................................RESERVED FOR FUTURE USE......................................................... l 2l 21100999990102