Your Code Spouse’s Code
*191111*
2019 Form M1, Individual Income Tax
Leave unused boxes blank. Do not use staples on anything you submit.
Your First Name and Inial Last Name Your Social Security Number (SSN) Your Date of Birth
If a Joint Return, Spouse’s First Name and Inial Spouse’s
Last Name
Spouse’s Social Security Number
Spouse’s Date of Birth
Current Home Address Check if: New Address Foreign Address
City State ZIP Code
2019 Federal Filing Status (place an X in one box):
(1) Single
(2) Married ling jointly
(3) Married ling separately
(4) Head of household
(5) Qualifying widow(er)
Spouse name and SSN
State Elecons Campaign Fund
If you want $5 to go to help candidates for state oces pay campaign expenses, enter the code number for the party of your choice. This will not increase your tax or reduce your refund.
A. Wages, salaries, ps, etc. B. IRA, pensions, and annuies C. Unemployment D. Federal taxable income
From Your Federal Return (see instrucons)
Place an X in box if a negave number
1 Federal adjusted gross income (from line 8b of federal Form 1040 and 1040-SR)
(if a negave number, place an X in the box) ......................................................... 1
2 Addions to Minnesota income from line 17 of Schedule M1M (see instrucons; enclose Schedule M1M).....
2
3
Add lines 1 and 2
(if a negave number, place an X in the box) .........................................
3
4 Itemized deducons (from Schedule M1SA) or your standard deducon (see instrucons) .................
4
5 Exempons (determine from instrucons) ..........................................................
5
6 State income tax refund from line 1 of federal Schedule 1 ............................................
6
7 Other subtracons from Minnesota income from line 46 of Schedule M1M
(see instrucons; enclose Schedule M1M) ..........................................................
7
8 Total subtracons. Add lines 4 through 7 ........................................................... 8
9 Minnesota taxable income.
Subtract line 8 from line 3. If zero or less, leave blank. ..........................
9
10 Tax from the table in the M1 instrucons ......................................................... 10
11 Alternave minimum tax (enclose Schedule M1MT) ................................................ 11
12 Add lines 10 and 11 ........................................................................... 12
13
Full-year residents: Enter the amount from line 12 on line 13. Skip lines 13a and 13b.
Part-year residents and nonresidents: From Schedule M1NR, enter
the amount from line 26 on
line 13,
from line 22 on
line 13a, and from line 23 on line 13b (enclose Schedule M1NR) ........................... 13
a
b (Place an X in box if a negave number)
14 Other taxes such as the tax on lump sum distribuons and recapture amounts from (check appropriate box):
Schedule M1HOME
Schedule M1529
Schedule M1LS ............................. 14
9995
Polical Party Code Numbers:
Republican—11
Democrac/Farmer-Labor—12
Independence—13
Grassroots/Legalize Cannabis—14
Green—15
Libertarian—16
Legal Marijuana Now—17
General Campaign Fund—99
Spouse’s Signature (If Filing Jointly)
15 Tax before credits. Add lines 13 and 14 ..........................................................
15
16 Marriage Credit for joint return when both spouses have taxable earned income
or taxable rerement income (enclose Schedule M1MA) ............................................
16
17 Credit for long-term care insurance premiums paid (enclose Schedule M1LTI) ........................... 17
18 Credit for taxes paid to another state (enclose Schedule(s) M1CR and M1RCR) ..........................
18
19 Other nonrefundable credits (enclose Schedule M1C) ............................................... 19
20 Total nonrefundable credits. Add lines 16 through 19 ............................................... 20
21 Subtract line 20 from line 15 (if result is zero or less, leave blank) .....................................
21
22 Nongame Wildlife Fund contribuon (see instrucons)
This will reduce your refund or increase the amount you owe ............................
22
23 Add lines 21 and 22 ........................................................................... 23
24
Minnesota income tax withheld. Complete and enclose Schedule M1W to report
Minnesota withholding from Forms W-2, 1099, and W-2G
(do not send)
.................................
24
25 Minnesota esmated tax and extension payments made for 2019 ....................................
25
26 Refundable credits from line 9 of Schedule M1REF (see instrucons; enclose Schedule M1REF).............
26
27 Total payments. Add lines 24 through 26 ......................................................... 27
28 REFUND. If line 27 is more than line 23, subtract line 23 from line 27 (see instrucons).
For direct deposit, complete line 29
............................................................. 28
29 Direct deposit of your refund (you must use an account not associated with a foreign bank):
Checking Savings
30 AMOUNT YOU OWE. If line 23 is more than line 27, subtractline 27 from line 23 (see instrucons) ......... 30
31 Penalty amount from Schedule M15 (see instrucons). Also subtract
this amount from line 28 or add it to line 30 (enclose Schedule M15)
................................. 31
IF YOU PAY ESTIMATED TAX and want part of your refund credited to esmated tax, complete lines 32 and 33.
32 Amount from line 28 you want sent to you .......................................................
32
33 Amount from line 28 you want applied to your 2020 esmated tax ...................................
33
Your Signature Date
I declare that this return is correct and complete to the best of my knowledge and belief. Paid preparer: You must sign below.
Include a copy of your 2019 federal return and schedules.
Mail to: Minnesota Individual Income Tax
St. Paul, MN 55145-0010
To check on the status of your refund, visit www.revenue.state.mn.us
I authorize the Minnesota Department of Revenue to discuss this return with my
paid preparer or the third-party designee indicated on my federal return.
I do not want my paid preparer to le my return electronically.
2019 M1, page 2
Paid Preparers Signature Date
Preparer’s Dayme Phone PTIN or VITA/TCE # (required)
Preparer’s Email Address
Taxpayer’s Dayme Phone
9995
Your Email Address
Account Type Roung Number Account Number
*191121*