Form PIT-RC Rebate and Credit Schedule

18a 00 18c 00 CALCULATE ALLOWABLE HOUSEHOLD MEMBERS AND EXTRA EXEMPTIONS $22 000 or less may qualify for the Low Income Comprehensive Tax Rebate $24 000 or less who live in Los Alamos or Santa Fe County ONLY may qualify for a Low Income Property Tax Rebate $30 160 or less may qualify for the New Mexico Child Day Care Credit (If line 13 is more than $16 000 DO NOT complete this section ) (If line 13 is MORE than $22 000 DO NOT complete this section ) (Must equal or exceed Federal Adjusted Gross Income from line 9 of Form PIT 1 ) = (See PIT RC instructions) *120380200* *120390200* 1 Number of exemptions from line 5 of Form PIT 1 1 10 00 11 00 11 All other income such as interest dividends gambling winnings insurance settlements scholarships grants VA benefits trust income and inheritance alimony and child support 12 00 12 Modified Gross Income (Add lines 4 through 11) Enter total on line 12 and on line 13 of page 2 13 00 13 Enter Modified Gross Income from line 12 14 00 14 Low Income Comprehensive Tax Rebate: On table 1 in the instructions find the Modified Gross Income range that includes the amount on line 13 then move across to the column that matches the number of exemptions on line 13a (Married couples filing separately must divide result by two ) 15 00 16a 00 16c 00 17 REBATE AMOUNT 17a 00 17b 00 17c 00 18 REBATE AMOUNT 18b % 19 00 2 a Enter number of household members who DO NOT qualify If all exemptions qualify leave blank 2a 2012 PIT RC 2012 PIT RC (page 2) 21 00 22 00 23 00 24 00 25 00 26 00 27 00 27 Add lines 14 17c 18c 22 23 24 25 and 26 Enter here and on line 24 of Form PIT 1 3 Add lines 2g and 2h Enter here and on line 13a on page 2 of this form 3 = 4 Wages salaries tips etc 5 Social Security benefits pensions annuities and Railroad Retirement a Add lines 15 and 16c and enter the total here a Amount of rent paid during the tax year for principal place of residence a Enter total exemptions from line 3 A I was a resident of New Mexico during any portion of the tax year TRUE TRUE b Check if the amount entered on line 16a includes rent paid on your behalf by a government entity B I was physically present in New Mexico for at least six months in 2012 TRUE TRUE b Subtract 2a from 1 Number of allowable household members 2b = c Extra Exemption: Enter 1 if you or your spouse (if Married Filing Jointly) are blind for federal income C I was NOT eligible to be claimed as a dependent of another taxpayer for income tax purposes in 2012 TRUE TRUE c Multiply line 16a by 06 and enter the amount here CALCULATE MODIFIED GROSS INCOME Modified Gross Income generally is all income of the taxpayer and household members both taxable and nontaxable and undiminished by losses See instructions for certain types of income that do not have to be included in modified gross income NOTE: If Married Filing Separately be sure to include spouse's income Capital gains undiminished by capital losses + d Add lines 2b and 2c 2d = D I was NOT an inmate of a public institution for a period of more than six months in 2012 TRUE TRUE e If you are 65 or older enter "2" 2e + Enter either the total of Column G or $1 200 WHICHEVER IS LESS Enter portion of Federal Child Care Credit applied against your federal tax from Form 1040 or 1040A f If Married Filing Jointly and your spouse is 65 or older enter "2" 2f + Find the Modified Gross Income range table 2 in the instructions that corresponds to the amount on line 13 Read across the table to the column showing your maximum property tax liability and enter amount here Find the Modified Gross Income range table 3 in the instructions that corresponds to the amount on line 13 above Read across the table to the column showing your property tax rebate percentage and enter here g Add lines 2d 2e and 2f 2g = Gifts of cash or marketable tangible items received (Must be given a reasonable value ) h If you checked filing status (3) Married filing separately on your Form PIT 1 enter the number Los Alamos County Santa Fe County Multiply line 18a by line 18b and enter here Do not enter more than $350 or $175 if Married Filing Separately Net profit from business farm or rentals If a loss enter zero Do not enter a negative number New Mexico child day care credit: Subtract line 21 from line 19 (Married couples filing separately must divide result by two ) NEW MEXICO REBATE AND CREDIT SCHEDULE Number of qualified dependents under age 15 receiving child day care of exemptions your spouse claimed on line 2g of his or her PIT RC if any 2h + Print your name (first middle last) PROPERTY OWNED only Tax billed for the calendar year on principal place of residence PROPERTY OWNED Tax billed for the calendar year on principal place of residence PROPERTY RENTED Property Tax Rebate: Subtract line 17b from 17a Do not enter more than $250 or more than $125 if Married Filing Separately Public assistance TANF welfare benefits and Supplemental Security Income (SSI) + Qualifications for Credits and Rebates Reported in Sections II to V: You and your spouse if applicable must mark the box to indicate whether the READ REBATE AND CREDIT SCHEDULE INSTRUCTIONS FOR COMPLETE ELIGIBILITY REQUIREMENTS Refundable medical care credit for persons 65 or older (See PIT RC instructions) Refundable portion of the film production tax credit (Attach Form RPD 41228) Renewable energy production tax credit (Attach Form RPD 41227) SECTION I: QUALIFICATIONS FOR REBATES AND CREDITS REPORTED IN SECTIONS II THROUGH V Complete Section I to claim the following rebates and credits in Sections II through V To claim any refundable tax credits in Section VI you do not need to complete Section I Persons with Modified Gross Income of: $16 000 or less who are age 65 or older may qualify for the Property Tax Rebate SECTION II: LOW INCOME COMPREHENSIVE TAX REBATE SECTION III: FOR PERSONS 65 OR OLDER PROPERTY TAX REBATE SECTION IV: ADDITIONAL LOW INCOME PROPERTY TAX REBATE for Los Alamos or Santa Fe County 18 LA residents only (If line 13 is over $24 000 DO NOT complete this section ) 18 SF SECTION V: NEW MEXICO CHILD DAY CARE CREDIT (If Modified Gross Income on line 13 is $30 160 or less use the worksheet in the instructions for the 2012 PIT RC Schedule to figure your available Child Day Care Credit Attach the worksheet and Forms PIT CG ) SECTION VI: REFUNDABLE TAX CREDITS SECTION VII: TOTAL REBATES AND CREDITS CLAIMED Special needs adopted child tax credit statement is true If the statement is not true leave the box blank If you are not married leave the boxes in the spouse column blank tax purposes Enter 2 if you and your spouse (if Married Filing Jointly) are blind 2c + TAXPAY ER SPOUSE This schedule may be used by individuals who qualify for one or more refundable rebates and credits offered by New Mexico Include Schedule PIT RC with your Personal Income Tax Return Form PIT 1 Unemployment and Workers' Compensation benefits You must indicate the county YOUR SOCIAL SECURITY NUMBER