Form

1040 Department of the Treasury—Internal Revenue Service

U.S. Individual Income Tax Return
(99)
2015 OMB No. 1545-0074 IRS Use Only–Do not write or staple in this space.
For the year Jan. 1–Dec. 31, 2015, or other tax year beginning , 2015, ending , 20 See separate instructions.
Your first name and initial Last name Your social security number

TIMOTHY J WALZ REDACTED

If a joint return, spouse's first name and initial Last name Spouse's social security number
GWEN L WALZ REDACTED
Home address (number and street). If you have a P.O. box, see instructions. Apt. no.
p Make sure the SSN(s) above
and on line 6c are correct.
REDACTED
City, town or post office, state, and ZIP code. If you have a foreign address, also complete spaces below (see instructions). Presidential Election Campaign
Check here if you, or your spouse
REDACTED if filing jointly, want $3 to go to this
fund. Checking a box below will
Foreign country name Foreign province/state/county Foreign postal code not change your tax or refund.

X You X Spouse
Head of household (with qualifying person). (See instructions.) If
Filing Status 1 Single 4 the qualifying person is a child but not your dependent, enter this
2 X Married filing jointly (even if only one had income) child's name here. u

Check only one 3 Married filing separately. Enter spouse's SSN above 5 Qualifying widow(er) with dependent child
box. and full name here. u

X Boxes checked
Exemptions 6a
b X
Yourself. If someone can claim you as a dependent, do not check box 6a . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
}
Spouse . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
on 6a and 6b
No. of children
2
(4) ü ifon 6c who:
c Dependents: child under
(2) Dependent's (3) Dependent's age 17 qual. •
lived with you 2
for child

(1) First name Last name

social security number relationship to you tax credit •
did not live with
(see instr.) you due to divorce
REDACTED or separation
If more than four WALZ REDACTED Daughter X (see instructions)
dependents, see REDACTED

instructions and
WALZ REDACTED Son X Dependents on 6c
check here u not entered above

Add numbers on
d Total number of exemptions claimed ................................................................................ lines above u 4
7 Wages, salaries, tips, etc. Attach Form(s) W-2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 203,700
Income 8a Taxable interest. Attach Schedule B if required ........................................................ 8a
Attach Form(s) b Tax-exempt interest. Do not include on line 8a ...................... 8b
W-2 here. Also 9a Ordinary dividends. Attach Schedule B if required 9a
......................................................
attach Forms
b Qualified dividends . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9b
W-2G and
1099-R if tax 10 Taxable refunds, credits, or offsets of state and local income taxes ..................................... 10 236
was withheld. 11 Alimony received . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
If you did not 12 Business income or (loss). Attach Schedule C or C-EZ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12
get a W-2, 13 Capital gain or (loss). Attach Schedule D if required. If not required, check here u . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
see instructions. 14 Other gains or (losses). Attach Form 4797 ............................................................. 14
15a IRA distributions . . . . . . . . . . . . . . 15a b Taxable amount . . . . . . . . . . . . . . 15b
16a Pensions and annuities . . . . . . . 16a b Taxable amount . . . . . . . . . . . . . . 16b
17 Rental real estate, royalties, partnerships, S corporations, trusts, etc. Attach Schedule E . . . . . . . . . . . . . . . 17
18 Farm income or (loss). Attach Schedule F . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18
19 Unemployment compensation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19
20a Social security benefits . . . . . . . . . . 20a b Taxable amount . . . . . . . . . . . . . . 20b
21 Other income. List type and amount .................................................................... 21
22 Combine the amounts in the far right column for lines 7 through 21. This is your total income ...... u 22 203,936
23 Educator expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23
Adjusted 24 Certain business expenses of reservists, performing artists, and
Gross fee-basis government officials. Attach Form 2106 or 2106-EZ ........ 24
Income 25 Health savings account deduction. Attach Form 8889 . . . . . . . . . . . . . . . . 25
26 Moving expenses. Attach Form 3903 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26
27 Deductible part of self-employment tax. Attach Schedule SE .........
27
28 Self-employed SEP, SIMPLE, and qualified plans ....................
28
29 Self-employed health insurance deduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29
30 Penalty on early withdrawal of savings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30
31a Alimony paid b Recipient's SSN u 31a
32 IRA deduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32
33 Student loan interest deduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33
34 Tuition and fees. Attach Form 8917 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34
35 Domestic production activities deduction. Attach Form 8903 ......... 35
36 Add lines 23 through 35 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36
37 Subtract line 36 from line 22. This is your adjusted gross income . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . u 37 203,936
For Disclosure, Privacy Act, and Paperwork Reduction Act Notice, see separate instructions. Form 1040 (2015)
DAA
Form 1040 (2015) TIMOTHY J & GWEN L WALZ REDACTED Page 2
38 Amount from line 37 (adjusted gross income) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 38 203,936
39a Check You were born before January 2, 1951, Blind.
Tax and
Credits
if: {Spouse was born before January 2, 1951, Blind.
Total boxes
checked u } 39a
b If your spouse itemizes on a separate return or you were a dual-status alien, check here u 39b
Standard
Deduction 40 Itemized deductions (from Schedule A) or your standard deduction (see left margin) ............... 40 28,556
for— 41 Subtract line 40 from line 38 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 41 175,380
• People who
check any
42 Exemptions. If line 38 is $154,950 or less, multiply $4,000 by the number on line 6d. Otherwise, see instructions . . . . . . . . . . . 42 16,000
box on line 43 Taxable income. Subtract line 42 from line 41. If line 42 is more than line 41, enter -0- . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 43 159,380
39a or 39b or Form(s) Form c
who can be 44 Tax (see instr.). Check if any from: a 8814 b 4972 . ........................ 44 31,678
claimed as a
dependent,
45 Alternative minimum tax (see instructions). Attach Form 6251 .......................................
45
see 46 Excess advance premium tax credit repayment. Attach Form 8962 46
instructions. .....................................

• All others:
47 Add lines 44, 45, and 46 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . u 47 31,678
Single or 48 Foreign tax credit. Attach Form 1116 if required . . . . . . . . . . . . . . . . . . . . . . . 48
Married filing
separately, 49 Credit for child and dependent care expenses. Attach Form 2441 ..... 49
$6,300 50
50 Education credits from Form 8863, line 19 ............................
Married filing
jointly or 51 Retirement savings contributions credit. Attach Form 8880 . . . . . . . . . . . . 51
Qualifying
widow(er), 52 Child tax credit. Attach Schedule 8812, if required . . . . . . . . . . . . . . . . . . . . . 52
$12,600 Residential energy credits. Attach Form 5695 53
53 .........................
Head of
household, 54 Other credits from Form: a 3800 b 8801 c 54
$9,250
55 Add lines 48 through 54. These are your total credits . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 55
56 Subtract line 55 from line 47. If line 55 is more than line 47, enter -0- . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . u 56 31,678
57 Self-employment tax. Attach Schedule SE 57
Other Unreported social security and Medicare tax from Form:
..................................................................
a 4137 b 8919 58
58
Taxes ............
59
59 Additional tax on IRAs, other qualified retirement plans, etc. Attach Form 5329 if required ..............
60a Household employment taxes from Schedule H ........................................................ 60a
b First-time homebuyer credit repayment. Attach Form 5405 if required . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 60b
61 Health care: individual responsibility (see instructions) Full-year coverage X ..................... 61
62 Taxes from: a b Form 8960 c
Form 8959 Instructions; enter code(s) 62
63 Add lines 56 through 62. This is your total tax . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . u 63 31,678
64 Federal income tax withheld from Forms W-2 and 1099 .............. 64 31,686
Payments 65 2015 estimated tax payments and amount applied from 2014 return 65
.........
If you have a 66a Earned income credit (EIC) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 66a
qualifying
b Nontaxable combat pay election . . . . 66b
child, attach
Schedule EIC. 67 Additional child tax credit. Attach Schedule 8812 ..................... 67
68 American opportunity credit from Form 8863, line 8 . . . . . . . . . . . . . . . . . . . 68
69 Net premium tax credit. Attach Form 8962 . . . . . . . . . . . . . . . . . . . . . . . . . . . . 69
70 Amount paid with request for extension to file . . . . . . . . . . . . . . . . . . . . . . . . . 70
71 Excess social security and tier 1 RRTA tax withheld . . . . . . . . . . . . . . . . . . 71
72 Credit for federal tax on fuels. Attach Form 4136 ..................... 72
73 Credits from Form: a 2439 b Reserved c 8885 d 73
74 Add lines 64, 65, 66a, and 67 through 73. These are your total payments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . u 74 31,686
Refund 75 If line 74 is more than line 63, subtract line 63 from line 74. This is the amount you overpaid . . . . . . . . . . . 75 8
76a Amount of line 75 you want refunded to you. If Form 8888 is attached, check here .......... u 76a 8
Direct deposit? u b Routing number XXXXXXXXX u c Type: Checking Savings
See
instructions.
u d Account number XXXXXXXXXXXXXXXXX
77 Amount of line 75 you want applied to your 2016 estimated tax u 77
Amount 78 Amount you owe. Subtract line 74 from line 63. For details on how to pay, see instructions . . . . . . . . u 78
You Owe 79 Estimated tax penalty (see instructions) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 79
Do you want to allow another person to discuss this return with the IRS (see instructions)? X Yes. Complete below. No
Third Party REDACTED
Designee's
Personal identification number (PIN) u
Designee
name u Thomas J Rosen Phone no. u REDACTED
Under penalties of perjury, I declare that I have examined this return and accompanying schedules and statements, and to the best of my knowledge and belief,
Sign they are true, correct, and complete. Declaration of preparer (other than taxpayer) is based on all information of which preparer has any knowledge. Daytime phone number
Here Your signature Date Your occupation
Joint return? If the IRS sent you an Identity
See instr. Protection PIN,
Keep a copy Spouse's signature. If a joint return, both must sign. Date Spouse's occupation
for your enter it here
records. (see instr.)
Print/Type preparer's name Preparer's signature Date Check if PTIN

Paid Thomas J Rosen self-employed REDACTED

Preparer Firm's name u Frederick & Rosen, Ltd. Firm's EIN u 41-1406219
Use Only Firm's address u 5922 Excelsior Blvd Phone no.

St. Louis Park MN 55416-2811 REDACTED

www.irs.gov/form1040
DAA Form 1040 (2015)
SCHEDULE A Itemized Deductions OMB No. 1545-0074

(Form 1040)
Department of the Treasury
u Information about Schedule A and its separate instructions is at www.irs.gov/schedulea. 2015
Attachment
Attach to Form 1040.
Internal Revenue Service (99) Sequence No. 07
Name(s) shown on Form 1040 Your social security number
TIMOTHY J & GWEN L WALZ REDACTED
Caution: Do not include expenses reimbursed or paid by others.
Medical 1 Medical and dental expenses (see instructions) 1
......................
and 2 Enter amount from Form 1040, line 38 2 203,936
Dental 3 Multiply line 2 by 10% (.10). But if either you or your spouse was
Expenses born before January 2, 1951, multiply line 2 by 7.5% (.075) instead 3 20,394
4 Subtract line 3 from line 1. If line 3 is more than line 1, enter -0- . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
Taxes You 5 State and local (check only one box):
Paid 5 11,634
a
b
X Income taxes, or
General sales taxes } ....................................

6 Real estate taxes (see instructions) .................................. 6 2,176

7 Personal property taxes .............................................. 7 260
8 Other taxes. List type and amount ................................
Payroll Taxes
. ...................................................................... 8
9 Add lines 5 through 8 .................................................................................. 9 14,070
Interest 10 Home mortgage interest and points reported to you on Form 1098 .......... 10 8,486
You Paid 11 Home mortgage interest not reported to you on Form 1098. If paid to the
person from whom you bought the home, see instructions and show that
Note: person's name, identifying no., and address ...........................
Your mortgage
. ......................................................................
interest
deduction may . ......................................................................
be limited (see . ...................................................................... 11
instructions). 12 Points not reported to you on Form 1098. See instructions for
special rules . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12
13 Mortgage insurance premiums (see instructions) . . . . . . . . . . . . . . . . . . . . . 13
14 Investment interest. Attach Form 4952 if required. (See
instructions.) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14
15 Add lines 10 through 14 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15 8,486
Gifts to 16 Gifts by cash or check. If you made any gift of $250 or more,
Charity see instructions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16 5,200
If you made a 17 Other than by cash or check. If any gift of $250 or more, see
gift and got a instructions. You must attach Form 8283 if over $500 . . . . . . . . . . . . . . . . 17 800
benefit for it, 18 Carryover from prior year . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18
see instructions.
19 Add lines 16 through 18 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19 6,000
Casualty and
Theft Losses 20 Casualty or theft loss(es). Attach Form 4684. (See instructions.) ....................................... 20
Job Expenses 21 Unreimbursed employee expenses—job travel, union dues,
job education, etc. Attach Form 2106 or 2106-EZ if required.
and Certain
(See instructions.) ................................................
Miscellaneous
....................................................................... 21
Deductions 22 Tax preparation fees . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22 350
23 Other expenses—investment, safe deposit box, etc. List type
and amount ......................................................

. ...................................................................... 23
24 Add lines 21 through 23 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24 350
25 Enter amount from Form 1040, line 38 25 203,936
26 Multiply line 25 by 2% (.02) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26 4,079
27 Subtract line 26 from line 24. If line 26 is more than line 24, enter -0- ................................... 27 0
Other 28 Other—from list in instructions. List type and amount ...............................................
Miscellaneous
Deductions . ........................................................................................................ 28
Total 29 Is Form 1040, line 38, over $154,950?
Itemized No. Your deduction is not limited. Add the amounts in the far right column
for lines 4 through 28. Also, enter this amount on Form 1040, line 40. 29 28,556
Deductions . ............
XYes. Your deduction may be limited. See the Itemized Deductions
Worksheet in the instructions to figure the amount to enter.
30 If you elect to itemize deductions even though they are less than your standard
deduction, check here . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
For Paperwork Reduction Act Notice, see Form 1040 instructions. Schedule A (Form 1040) 2015
DAA
 Child and Dependent Care Expenses 1040
Form 2441 u Attach to Form 1040, Form 1040A, or Form 1040NR.
. ......
1040A
t OMB No. 1545-0074

u Information about Form 2441 and its separate instructions is at

. ......
1040NR 2015
Department of the Treasury 2441 Attachment
Internal Revenue Service (99) www.irs.gov/form2441. Sequence No. 21
Name(s) shown on return Your social security number

TIMOTHY J & GWEN L WALZ REDACTED

Part I Persons or Organizations Who Provided the Care –You must complete this part.
(If you have more than two care providers, see the instructions.)
1 (a) Care provider's (b) Address (c) Identifying number (d) Amount paid
name (number, street, apt. no., city, state, and ZIP code) (SSN or EIN) (see instructions)

. ......................................................
See Statement 1 2,500
. ......................................................

Did you receive No u Complete only Part II below.

dependent care benefits? Yes u Complete Part III on the back next.
Caution. If the care was provided in your home, you may owe employment taxes. If you do, you cannot file Form 1040A. For details,
see the instructions for Form 1040, line 60a, or Form 1040NR, line 59a.
Part II Credit for Child and Dependent Care Expenses
2 Information about your qualifying person(s). If you have more than two qualifying persons, see the instructions.
(a) Qualifying person's name (b) Qualifying person's social
(c) Qualified expenses you
incurred and paid in 2015 for the
security number
First Last person listed in column (a)

REDACTED
WALZ REDACTED 2,500

3 Add the amounts in column (c) of line 2. Do not enter more than $3,000 for one qualifying
person or $6,000 for two or more persons. If you completed Part III, enter the amount
from line 31 ................................................................................................................ 3 0
4 Enter your earned income. See instructions ............................................................................... 4 148,912
5 If married filing jointly, enter your spouse's earned income (if you or your spouse was a
student or was disabled, see the instructions); all others, enter the amount from line 4 ..................................... 5 54,788
6 Enter the smallest of line 3, 4, or 5 ......................................................................................... 6 0
7 Enter the amount from Form 1040, line 38; Form
1040A, line 22; or Form 1040NR, line 37 ................................................. 7 203,936
8 Enter on line 8 the decimal amount shown below that applies to the amount on line 7
If line 7 is: If line 7 is:
But not Decimal But not Decimal
Over over amount is Over over amount is
$0 – 15,000 .35 $29,000 – 31,000 .27
15,000 – 17,000 .34 31,000 – 33,000 .26
17,000 – 19,000 .33 33,000 – 35,000 .25 8 X .20
19,000 – 21,000 .32 35,000 – 37,000 .24
21,000 – 23,000 .31 37,000 – 39,000 .23
23,000 – 25,000 .30 39,000 – 41,000 .22
25,000 – 27,000 .29 41,000 – 43,000 .21
27,000 – 29,000 .28 43,000 – No limit .20
9 Multiply line 6 by the decimal amount on line 8. If you paid 2014 expenses in 2015, see
the instructions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9
10 Tax liability limit. Enter the amount from the Credit
Limit Worksheet in the instructions ....................................................... 10 31,678
11 Credit for child and dependent care expenses. Enter the smaller of line 9 or line 10
here and on Form 1040, line 49; Form 1040A, line 31; or Form 1040NR, line 47 ............................................ 11
For Paperwork Reduction Act Notice, see your tax return instructions. Form 2441 (2015)

DAA
 TIMOTHY J & GWEN L WALZ REDACTED
Form 2441 (2015) Page 2
Part III Dependent Care Benefits
12 Enter the total amount of dependent care benefits you received in 2015. Amounts you
received as an employee should be shown in box 10 of your Form(s) W-2. Do not include
amounts reported as wages in box 1 of Form(s) W-2. If you were self-employed or a
partner, include amounts you received under a dependent care assistance program from
your sole proprietorship or partnership ...................................................................................... 12 2,500
13 Enter the amount, if any, you carried over from 2014 and used in 2015 during the grace
period. See instructions .................................................................................................... 13
14 Enter the amount, if any, you forfeited or carried forward to 2016. See instructions .......................................... 14 ( )
15 Combine lines 12 through 14. See instructions ............................................................................. 15 2,500
16 Enter the total amount of qualified expenses incurred
in 2015 for the care of the qualifying person(s) ......................................... 16 2,500
17 Enter the smaller of line 15 or 16 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17 2,500
18 Enter your earned income. See instructions ............................................. 18 148,912
19 Enter the amount shown below that applies
to you.
• If married filing jointly, enter your
spouse’s earned income (if you or your
spouse was a student or was disabled,
see the instructions for line 5). u .................................... 19 54,788
• If married filing separately, see
instructions.
• All others, enter the amount from line 18.
20 Enter the smallest of line 17, 18, or 19 ................................................... 20 2,500
21 Enter $5,000 ($2,500 if married filing separately and
you were required to enter your spouse’s earned
income on line 19) ........................................................................ 21 5,000
22 Is any amount on line 12 from your sole proprietorship or partnership? (Form 1040A filers
go to line 25.)
X No. Enter -0-.
Yes. Enter the amount here ........................................................................................... 22 0
23 Subtract line 22 from line 15 .............................................................. 23 2,500
24 Deductible benefits. Enter the smallest of line 20, 21, or 22. Also, include this amount on
the appropriate line(s) of your return. See instructions ...................................................................... 24
25 Excluded benefits. Form 1040 and 1040NR filers: If you checked "No" on line 22, enter
the smaller of line 20 or 21. Otherwise, subtract line 24 from the smaller of line 20 or line
21. If zero or less, enter -0-. Form 1040A filers: Enter the smaller of line 20 or line 21 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25 2,500
26 Taxable benefits. Form 1040 and 1040NR filers: Subtract line 25 from line 23. If zero or
less, enter -0-. Also, include this amount on Form 1040, line 7, or Form 1040NR, line 8. On
the dotted line next to Form 1040, line 7, or Form 1040NR, line 8, enter “DCB.”
Form 1040A filers: Subtract line 25 from line 15. Also, include this amount on Form 1040A,
line 7. In the space to the left of line 7, enter “DCB” ......................................................................... 26 0
To claim the child and dependent care
credit, complete lines 27 through 31 below.
27 Enter $3,000 ($6,000 if two or more qualifying persons) .................................................................... 27 3,000
28 Form 1040 and 1040NR filers: Add lines 24 and 25. Form 1040A filers: Enter the amount
from line 25 ................................................................................................................ 28 2,500
29 Subtract line 28 from line 27. If zero or less, stop. You cannot take the credit.
Exception. If you paid 2014 expenses in 2015, see the instructions for line 9 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29 500
30 Complete line 2 on the front of this form. Do not include in column (c) any benefits shown
on line 28 above. Then, add the amounts in column (c) and enter the total here ............................................. 30 0
31 Enter the smaller of line 29 or 30. Also, enter this amount on line 3 on the front of this form
and complete lines 4 through 11 ............................................................................................ 31 0
Form 2441 (2015)

DAA
Form 8283 Noncash Charitable Contributions OMB No. 1545-0908
(Rev. December 2014) u Attach to your tax return if you claimed a total deduction
Department of the Treasury
of over $500 for all contributed property.
Attachment
Internal Revenue Service
u Information about Form 8283 and its separate instructions is at www.irs.gov/form8283. Sequence No. 155
Name(s) shown on your income tax return Identifying number
TIMOTHY J & GWEN L WALZ REDACTED
Note. Figure the amount of your contribution deduction before completing this form. See your tax return instructions.
Section A. Donated Property of $5,000 or Less and Publicly Traded Securities–List in this section only items (or
groups of similar items) for which you claimed a deduction of $5,000 or less. Also list publicly traded
securities even if the deduction is more than $5,000 (see instructions).
Part I Information on Donated Property–If you need more space, attach a statement.
(b) If donated property is a vehicle (see instructions), (c) Description of donated property
(a) Name and address of the
1 check the box. Also enter the vehicle identification (For a vehicle, enter the year, make, model, and mileage. For
donee organization
number (unless Form 1098-C is attached). securities, enter the company name and the number of shares.)

Minnesota Valley Action Council

A 706 Victory Drive Clothing,Household Goods,Furniture
Mankato MN 56001

Note. If the amount you claimed as a deduction for an item is $500 or less, you do not have to complete columns (e), (f), and (g).
(d) Date of the (e) Date acquired (f) How acquired (g) Donor's cost (h) Fair market value (i) Method used to determine
contribution by donor (mo., yr.) by donor or adjusted basis (see instructions) the fair market value

A Various Various Purchase 3,250 800 Thrift Shop Value

B
C
D
E
Part II Partial Interests and Restricted Use Property–Complete lines 2a through 2e if you gave less than an
entire interest in a property listed in Part I. Complete lines 3a through 3c if conditions were placed on a
contribution listed in Part I; also attach the required statement (see instructions).
2a Enter the letter from Part I that identifies the property for which you gave less than an entire interest
If Part II applies to more than one property, attach a separate statement.
b Total amount claimed as a deduction for the property listed in Part I: (1) For this tax year
(2) For any prior tax years
c Name and address of each organization to which any such contribution was made in a prior year (complete only if different
from the donee organization above):
Name of charitable organization (donee)

Address (number, street, and room or suite no.)

City or town, state, and ZIP code

d For tangible property, enter the place where the property is located or kept u
e Name of any person, other than the donee organization, having actual possession of the property u

3a Is there a restriction, either temporary or permanent, on the donee's right to use or dispose of the donated Yes No
property? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
b Did you give to anyone (other than the donee organization or another organization participating with the donee
organization in cooperative fundraising) the right to the income from the donated property or to the possession of
the property, including the right to vote donated securities, to acquire the property by purchase or otherwise, or to
designate the person having such income, possession, or right to acquire? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
c Is there a restriction limiting the donated property for a particular use? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
For Paperwork Reduction Act Notice, see separate instructions. Form 8283 (Rev. 12-2014)
DAA
REDACTED Federal Statements

Statement 1 - Form 2441, Part I, Line 1 - Child Care Provider Information

Provider's Provider's
Name Address SSN or EIN Amount Paid
Whitney Sannes REDACTED REDACTED $ 825
REDACTED
Mankato Community Education REDACTED REDACTED 1,225
REDACTED
Amanda Frie REDACTED REDACTED 450
REDACTED

1
 Form 1040 Salaries & Wages Report 2015
Name Taxpayer Identification Number
TIMOTHY J & GWEN L WALZ REDACTED
T/S Employer Federal Wages Federal Withheld Soc Sec Wages
A T House of Rep-Member Services 148,912 25,680 118,500
B S Independent School District 77 54,788 6,006 61,525
C
D
E
F
G
H
I
J
K
L
M

Taxpayer 148,912 25,680 118,500

Spouse 54,788 6,006 61,525
Totals 203,700 31,686 180,025

Soc Sec Withheld Medicare Wages Medicare Withheld Soc Sec Tips Allocated Tips Dep Care Ben Other, Box 14
A 7,347 160,012 2,320 2,500
B 3,815 61,525 892
C
D
E
F
G
H
I
J
K
L
M

Taxpayer 7,347 160,012 2,320 2,500

Spouse 3,815 61,525 892
Totals 11,162 221,537 3,212 2,500
State State Wages State Withheld Name of Locality Local Wages Local Withheld
A MN 148,912 9,001
B MN 54,788 2,633
C
D
E
F
G
H
I
J
K
L
M

Taxpayer 148,912 9,001

Spouse 54,788 2,633
Totals 203,700 11,634
 M1 MINNESOTA . REVENUE Individual Income Tax 2015 1511

Leave unused boxes blank. Do not use staples on anything you submit.
Your First Name and Initial Last Name
TIMOTHY J WALZ REDACTED
Place If a Joint Return, Spouse’s First Name and Initial Spouse’s Last Name

an X if a GWEN L WALZ REDACTED

Foreign Current Home Address (Street, Apartment Number, Route)
REDACTED
Address: REDACTED 1964
City State Zip Code
REDACTED
REDACTED 1966
2015 Federal
Filing Status (1) Single X (2) Married filing joint (3) Married filing separate:
(place an X in (4) Head of Enter spouse's name and
one box): household (5) Qualifying widow(er) Social Security number here
State Elections Campaign Fund
If you want $5 to go to help candidates for state of- Political party and code number:
fices pay campaign expenses, you may each enter Republican . . . . . . . . . . . . 11 Grassroots–Legalize Cannabis 14 Legal Marijuana Now . . . . 17
the code number for the party of your choice. This Democratic/Farmer-Labor 12 Green . . . . . . . . . . . . . . . . . . . . 15 General Campaign
will not increase your tax or reduce your refund. Independence . . . . . . . . . 13 Libertarian . . . . . . . . . . . . . . . . . 16 Fund . . . . . . . . . . . . . . . . . 99 12 12
From Your Federal Return (for line references see instructions), enter the amount of:
A Wages, salaries, tips, etc.: B IRA, Pensions and annuities: C Unemployment: D Federal adjusted gross income:

203700 203936
Do not send W-2s. Enclose Schedule M1W to

1 Federal taxable income (from line 43 of federal Form 1040,

line 27 of Form 1040A or line 6 of Form 1040EZ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 159380
2 State income tax or sales tax addition. If you itemized deductions
claim Minnesota withholding.

on federal Form 1040, complete the worksheet in the instructions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 11634

3 Other additions to income, including disallowed itemized deductions,
personal exemptions, non-Minnesota bond interest and domestic production
activities deduction (see instructions; enclose Schedule M1M) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 598

4 Add lines 1 through 3 (if a negative number, place an X in the box) ........................... 4 171612

5 State income tax refund from line 10 of federal Form 1040 .................................... 5 236

6 Other subtractions, such as net interest or mutual fund dividends from U.S. bonds
or K-12 education expenses (see instructions; enclose Schedule M1M) . . . . . . . . . . . . . . . . . . . . . . 6

7 Total subtractions. Add lines 5 and 6 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 236

8 Minnesota taxable income. Subtract line 7 from line 4. If zero or less, leave blank. ......... 8 171376

9 Tax from the table in the M1 instructions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 11665

10 Alternative minimum tax (enclose Schedule M1MT) ......................................... 10

11 Add lines 9 and 10 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11 11665

12 Full-year residents: Enter the amount from line 11 on line 12. Skip lines 12a and 12b.
Part-year residents and nonresidents: From Schedule M1NR, enter the tax from line 27 on
line 12, from line 23 on line 12a, and from line 24 on line 12b (enclose Schedule M1NR) . . . . . . . . . . . 12 11665
a. b.

13 Tax on lump-sum distribution (enclose Schedule M1LS) ..................................... 13

14 Tax before credits. Add lines 12 and 13 ...................................................... 14 11665

1015
 2015 M1, page 2 1512

15 Tax before credits. Amount from line 14 ...................................................... 15 11665

16 Marriage credit for joint return when both spouses have taxable earned income
or taxable retirement income (enclose Schedule M1MA) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16 81
17 Credit for taxes paid to another state (enclose Schedule(s) M1CR) ........................... 17

18 Other nonrefundable credits (enclose Schedule M1C) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18

19 Total nonrefundable credits. Add lines 16 through 18 ......................................... 19 81

20 Subtract line 19 from line 15 (if result is zero or less, leave blank) ............................ 20 11584
21 Nongame Wildlife Fund contribution (see instructions)
This will reduce your refund or increase amount owed . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21

22 Add lines 20 and 21 .......................................................................... 22 11584

23 Minnesota income tax withheld. Complete and enclose Schedule M1W to report
Minnesota withholding from W-2, 1099 and W-2G forms (do not send) . . . . . . . . . . . . . . . . . . . . . . . 23 11634

24 Minnesota estimated tax and extension payments made for 2015 ............................. 24
25 Child and Dependent Care Credit (enclose Schedule
M1CD). Enter number of qualifying persons here: . ............ 25
26 Minnesota Working Family Credit (enclose Schedule
M1WFC). Enter number of qualifying children here: . ............ 26
27 K–12 Education Credit (enclose Schedule M1ED).
Enter number of qualifying children here: . ............ 27

28 Business and investment credits (enclose Schedule M1B) ................................... 28

29 Total payments. Add lines 23 through 28 ..................................................... 29 11634

30 REFUND. If line 29 is more than line 22, subtract line 22 from line 29
(see instructions). For direct deposit, complete line 31 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30 50
31 Direct deposit of your refund (you must use an account not associated with a foreign bank):

Checking Savings

32 AMOUNT YOU OWE. If line 22 is more than line 29, subtract

line 29 from line 22 (see instructions) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32
33 Penalty amount from Schedule M15 (see instructions). Also subtract
this amount from line 30 or add it to line 32 (enclose Schedule M15) . . . . . . . . . . . . . . . . . . . . . . . . . 33
IF YOU PAY ESTIMATED TAX and want part of your refund credited to estimated tax, complete lines 34 and 35.
34 Amount from line 30 you want sent to you .................................................... 34

35 Amount from line 30 you want applied to your 2016 estimated tax . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35

I declare that this return is correct and complete to the best of my knowledge and belief. Paid preparer: You must sign below.
Your signature Date Paid preparer’s signature Date

Spouse's signature (if filing jointly) Taxpayer’s daytime phone Preparer’s daytime phone

REDACTED REDACTED
Include a copy of your 2015 federal return and schedules.
Mail to: Minnesota Individual Income Tax I authorize the Minnesota Department of
St. Paul, MN 55145-0010 X Revenue to discuss this return with my I do not want my paid preparer
To check on the status of your refund, visit www.revenue.state.mn.us paid preparer or the third-party designee to file my return electronically.
indicated on my federal return.

1015
MINNESOTA . REVENUE 1531

2015 Schedule M1W, Minnesota Income Tax Withheld

Sequence #2

Complete this schedule to report Minnesota income tax withheld. Include this schedule when you file your return.

TIMOTHY J WALZ REDACTED

GWEN L WALZ REDACTED

If you received a W-2, 1099, W-2G, Schedule KPI, KS or KF that shows Minnesota income tax was withheld, complete this schedule
to determine line 22 of Form M1. List only the forms that report Minnesota income tax withheld. Round dollar amounts to the nearest
whole dollar. You must include this schedule when you file your return. DO NOT send in your W-2, 1099 or W-2G forms; keep them with
your tax records. All instructions are included on this schedule.
1 Minnesota wages and tax withheld from W-2s, other than from W-2G. If you have more than five W-2s, complete line 5 on the back.
A B—Box 13 C—Box 15 D—Box 16 E—Box 17

If the W-2 is for: If Retirement Plan Employer's 7-digit Minnesota State wages, tips, etc. Minnesota tax withheld

• you, enter 1 box is checked, state tax ID number (round to nearest whole dollar) (round to nearest whole dollar)

• spouse, enter 2 mark an X below.

1 X REDACTED 148912 9001

2 X REDACTED 54788 2633

Subtotal for additional W-2s (from line 5 on the back) .............................................................

Total Minnesota tax withheld from all W-2 forms (add amounts in line 1, column E) .......................... 1 11634

2 Minnesota tax withheld from 1099 and W-2G forms. If you have more than four forms, complete line 6 on the back.
A B C D

If the 1099 or W-2G is for: Payer's 7-digit Minnesota state tax ID Income amount (see the table on Minnesota tax withheld

• you, enter 1 number (if unknown, contact the payer) the back for amounts to include) (round to nearest whole dollar)

• spouse, enter 2

Subtotal for additional 1099 and W-2G forms (from line 6 on the back) ............................................

Total Minnesota tax withheld from all 1099 and W-2G forms (add amounts in line 2, column D) ............. 2

3 Total Minnesota tax withheld by partnerships, S corporations and fiduciaries

(from line 7 on the back) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
4 Total. Add the Minnesota tax withheld on lines 1, 2 and 3.
Enter the total here and on line 22 of Form M1 ................................................................... 4 11634
Include this schedule with your Form M1.
If required, include Schedules KPI, KS and/or KF.

1015
MINNESOTA . REVENUE 1555
2015 Schedule M1M, Income Additions and Subtractions
Sequence #3

Complete this schedule to determine line 3 and line 6 of Form M1.

TIMOTHY J WALZ REDACTED

Additions to Income
1 Itemized deduction limitation for taxpayers with an adjusted gross income which
exceeds $184,000 ($92,000 if married filing separate) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 598
2 Personal exemption phase out for taxpayers with an adjusted gross income
that exceeds the applicable threshold (see instructions) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
3 Interest from municipal bonds of another state or its governmental units
included on line 8b of federal Form 1040 or 1040A . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
4 Federally tax-exempt dividends from mutual funds investing in bonds of another state
or its governmental units included on line 8b of federal Form 1040 or 1040A . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4

5 Federal bonus depreciation addition (determine from worksheet in the instructions) ....................... 5

6 Federal section 179 expensing addition (determine from worksheet in the instructions) .................... 6
7 State income taxes passed through to you as a partner of a partnership,
a shareholder of an S corporation or a beneficiary of a trust (see instructions) ............................. 7

8 Domestic production activities deduction (from line 35 of federal Form 1040) .............................. 8
9 Expenses deducted on your federal return attributable to income not taxed
by Minnesota (other than interest or mutual fund dividends from U.S. bonds) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9
10 Fines, fees and penalties federally deducted as a trade or business expense
(see instructions) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10
11 Suspended loss from 2001 through 2005 or 2008 through 2014 on your federal return that
was generated by bonus depreciation (determine from worksheet in the instructions) ...................... 11
12 Capital gain portion of a lump-sum distribution
(from line 6 of federal Form 4972; enclose Form 4972) .................................................... 12

13 Net operating loss carryover adjustment (see instructions) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13

14 Addition from Schedule M1NC, Federal Adjustments,

line 18 .................................................................................................... 14

15 Add lines 1 through 14. Enter the total here and on line 3 of Form M1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15 598

Subtractions From Income

16 Net interest or mutual fund dividends from U.S. bonds (see instructions) .................................. 16

17 Education expenses you paid for your qualifying children in grades K–12 (see instructions)
Enter the name and grade of each child: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17

18 If you did not itemize deductions on your federal return and your charitable
contributions were more than $500, see instructions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18
19 Subtraction for federal bonus depreciation added back to Minnesota taxable income
in 2010 through 2014 (determine from worksheet in the instructions) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19
20 Subtraction for federal section 179 expensing added back to Minnesota
taxable income in 2010 through 2014 (see instructions) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20
21 Subtraction for persons age 65 or older, or permanently
and totally disabled (enclose Schedule M1R) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21

1015
MINNESOTA . REVENUE
2015 Schedule M1MA, Marriage Credit
Sequence #19

Your First Name and Initial Last Name Social Security Number

TIMOTHY J WALZ REDACTED

Spouse's First Name and Initial Last Name Social Security Number
GWEN L WALZ REDACTED
A B
Taxpayer Spouse
1 Wages, salaries, tips, etc. (from line 7 of federal Form 1040
or Form 1040A or line 1 of Form 1040EZ) ............................................. 1 148912 54788
Taxpayer/Spouse Income Information

2 Self-employment income (from line 3 of federal Schedule SE

less the self-employment tax deduction from line 6 of Schedule SE) . . . . . . . . . . . . . . . . . . . 2
3 Taxable pension income
(see instructions) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
4 Taxable Social Security income
(from line 20b of Form 1040 or 14b of Form 1040A) ................................... 4

5 Add lines 1 through 4 for each column . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 148912 54788

6 Amount from line 5, Column A or B, whichever is less
(If less than $22,000, STOP HERE. You do not qualify) ........................................................ 6 54788

7 Joint taxable income from line 8 of Form M1. (If less than $37,000, STOP HERE. You do not qualify) . . . . . . . . . . . 7 171376
8 If line 6 is less than $100,000, determine the amount of your credit using lines 6 and 7 and the
table in the instructions. Full-year residents: Enter the result here and on line 16 of Form M1.
Part-year residents and nonresidents: Continue with line 20 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 81

If line 6 is $100,000 or more, complete lines 9 through 19.

9 Enter the amount from line 6 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9

10 Value of one personal exemption plus one-half of the married-joint standard deduction . . . . . . . . . . . . . . . . . . . . . . . . . . 10 10,300

11 Subtract line 10 from line 9 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11

12 Using the tax table for single persons in the M1 instructions,
If Line 6 is $100,000 or More

compute the tax for the amount on line 11 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12

13 Amount from line 7 ............................................................................................. 13

14 Amount from line 11 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14

15 Subtract line 14 from line 13 (if zero or less, you do not qualify) ................................................ 15
16 Using the tax table for single persons in the M1 instructions,
compute the tax for the amount on line 15 ...................................................................... 16

17 Tax from line 9 of Form M1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17

18 Add lines 12 and 16 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18

19 Subtract line 18 from line 17. If the result is more than $1,415, enter $1,415.
If result is zero or less, you do not qualify. Full-year residents: Enter the result here and on
line 16 of Form M1. Part-year residents and nonresidents: Continue with line 20 . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19
Nonresidents

Part-Year Residents and Nonresidents

Part-Year/

20 Part-year residents and nonresidents: Enter the percentage from line 25 of Schedule M1NR ................ 20
21 Multiply line 8 or line 19, whichever is applicable, by line 20. Enter the result here and
on line 16 of Form M1 .......................................................................................... 21
Include this schedule when you file Form M1. Keep a copy for your records.

1015