8734
                              Form 24                                                                             State Use Only
                              Grocery Credit Refund                                                                                         2022
                              You or Your Spouse Must be Age 65 or Older
Your first name and initial                     Last name                                   Your Social Security number         Deceased on

If a joint return, spouse’s first name and initial Last name                                Spouse’s Social Security number     Deceased on

Current mailing address

City                                                                      State                  ZIP code

A. Income
  1. Enter your gross income. Include wages, salaries, tips, interest, 
     dividends, self-employment income before expenses, farm income 
     before expenses, rental income before expenses, and pensions. 
     Don’t include Social Security benefits and/or Veterans 
     Administration disability benefits on this line ...............................................               1

  2. Filing Status
     ▪   Married filing jointly: one 65 or older $27,300 ................................................
     ▪   Married filing jointly: both 65 or older $28,700 ...............................................
     ▪   Single: 65 or older $14,700 ............................................................................  2

  3. Compare lines 1 and 2.
     ▪   If line 1 is equal to or larger than line 2, you can’t use this form. You must file Form 40
         to receive your grocery credit.
     ▪   If line 1 is less than line 2, continue.
B. Refund Claimed                                                                           Yourself                        Spouse
  1. Enter the date of birth ..........................................................
                                                                                       Month Day     Year            Month    Day            Year
  2. Check the boxes that apply.
     ▪   Under age 65 ................................................... $100 per person                         ▪
     ▪   Age 65 or older ................................................ $120 per person                         ▪
  3.  If you’re donating your grocery credit to the Cooperative Welfare Fund, check here and the 
     $0 total refund claimed box on line 4 ................................................................................................ ▪
                                                                                                                  $0 $120 $220 $240
  4. Total refund claimed (check one box) .............................................................. ▪
  5. Direct Deposit. See instructions.                       ▪  Check if final deposit destination is outside of U.S.

  ▪ Routing No.                                              ▪ Account No.
     Type of Account        ▪          Checking        ▪ Savings

C. Signatures Required
     If you or your spouse can’t sign, your representative must                        If anyone other than the surviving spouse signs 
     write “unable to sign” in the signature spaces and enter their                    on behalf of a deceased person, you must 
     name, address, and relationship.                                                  complete and include IRS Form 1310.
Your signature                                                                         Date                       Phone number

▪ X
Spouse’s signature (If a joint return, both must sign.)

▪ X
MAIL TO:  Idaho State Tax Commission
               PO Box 56
               Boise, ID 83756-0056
EFO00086       12-30-2022

                      Form 24 — Instructions
                      Grocery Credit Refund                                                                           2022

Who Qualifies to Use This Form                                        If your refund is being forwarded from a United States 
You can use this form if all of these are true:                       financial institution to a financial institution or financial 
• You and your spouse were Idaho residents for all                    agency located outside the United States, check the 
  of 2022                                                             box on line 5. If, after filing this form, you become aware 
                                                                      that your electronic refund payment will be electronically 
• You and your spouse aren’t required to file an 
                                                                      deposited in a financial institution or financial agency 
  Idaho income tax return
                                                                      located outside of the United States, please notify us at:
• You’re 65 or older on December 31, 2022, (you 
                                                                           Idaho State Tax Commission
  or your spouse)
                                                                           PO Box 56
You can’t use this form if, for any part of the year, you                  Boise ID 83756-0056
or your spouse:
• Received assistance under the federal food                          Contact your bank to make sure your deposit will be 
  stamp program                                                       accepted and that you have the correct routing and 
                                                                      account numbers.
• Were incarcerated
•  Resided illegally in the United States                             Enter your nine-digit routing number. The routing 
•  Had dependents                                                     number must begin with 01 through 12, or 21 through 32.
• Filed as married filing separately                                  Enter the account number of the account you want your 
If you don’t meet the requirements to use Form 24,                    refund deposited into. The account number can be up to 
you can claim the grocery credit on Form 40 or 43.                    17 characters (both numbers and letters). Don’t include 
                                                                      hyphens, spaces, or special symbols. Enter the number 
You can’t claim the grocery credit on more than one 
                                                                      left to right and leave any unused boxes blank.
form.
                                                                      Check the appropriate box for account type. Check 
Part A. Income                                                        either checking or savings, but not both.
Line 2. Filing Status                                                 The check example below shows where the proper 
Status                               Gross Income                     banking information is located. You’re responsible for the 
If you’re married:                                                    accuracy of this information.
• Filing jointly, one spouse 65 or older ....... $27,300              If your financial institution rejects your request for direct 
• Filing jointly, both spouses 65 or older .... $28,700               deposit, you’ll receive a check by mail instead.
If you’re single:
•  65 or older ............................................... $14,700

Part B. Refund Claimed
Line 3. Grocery Credit Donation
You can donate your entire grocery credit to the 
Cooperative Welfare Fund. It’s a trust fund in the 
state treasury. All money in the fund is used for public 
assistance and welfare purposes. To donate, check the 
box on line 3 and the zero ($0) box on line 4.
Once the donation is made, it can’t be changed.

Line 5. Direct Deposit
Complete line 5 if you want us to deposit your refund 
directly into your bank account instead of mailing you 
a check. 

                                                               Contact us:
                      In the Boise area: (208) 334-7660   Toll free: (800)|972-7660
                                   Hearing impaired (TDD) (800) 377-3529
                                                tax.idaho.gov/contact
EIN00072 03-29-2022