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    4                                                                                                                                          NEAR FINAL DRAFT 8/1/24                                                                                                                                        4
    5                                                                                                                                                                                                                                                                                                         5
    6                                                                                                                                                                                                    *241211*                                                                                             6
    7                                                                                                                                                                                                                                                                                                         7
    8  2024 Schedule M1QPEN, Qualified Public Pension Subtraction                                                                                                                                                                                                                                             8
    9                                                                                                                                                                                                                                                                                                         9
    10 Before you complete this schedule, read the instructions on the next page.                                                                                                                                                                                                                             10
    11                                                                                                                                                                                                                                                                                                        11
    12 TAXPAYER’S 1ST NAME,IN                                                                                                           TAXPAYER’S LAST NAMEXXXXXX                                       999999999                                                                                            12
    13 Your First Name and Initial                                                                                                      Last Name                                                        Social Security Number                                                                               13
    14 YOUR PENSION ADMINISTR  PAYER TINXXXXXXXXXXXXXXXXXXXXXXX                                                                                                                                                                                                                                               14
       Your Pension Administrator                                                                                                       Payer TIN (found on federal Form 1099-R)
    15                                                                                                                                                                                                                                                                                                        15
    16                                                                                                                                                                                                                                                                                                        16
    17 You may qualify for this subtraction if all of these are true:                                                                                                                                                                                                                                         17
    18                                      You receive payments or survivor benefits from a qualified public pension plan                                                                                                                                                                                  18
    19                                      Your payments are taxable on your federal return                                                                                                                                                                                                                19
    20                                      Your income is below a certain threshold based on your filing status (see the table in the instructions)                                                                                                                                                        20
    21                                      Your payments are not based on service for which Social Security benefits were also earned                                                                                                                                                                      21
    22                                                                                                                                                                                                                                                                                                        22
    23 X    Qualified Pension Plan: Check this box if you are receiving taxable payments from a qualified public pension plan                                                                                                                                                                                 23
    24                                                                                                listed in the instructions                                                                                                                                                                              24
    25                                                                                                                                                                                                                                                                                                        25
    26 Membership Type: Check the boxes that apply to your pension plan membership (see instructions):                                                                                                                                                                                                        26
    27                                                                                                                                                                                                                                                                                                        27
    28 X                                                                                              Basic Member: You were a basic member of the pension plan                                                                                                                                               28
    29                                                                                                                                                                                                                                                                                                        29
    30 X                                                                                              Coordinated Member: You were a coordinated member of the pension plan                                                                                                                                   30
    31                                                                                                                                                                                                                                                                                     1.12345            31
    32 X                                                                                              Basic to Coordinated Member Conversion: You were a basic member of the pension plan who was converted to a                                                                                              32
    33                                                                                                coordinated member during your service                                                                                                                                                                  33
    34                                                                                                                                                                                                                                                                                                        34
    35                                                                                                                                                                                        123456                                                                                                          35
    36 Qualified Public Pension Plan                                                                                                                                                                                                                                                                          36
    37                                                                                                                                                                                                                                                                                                        37
    38   1                      Enter your total qualified public pension plan payments included in adjusted gross income     . . .  . . . . . . .  . . . . .  . . . .   1                                                                                                                 12345678           38
    39                                                                                                                                                                                                                                                                                                        39
    40   2                      Enter $13,170 ($26,340 if Married Filing Jointly or Qualifying Surviving Spouse)  . . .  . . . . . .  . . . . .  . . . . . . .  . . . . .  . . . .   2                                                                                                     12345678           40
    41                                                                                                                                                                                                                                                                                                        41
    42   3    Enter the lesser of line 1 or line 2   . . . . . .  . . . . . .  . . . . .  . . . . . . .  . . . . .  . . . . .  . . . . . .  . . . . .  . . . . . .  . . . . . .  . . . . . .  . . . . .   3                                                                                12345678           42
    43                                                                                                                                                                                                                                                                                                        43
    44   4                      Enter your adjusted gross income from line 1 of Form M1  . . .  . . . . . .  . . . . .  . . . . . . .  . . . . .  . . . . . .  . . . . .  . . . . .  . . . . . .  . 4                                                                                      12345678           44
    45                                                                                                                                                                                                                                                                                                        45
    46   5    Enter the amount for your filing status:                                                                                   . . .  . . . . . .  . . . . .  . . . . . . .  . . . . .  . . . . . .  . . . . .  . . . . .  . . . . . .  . . . . . .  . . . . . .  . . .   5      12345678           46
    47        Married Filing Jointly or Qualifying Surviving Spouse: $105,380                                                                                                                                                                                                                                 47
    48        Single or Head of Household: $82,190                                                                                                                                                                                                                                                            48
    49        Married Filing Separately: $52,690                                                                                                                                                                                                                                                              49
    50        If line 4 is less than or equal to line 5, skip lines 6 through 9 and enter the amount from line 3 on line 10.                                                                                                                                                                                  50
    51                                                                                                                                                                                                                                                                                                        51
    52   6                    Subtract line 5 from line 4   . .  . . . . .  . . . . . .  . . . . .  . . . . . .  . . . . .  . . . . . .  . . . . . .  . . . . . .  . . . . .  . . . . .  . . . . . .  . . . . . .  . . . . . .  6                                                          12345678           52
    53                                                                                                                                                                                                                                                                                                        53
    54   7                    Divide line 6 by 2,000. Round up to the nearest whole number   . . . .  . . . . .  . . . . .  . . . . . .  . . . . .  . . . . . .  . . . . . .  . . . . . .   7                                                                                              12345678           54
    55                                                                                                                                                                                                                                                                                                        55
    56   8                  Multiply   line by7                            Enter (.1). 10% asresult the a decimal                                          . . .  . . . . . .  . . . . .  . . . . . . .  . . . . .  . . . . . .  . . . . .  . . . . .  . . . . . .  .   8               1.12345               56
    57                                                                                                                                                                                                                                                                                                        57
    58   9                    Multiply line 8 by line 3   . . .  . . . . .  . . . . .  . . . . . . .  . . . . .  . . . . . .  . . . . . .  . . . . .  . . . . .  . . . . . .  . . . . . .  . . . . . .  . . . . . .  . . . . .   9                                                         12345678           58
    59  10                    Subtract line 9 from line 3 and enter the result here and on line 29 of Schedule M1M                                                                                                                                                                                            59
    60      (if zero or less, enter 0. You do not qualify for this subtraction)  . . .  . . . . . .  . . . . .  . . . . . . .  . . . . .  . . . . . .  . . . . .  . . . . .    10                                                                                                          12345678           60
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    63                                                                                                                                                           9995                                                                                                                                         63
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