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2 4 6 8 10 12 14 16 18 20 22 24 26 28 30 32 FINAL DRAFT - 10/2/2334 36 38 40 42 44 46 48 50 52 54 56 58 60 62 64 66 68 70 72 74 76 78 80 82 84 86
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6 *235711* 6
7 2023 Schedule M1PR-AI, Additions to Income 7
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9 Complete Schedule M1PR-AI, Additions to Income, to report amounts for line 5 of Form M1PR, Homestead Credit Refund (for Home- 9
10 owners) and Renter’s Property Tax Refund. Enter the type of income that was received in Column A and the amount in Column B. 10
11 See instructions to determine which types of income to include. 11
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13 YOUR FIRST NAME,INIT YOUR LAST NAMEXXXXXXXXXXXXXXXXXXX 999999999 13
14 Your First Name and Initial Last Name Your Social Security Number 14
15 SPOUSE FIRST NAME,IN SPOUSE LAST NAMEXXXXXXXXXXXXXXXXX 999999999 15
16 If a Joint Return, Spouse’s First Name and Initial Spouse’s Last Name Spouse’s Social Security Number 16
17 Column A — Type of Income Received Column B —Amount 17
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19 1a TYPE OF INCOMEXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX 1b 12345678 19
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21 2a TYPE OF INCOMEXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX X2b 12345678 21
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23 3a TYPE OF INCOMEXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX 3b 12345678 23
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25 4a TYPE OF INCOMEXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX 4b 12345678 25
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27 5a TYPE OF INCOMEXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX 5b 12345678 27
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29 6a TYPE OF INCOMEXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX 6b 12345678 29
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31 7a TYPE OF INCOMEXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX 7b 12345678 31
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33 8a TYPE OF INCOMEXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX 8b 12345678 33
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35 9a TYPE OF INCOMEXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX 9b 12345678 35
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37 10a TYPE OF INCOMEXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX 10b 12345678 37
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39 11a TYPE OF INCOMEXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX 11b 12345678 39
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41 12a TYPE OF INCOMEXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX 12b 12345678 41
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43 13a TYPE OF INCOMEXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX 13b 12345678 43
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45 14a TYPE OF INCOMEXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX 14b 12345678 45
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47 15a TYPE OF INCOMEXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX 15b 12345678 47
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49 16a TYPE OF INCOMEXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX 16b 12345678 49
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51 17a TYPE OF INCOMEXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX 17b 12345678 51
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53 18a TYPE OF INCOMEXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX 18b 12345678 53
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55 19a TYPE OF INCOMEXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX19b 12345678 55
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57 20 Total of Column B. Add all amounts in Column B. Enter here and on line 5 of Form M1PR .... ..... ....... .. 20 12345678 57
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59 You must include this schedule with your Form M1PR. If you had more than 19 items, include a statement with the type of income 59
60 and amounts received. 60
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