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Michigan Department of Treasury (Rev. 12-08), Page 1


2008 MICHIGAN Home Heating Credit Claim MI-1040CR-7
                                                               Type or print in blue or black ink.
Issued under authority of Public Act 281 of 1967.

                                                                                                 14
                                            0123456789 - NOT like this:
Print numbers like this :                                                                                                                                                    Attachment 08
                                                            M.I.     Last Name
   41. Filer’s First Name                                                                                                         42. Filer’s Social Security Number (Example: 123-45-6789)
PLACE LABEL HERE




                   If a Joint Return, Spouse’s First Name   M.I.     Last Name

                                                                                                                                  43. Spouse’s Social Security Number (Example: 123-45-6789)
                   Home Address (No., Street, P.O. Box or Rural Route)


                   City or Town                                                                                       State        ZIP Code                         44. County Code (p. 15)

                                                                                          Yes                          No 411. Exemptions. Enter the number that applies
      45. Are your heating costs currently included in your rent or in
                                                                                                                                      to you, your spouse, or your dependents and
          someone else’s name (see instructions)?........................................
                                                                                                                                      complete line 12 below.
                                                                                                                                  Personal Exemption
      46. Do you want your name and address referred to other                                                                     (You and your spouse only) .......................... 4 a.
          government assistance programs for which you may qualify?....
                                                                                                                                  Age 65 or older ...............................   4 b.
      47. Do you or your spouse now receive Supplemental Security                                                                 Deaf, Disabled or Blind, Qualified
          Income (SSI)?...........................................................................                                Disabled Veteran ............................     4 c.
                                                                                                                                  Unemployment compensation
                                                                                           You              Spouse
                                                                                                                                  greater than 50% of AGI .................         4 d.
      48. ENTER YOUR AGE if you are age 60 or older...                                                                            Number of children living with you:
                                                                                                                                  = Ages 2 and under .......................        4 e.
 49. How much were you billed for heat between
     11/1/2007 - 10/31/2008?.....................................                     00
                                                                                                                                  = Ages     3-5...................................... 4 f.
410. If you lived in one of these CARE facilities (not a senior apartment
     complex) for all of 2008, check the box and STOP here, see instructions.                                                     = Ages 6-18.................................... 4 g.
                                                                                                                                  Dependent adults, other than your
     a.       Nursing Home                            b.          Adult Foster Care Home
                                                                                                                                  spouse, who live with you ............... 4 h.
                       c.         Licensed Home for the Aged                d.         Substance Abuse Center
                                                                                                                                  Add lines 11a through 11h ..............               i.
         12. Enter below the name, Social Security number, relationship and age of the dependents you claimed in line 11, e - h above.
                             Dependent’s Name                                Dependent’s Relationship to You                            Social Security Number                    Age in Years
  a.

  b.

  c.

  d.

         13. Wages, salaries, tips, sick, strike and SUB pay, etc .....................................................................                       13.                                00

         14. All interest and dividend income (including nontaxable interest) ..................................................                              14.                                00

         15. Net business, royalty or rent income (including self-employment) ............................................... 415.                                                               00

         16. Annuity, retirement pension and IRA benefits. Name of Payer: _________________________                                                           16.                                00

         17. Net farm income ...........................................................................................................................      17.                                00

         18. Capital gains less capital losses ...................................................................................................            18.                                00

         19. Alimony and other taxable income (see instructions). Describe: _________________________                                                         19.                                00

         20. Social Security, Supplemental Security Income (SSI) and/or railroad retirement benefits ........... 420.                                                                            00

         21. Child support ................................................................................................................................   21.                                00

          22. Unemployment compensation ...................................................................................................... 422.                                              00

          23. Other nontaxable income (see instructions). Describe: ________________________________                                                          23.                                00

          24. Workers’ compensation, veterans’ disability compensation and pension benefits .......................                                           24.                                00

          25. FIP and other DHS benefits (do not include Food Assistance Program benefits) ........................ 425.                                                                         00

          26. Subtotal. Add lines 13 through 25. Enter here and carry amount to line 27 ............ SUBTOTAL                                                 26.                                00

+ 0000                       2008 37 01 27 7
2008 MI-1040CR-7, Page 2                                                                                                      Filer’s Social Security Number




  27. Enter amount from line 26 ..................................................................................................................        27.                        00

  28. Other adjustments (see instructions).
      Describe: __________________________________________________                                                      28.                               00

  29. Medical insurance or HMO premiums you paid for you and your family ....                                           29.                               00


  30. Add lines 28 and 29 ............................................................................................................................    30.                        00

  31. HOUSEHOLD INCOME. Subtract line 30 from line 27. If line 30 is greater than line 27, enter “0”.... 431.                                                                        00
Standard and Alternate Home Heating Credit Computations
  32. STANDARD CREDIT. Standard allowance from Table A, p.15 ..................                                         32.                               00

  33. Multiply line 31 (Household Income) by 3.5% (0.035) .................................                             33.                               00
  34. Subtract line 33 from line 32 for standard credit amount.
      If line 33 is greater than line 32, enter “0” ....................................................                34.                               00

  35. If you answered “Yes” to line 5, multiply the amount on line 34 by 50% (0.50). Enter here and
      on line 40. (If approved, the final amount as shown on line 41 is issued as a check.) .......................                                       35.                        00

  36. ALTERNATE CREDIT. Total heating costs from line 9 or
      $2,351 (whichever is less) ...........................................................................            36.                               00

  37. Multiply line 31 (Household Income) by 11% (0.11) ....................................                            37.                               00

  38. Subtract line 37 from line 36. If line 37 is greater than line 36, enter “0” .....                                38.                               00

  39. Multiply line 38 by 70% (0.70) for alternate credit amount ..........................                             39.                               00

  40. If you completed line 35, enter that amount here. Otherwise, enter the larger
      of lines 34 or 39 here ..........................................................................................................................   40.                        00

  41. HOME HEATING CREDIT. Multiply line 40 by 65% (0.65) ............................................................... 441.                                                       00

  42. RESIDENCY in 2008:                                                                                          *Complete Dates of Michigan Residency in 2008.
                                                                                                                 Enter dates as MM-DD-YYYY (Example: 04-15-2008)
         a.       Resident                                                                                          YOU                                         SPOUSE

                                                                                FROM:                                              2008                                    2008
         b.       Nonresident
                                                                                TO:                                                2008                                    2008
         c.       Part-Year Resident*

IMPORTANT
             You must check this box to receive a refund from your heat provider for any overpayment to your heat account,
  43. 4
             if eligible. See instructions, p. 8.
Before you sign, please review your claim. Make sure your name, Social Security number and current mailing address are on the
form and that you have answered all the questions that pertain to you.
 Deceased Taxpayers. If Filer and/or Spouse died after 12-31-2007, enter dates below. Preparer Certification. I declare under penalty of perjury that this
 ENTER DATE OF DEATH ONLY.                                                                                       return is based on all information of which I have any knowledge.
                                             Example: 04-15-2008 (MM-DD-YYYY).

                                                                                                                4Preparer’s      PTIN, FEIN or SSN
4Filer                                              4Spouse

 Taxpayer Certification.        I declare under penalty of perjury that the information in this return
                                                                                                                4Preparer’s Business Name (print or type)
 and attachments is true and complete to the best of my knowledge.
 Filer’s Signature                                                     Date
                                                                                                                 Preparer’s Business Address (print or type)
 Spouse’s Signature                                                            Date



                                                                                   Yes               No
 4   I authorize Treasury to discuss my return with my preparer.

File (postmark) your claim by September 30, 2009. Mail your claim to: Michigan Department of Treasury
                                                                      Lansing, MI 48956

+ 0000           2008 37 02 27 5

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  • 1. Reset Form Michigan Department of Treasury (Rev. 12-08), Page 1 2008 MICHIGAN Home Heating Credit Claim MI-1040CR-7 Type or print in blue or black ink. Issued under authority of Public Act 281 of 1967. 14 0123456789 - NOT like this: Print numbers like this : Attachment 08 M.I. Last Name 41. Filer’s First Name 42. Filer’s Social Security Number (Example: 123-45-6789) PLACE LABEL HERE If a Joint Return, Spouse’s First Name M.I. Last Name 43. Spouse’s Social Security Number (Example: 123-45-6789) Home Address (No., Street, P.O. Box or Rural Route) City or Town State ZIP Code 44. County Code (p. 15) Yes No 411. Exemptions. Enter the number that applies 45. Are your heating costs currently included in your rent or in to you, your spouse, or your dependents and someone else’s name (see instructions)?........................................ complete line 12 below. Personal Exemption 46. Do you want your name and address referred to other (You and your spouse only) .......................... 4 a. government assistance programs for which you may qualify?.... Age 65 or older ............................... 4 b. 47. Do you or your spouse now receive Supplemental Security Deaf, Disabled or Blind, Qualified Income (SSI)?........................................................................... Disabled Veteran ............................ 4 c. Unemployment compensation You Spouse greater than 50% of AGI ................. 4 d. 48. ENTER YOUR AGE if you are age 60 or older... Number of children living with you: = Ages 2 and under ....................... 4 e. 49. How much were you billed for heat between 11/1/2007 - 10/31/2008?..................................... 00 = Ages 3-5...................................... 4 f. 410. If you lived in one of these CARE facilities (not a senior apartment complex) for all of 2008, check the box and STOP here, see instructions. = Ages 6-18.................................... 4 g. Dependent adults, other than your a. Nursing Home b. Adult Foster Care Home spouse, who live with you ............... 4 h. c. Licensed Home for the Aged d. Substance Abuse Center Add lines 11a through 11h .............. i. 12. Enter below the name, Social Security number, relationship and age of the dependents you claimed in line 11, e - h above. Dependent’s Name Dependent’s Relationship to You Social Security Number Age in Years a. b. c. d. 13. Wages, salaries, tips, sick, strike and SUB pay, etc ..................................................................... 13. 00 14. All interest and dividend income (including nontaxable interest) .................................................. 14. 00 15. Net business, royalty or rent income (including self-employment) ............................................... 415. 00 16. Annuity, retirement pension and IRA benefits. Name of Payer: _________________________ 16. 00 17. Net farm income ........................................................................................................................... 17. 00 18. Capital gains less capital losses ................................................................................................... 18. 00 19. Alimony and other taxable income (see instructions). Describe: _________________________ 19. 00 20. Social Security, Supplemental Security Income (SSI) and/or railroad retirement benefits ........... 420. 00 21. Child support ................................................................................................................................ 21. 00 22. Unemployment compensation ...................................................................................................... 422. 00 23. Other nontaxable income (see instructions). Describe: ________________________________ 23. 00 24. Workers’ compensation, veterans’ disability compensation and pension benefits ....................... 24. 00 25. FIP and other DHS benefits (do not include Food Assistance Program benefits) ........................ 425. 00 26. Subtotal. Add lines 13 through 25. Enter here and carry amount to line 27 ............ SUBTOTAL 26. 00 + 0000 2008 37 01 27 7
  • 2. 2008 MI-1040CR-7, Page 2 Filer’s Social Security Number 27. Enter amount from line 26 .................................................................................................................. 27. 00 28. Other adjustments (see instructions). Describe: __________________________________________________ 28. 00 29. Medical insurance or HMO premiums you paid for you and your family .... 29. 00 30. Add lines 28 and 29 ............................................................................................................................ 30. 00 31. HOUSEHOLD INCOME. Subtract line 30 from line 27. If line 30 is greater than line 27, enter “0”.... 431. 00 Standard and Alternate Home Heating Credit Computations 32. STANDARD CREDIT. Standard allowance from Table A, p.15 .................. 32. 00 33. Multiply line 31 (Household Income) by 3.5% (0.035) ................................. 33. 00 34. Subtract line 33 from line 32 for standard credit amount. If line 33 is greater than line 32, enter “0” .................................................... 34. 00 35. If you answered “Yes” to line 5, multiply the amount on line 34 by 50% (0.50). Enter here and on line 40. (If approved, the final amount as shown on line 41 is issued as a check.) ....................... 35. 00 36. ALTERNATE CREDIT. Total heating costs from line 9 or $2,351 (whichever is less) ........................................................................... 36. 00 37. Multiply line 31 (Household Income) by 11% (0.11) .................................... 37. 00 38. Subtract line 37 from line 36. If line 37 is greater than line 36, enter “0” ..... 38. 00 39. Multiply line 38 by 70% (0.70) for alternate credit amount .......................... 39. 00 40. If you completed line 35, enter that amount here. Otherwise, enter the larger of lines 34 or 39 here .......................................................................................................................... 40. 00 41. HOME HEATING CREDIT. Multiply line 40 by 65% (0.65) ............................................................... 441. 00 42. RESIDENCY in 2008: *Complete Dates of Michigan Residency in 2008. Enter dates as MM-DD-YYYY (Example: 04-15-2008) a. Resident YOU SPOUSE FROM: 2008 2008 b. Nonresident TO: 2008 2008 c. Part-Year Resident* IMPORTANT You must check this box to receive a refund from your heat provider for any overpayment to your heat account, 43. 4 if eligible. See instructions, p. 8. Before you sign, please review your claim. Make sure your name, Social Security number and current mailing address are on the form and that you have answered all the questions that pertain to you. Deceased Taxpayers. If Filer and/or Spouse died after 12-31-2007, enter dates below. Preparer Certification. I declare under penalty of perjury that this ENTER DATE OF DEATH ONLY. return is based on all information of which I have any knowledge. Example: 04-15-2008 (MM-DD-YYYY). 4Preparer’s PTIN, FEIN or SSN 4Filer 4Spouse Taxpayer Certification. I declare under penalty of perjury that the information in this return 4Preparer’s Business Name (print or type) and attachments is true and complete to the best of my knowledge. Filer’s Signature Date Preparer’s Business Address (print or type) Spouse’s Signature Date Yes No 4 I authorize Treasury to discuss my return with my preparer. File (postmark) your claim by September 30, 2009. Mail your claim to: Michigan Department of Treasury Lansing, MI 48956 + 0000 2008 37 02 27 5