Form MO-A Fillable Individual Income Tax Adjustments
(all forms fillable on Windows, Mac, Android tablets, and iPad using Adobe Reader XI)

$275 000 if head of household $250 000 if single or claimed as a dependent or $150 000 if married filing separate If your federal adjusted gross income is less than or equal (: fiduc) Unchecked (: Yes) Unchecked (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked (Print Form) Print Form (Reset Form) Reset Form (See page A 12 of Federal Schedule A instructions ) If $0 or less enter 0 (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) 1 Enter amount from Federal Itemized Deduction Worksheet Line 3 1 Interest on state and local obligations other than Missouri source 1 Military retirement benefits included on Federal Form 1040A Line 12b or Federal Form 1040 Line 16b 1 Missouri adjusted gross income from Form MO 1040 Line 6 1 Missouri adjusted gross income from Form MO 1040 Line 6 1 Total federal itemized deductions from Federal Form 1040 Line 40 1 00 10 Earnings taxes included in Line 9 10 00 10 Exempt contributions made to a qualified 529 plan (higher education savings program) 10 If you received taxable social security complete Lines 1 through 8 of Section C and enter the amount(s) from Line(s) 10Y 00 10S 00 11 Net state income taxes Subtract Line 10 from Line 9 or enter Line 8 from worksheet below 11 00 11 Qualified Health Insurance Premiums 11 Subtract Line 10 from Line 9 If Line 10 is greater than Line 9 enter $0 11Y 00 11S 00 12 Add amounts on Lines 11Y and 11S 12 Missouri depreciation adjustment (Section 143 121 RSMo) 12 MISSOURI ITEMIZED DEDUCTIONS Subtract Line 11 from Line 8 Enter here and on Form MO 1040 Line 14 12 00 12Y 00 12S 00 13 Home Energy Audit Expenses 13 Total public pension subtract Line 5 from Line 12 If Line 5 is greater than Line 12 enter $0 13Y 00 13S 00 14 TOTAL SUBTRACTIONS Add Lines 7 8 9 10 11 12 and 13 Enter here and on Form MO 1040 Line 4 14Y 00 14S 00 1Y 00 1S 00 2 2013 Social security tax (Yourself) 2 00 2 Enter amount from Federal Itemized Deduction Worksheet Line 9 (See Federal Schedule A instructions ) 2 Partnership; Fiduciary; S corporation; Net Operating Loss (Carryback/Carryforward); 2 Select the appropriate filing status and enter the amount on Line 2 Married filing combined $100 000 2 Taxable public pension from Federal Form 1040A Line 12b or Federal Form 1040 Line 16b 2 Taxable social security benefits from Federal Form 1040A Line 14b or Federal Form 1040 Line 20b 2Y 00 2S 00 3 2013 Social security tax (Spouse) 3 00 3 Divide Line 1 by Line 2 (Round to whole number) 3 Nonqualified distribution received from a qualified 529 plan (higher education savings program) not 3 State and local income taxes from Federal Form 1040 Schedule A Line 5 3 Subtract Line 2 from Line 1 3 Subtract Line 2 from Line 1 and enter on Line 3 If Line 2 is greater than Line 1 enter $0 3Y 00 3S 00 4 2013 Railroad retirement tax Tier I and Tier II (Yourself) 4 00 4 Earnings taxes included on Federal Form 1040 Schedule A Line 5 4 Food Pantry contributions included on Federal Schedule A 4 Multiply Line 3 by Line 13 of Section A If you are not claiming a public pension exemption enter $0 4 Select the appropriate filing status and enter amount on Line 4 Married filing combined $100 000; Single Head of 4 Select the appropriate filing status and enter the amount on Line 4: Married filing combined: $32 000; Single 4 Taxable social security benefits for each spouse from Federal Form 1040A Line 14b or Federal Form 1040 Line 20b 4Y 00 4S 00 5 2013 Railroad retirement tax Tier I and Tier II (Spouse) 5 00 5 Nonresident Property Tax 5 Subtract Line 4 from Line 1 5 Subtract Line 4 from Line 3 5 Subtract Line 4 from Line 3 and enter on Line 5 If Line 4 is greater than Line 3 enter $0 5 Subtract Line 4 from Line 3 If Line 4 is greater than Line 3 enter $0 5 Taxable social security disability benefits for each spouse from Federal Form 1040A Line 14b or 1040 Line 20b 5Y 00 5S 00 6 2013 Medicare tax Yourself and Spouse See instructions on Page 35 6 00 6 Amount from Line(s) 4Y or 5Y and 4S or 5S 6 Divide Line 5 by Line 1 6 Taxable pension for each spouse from private sources from Federal Form 1040A Lines 11b and 12b or Federal 6 Taxable pension for each spouse from public sources from Federal Form 1040A Line 12b or 1040 Line 16b 6 TOTAL ADDITIONS Add Lines 1 2 3 4 and 5 Enter here and on Form MO 1040 Line 2 6 Total military pension multiply Line 5 by 60% 6Y 00 6S 00 6Y and 6S See instructions if Line 3 of Section C is more than $0 7 2013 Self employment tax See instructions on Page 35 7 00 7 Add Lines 6Y and 6S 7 Amount from Line 6 or $35 939 (maximum social security benefit) whichever is less 7 Amounts from Line 6Y and 6S or $6 000 whichever is less 7 Interest from exempt federal obligations included in federal adjusted gross income (reduced by 7 Multiply Line 2 by Line 6 7Y 00 7S 00 8 Add Lines 7Y and 7S 8 Amount from Line 6 or $6 000 whichever is less 8 Any state income tax refund included in federal adjusted gross income 8 Subtract Line 7 from Line 5 Enter here and on Form MO A Part 2 Line 11 Worksheet For Part 2 Net StateIncome Taxes Line 111 00 8 TOTAL Add Lines 1 through 7 8 00 8 Total social security/social security disability subtract Line 3 from Line 7 If Line 3 is greater than Line 7 enter $0 8Y 00 8S 00 9 Amount from Line 7 or Line 8 whichever is greater 9 Partnership; Fiduciary; S corporation; Railroad retirement benefits; 9 State and local income taxes from Federal Schedule A Line 5 or see the worksheet below 9 00 9 Total private pension subtract Line 5 from Line 8 If Line 5 is greater than Line 8 enter $0 9Y 00 9S 00 Add Line 13 (Section A) Line 9 (Section B) Line 8 (Section C) and Line 6 (Section D) ADDITIONS ADJUSTMENTS ATTACH TO FORM MO 1040 ATTACH A COPY OF YOUR FEDERAL Attachment Sequence No 1040 01 by December 31 and have marked the 62 and older box on page 1 of Form MO 1040 Age limit does not apply to social security disability deduction Combat pay included in federal adjusted gross income; MO Public Private Transportation Act Complete this worksheet only if your federal adjusted gross income from Federal Form 1040 Line 37 is more than $300 000 if married filing combined or qualifying widow(er) copy of your Federal Form 1040 (pages 1 and 2) and Federal Schedule A Enter total amount here and on Form MO 1040 Line 8 EXEMPTION For Privacy Notice see instructions MO A (Revised 12 2013) Form 1040 Lines 15b and 16b Head of Household and Qualifying Widow(er): $25 000; Married Filing Separate: $16 000 Household Married Filing Separate and Qualifying Widow(er) $85 000 in completing this form INDIVIDUAL INCOME TAX LAST NAME FIRST NAME INITIAL SOCIAL SECURITY NO MILITARY PENSION CALCULATION MISSOURI DEPARTMENT OF REVENUE MO A (Revised 12 2013) Net Operating Loss; Military (nonresident); Build America and Recovery Zone Bond Interest NOTE: IF LINE 12 IS LESS THAN YOUR FEDERAL STANDARD DEDUCTION SEE INFORMATION ON PAGE 7 Other (description) Other (description) Attach supporting documentation PART 1 MISSOURI MODIFICATIONS TO FEDERAL ADJUSTED GROSS INCOME (SEE PAGE 11) PART 2 MISSOURI ITEMIZED DEDUCTIONS Complete this section only if you itemize deductions on your federal return Attach a PART 3 PENSION AND SOCIAL SECURITY/SOCIAL SECURITY DISABILITY/MILITARY EXEMPTION PRIVATE PENSION CALCULATION Annuities pensions IRA S and 401(k) plans funded by a private source PUBLIC PENSION CALCULATION Pensions received from any federal state or local government related expenses if expenses were over $500) Attach a detailed list or all Federal Forms 1099 RETURN See information beginning on page 11 to assist you S SPOUSE S SPOUSE SECTION A SECTION BSECTION CSECTION DSECTION Single Head of Household Married Filing Separate and Qualifying Widow(er) $85 000 SOCIAL SECURITY OR SOCIAL SECURITY DISABILITY CALCULATION To be eligible for social security deduction you must be 62 years of age Sold or disposed property previously taken as addition modification SPOUSE S LAST NAME FIRST NAME INITIAL SPOUSE S SOCIAL SECURITY NO SUBTRACTIONS to these amounts do not complete this worksheet Attach a copy of your Federal Itemized Deduction Worksheet (Page A 12 of Federal Schedule A instructions) TOTAL TOTAL PENSION AND SOCIAL SECURITY/SOCIAL SECURITY DISABILITY/MILITARY EXEMPTION used for qualified higher education expenses Y YOURSELF Y YOURSELF Y YOURSELF S SPOUSE