NEAR FINAL DRAFT 8/1/24

                                                                                                                                                                                                         *241811*
2024 Schedule M1LTI, Long-Term Care Insurance Credit

 Your First Name and Initial                                                                                 Last Name                                                                                       Social Security Number
If you (or your spouse, if filing a joint return) paid premiums in 2024 for a qualified long-term care insurance policy, complete this schedule 
to determine the amount of the credit you may claim when filing Form M1, Individual Income Tax .
To qualify for this credit, both of these must apply to your long-term care insurance policy:
 •  It qualifies as an itemized deduction on Schedule M1SA, Minnesota Itemized Deductions, regardless of income limitations
 •  It has a lifetime long-term care benefit limit of $100,000 or more
There are no separate instructions for Schedule M1LTI.

Policy Information (only one qualifying policy per person):
Name of Insured                                                                                              Insurance Company                                                                Policy Number

Provide the information in the appropriate column for each insured person. If you are 
filing a joint return and both you and your spouse are covered by one policy, use half                                                                                            Round amounts to the nearest whole dollar.
of the premiums in column A and half in column B (below).
                                                                                                                                                                                             A —You                             B —Spouse 
                                                                                                                                                                                            
  1                              Premiums paid in 2024 for the qualifying long-term care insurance policy   . . .  . . . . . . .  . . . . .  . .   1                                                                                        
                                                         Did you file Schedule M1SA? 
     •   If no, skip lines 2, 3, and 4, and enter amounts from line 1 on line 5.
     •   If yes, continue with line 2.
 2  Amount of premiums paid on this policy that are included on line 1 of Schedule M1SA   . . . . .  .  . 2                                                                                                                                

  3                              Amount from line 4 of Schedule M1SA (If you and your spouse are claiming  
     premiums paid, enter half of this amount in each column) . . .  . . . . . .  . . . . .  . . . . . . .  . . . . .  . . . . .  . 3                                                                                           
 
  4  Amount from line 2 or line 3, whichever is less   . . . . . . .  . . . . .  . . . . . .  . . . . .  . . . . .  . . . . . .  . . . . .   4                                                                                  
 
  5  Subtract line 4 from line 1                          . . .  . . . . . .  . . . . .  . . . . . . .  . . . . .  . . . . . .  . . . . .  . . . . .  . . . . . .  . . . . . .  . . .   5                                       
 
  6                              Multiply line 5 by 25% (.25)  . . .  . . . . . .  . . . . .  . . . . . . .  . . . . .  . . . . . .  . . . . .  . . . . .  . . . . . .  . . . . . .  . .   6                                    
 
 7maximumThe                   credit $100 per person is                               . . .  . . . . . . .  . . . . .  . . . . .  . . . . . .  . . . . .  . . . . . .  . . . . . . 7. .                       100                  100
 
  8                              Amount from line 6 or line 7, whichever is less   . . . . . . .  . . . . .  . . . . . .  . . . . .  . . . . .  . . . . . .  . . . . .   8                                                      
 
 9andA   line Add columns 8,   B                                . . . . . .  . . . . .  . . . . . .  . . . . . .  . . . . .  . . . . . .  . . . . . .  . . . . .  . . . . . .  . . . . . .  . . . . .  . . . . . .  .9. . . .     
                                 Full-year residents: Also enter this amount on line 2 of Schedule M1C.

Part-year Residents and Nonresidents
 10                        Multiply line 9 by line 30 of Schedule M1NR.  
     Enter the result here and on line 2 of Schedule M1C                                                   . . .  . . . . . .  . . . . .  . . . . . . .  . . . . .  . . . . . .  . . . . .  . . . . .  . . . . . .  . . . .  10 

You must include this schedule with your Form M1. 

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