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                                                                                                 Department Use Only
           Form                                                                                  (MM/DD/YY)
 MO-TC                   2023 Miscellaneous Income Tax Credits

Name                                                                                  Social Security 
(Last, First)                                                                         Number
Spouse’s Name                                                                         Spouse’s Social 
(Last, First)                                                                         Security Number
Corporation                                                                           Charter 
Name                                                                                  Number
Missouri Tax                                                                          Federal Employer 
I.D. Number                                                                           I.D. Number
 •   Benefit Number - The number is the last six (6) digits of the number             of this form.  Each credit is assigned an alpha code to ensure proper 
    located on your Certificate of Eligibility.                                       processing of the credit claimed.                              
   Example:  For benefit, ABC-2018-12345-123456, enter 123456, on                     •   If you are claiming more than 10 credits, attach additional MO-TC(s)
   Form MO-TC.                                                                        •  The sum of the tax credits claimed in Column 1 or Column 2 cannot            
 •   Alpha code - The three (3) character code located on the next page                 exceed the applicable tax liability, unless the credit is refundable. 

                               Alpha Code           Credit Name                                                                • Yourself            • Spouse 
           Benefit Number      (3 characters)       Each credit will apply against your tax                                    • Corporation Income    (on a combined return)
           (See example above) from the next        liability in the order they appear below.                                  • Fiduciary
                                page                                                                                           Column 1              Column 2

 1.                                                                                                                        1.              00                        00

 2.                                                                                                                        2.              00                        00

 3.                                                                                                                        3.              00                        00

 4.                                                                                                                        4.              00                        00

 5.                                                                                                                        5.              00                        00

 6.                                                                                                                        6.              00                        00

 7.                                                                                                                        7.              00                        00

 8.                                                                                                                        8.              00                        00

 9.                                                                                                                        9.              00                        00

  10.                                                                                                                      10.             00                        00

 11. Subtotals - add Lines 1 through 10. .........................................................   11.                                   00                        00
12.        Enter the amount of the tax liability from Form MO-1040, Line 35Y for yourself and Line 35S for your spouse, or 
           Form MO-1120, Line 16, Form MO-1041, Line 15 or Form MO-PTE, Line 10 ...........................                12.             00                        00 
 13. Total Credits - add amounts from Line 11, Columns 1 and 2. (Enter here and on Form MO-1120, Line 17; Form MO-1040,  
     Line 42; or Form MO-1041, Line 16; or Form MO-PTE, Line 11.) Line 13 cannot exceed the amount on Line 12, unless the  
     credit is refundable. ....................................................................................                13.                   00
           I declare under penalties of perjury that I employ no illegal or unauthorized aliens as defined under federal law and that I am not eligible for any tax 
           exemption, credit or abatement if I employ such aliens. I also declare that if I am a business entity, I participate in a federal work authorization program 
           with respect to the employees working in connection with any contracted services and I do not knowingly employ any person who is an unauthorized 
           alien in connection with any contracted services. I am aware of any applicable reporting requirements of            Section 135.805 RSMo and the penalty 
           provisions of Section 135.810 RSMo. 
 Signature Taxpayer’s Signature                     Printed Name                                                                          Date (MM/DD/YYYY)
                                                                                                                                          __ __ / __ __ / __ __ __ __
           Spouse’s Signature                       Printed Name                                                                          Date (MM/DD/YYYY)
                                                                                                                                          __ __ / __ __ / __ __ __ __
Use this form to claim income tax credits on Form MO-1040, MO-1120, or MO-1041. Attach to Form MO-1040, MO-1120, or MO-1041.
Ever served on active duty in the United States Armed Forces?                                          *23306010001*
If yes, visit dor.mo.gov/military/ to see the services and benefits we offer to all                                            23306010001
eligible military individuals. A list of all state agency resources and benefits can 
be found at veteranbenefits.mo.gov/state-benefits/.                                                                        For Privacy Notice, see instructions.
                                                                                                                                           Form MO-TC (Revised 12-2023)
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              Use Column 1 if you are filing:                                         If you are filing a combined return and both you and your spouse have income: 
              •  An individual income tax return with a single type filing status; or •  Use Column 1 for yourself and Column 2 for spouse. 
              •  A corporation income tax or fiduciary return.                        •  Both names must be on the credit certificate.
              If you are a shareholder or partner claiming a credit, attach a copy of the shareholder listing or Federal Schedule K-1, specifying your percentage and the corporation’s 
 Instructions percentage of ownership. 
Miscellaneous tax credits are administered by various agencies. For more information, forms, and approval to claim these credits, contact the following 
Departments. Visit     dor.mo.gov/tax-credits   / for a description of each credit and more contact information for agencies administering each credit. 
              Missouri Department of Economic Development                                                              Missouri Department of Revenue
              P.O. Box 118, Jefferson City, MO 65102-0118                                                    P.O. Box 2200, Jefferson City, MO 65105-2200
                                       ded.mo.gov                                                            taxcredit@dor.mo.gov  •  (573) 751-3220
  Alpha                                                         Attach to                            Alpha                                                  Attach to 
  Code  Name of Credit and Phone Number                         Form MO-TC                            Code  Name of Credit                                  Form MO-TC
  BFC         New or Expanded Business Facility - (573) 526-0308  Certificate*                        ATC  Adoption Tax Credit                              Form ATC, and 
  BJI         Brownfield “Jobs and Investment” - (573) 522-8004   Certificate*                                                                              Federal Form 8839
 CCA          Capitol Complex - Artifact Donation - (573) 522-4216  Certificate*
 CCM  Capitol Complex - Monetary Donation -(573) 522-4216 Certificate*                                BFT  Bank Franchise Tax                                 Form INT-2, INT-2-1
  FDA         Family Development Account - (573) 522-4216       Certificate*                          BPT  Biodiesel Producer                               Form 5875 
  FPC         Show-Mo Act/Motion Media - (573)526-2102          Certificate*                         BRD  Biodiesel Retailer and Distributor                Form 5879
  HPC  Historic Preservation - (573) 522-8004                   Certificate*                          BTC  Bank Tax Credit for S Corporation                  Form BTC, INT-3,  
  MQJ  Missouri Quality Jobs - (573) 526-3285                   Certificate*                                                                                2823, INT-2, Fed. K-1 
  MWC  Missouri Works Credit - (573) 526-0308                   Certificate*                         CFC  Champion for Children                             Form CFC 
  NAC  Neighborhood Assistance - (573) 522-4216                 Certificate*                         DAC  Disabled Access                                     Federal Form 8826 
  NEZ         New Enhanced Enterprise Zone - (573) 526-3285     Certificate*                                                                                 and Form MO-8826
  RCN  Rebuilding Communities and Neighborhood                                                        DAT  Residential Dwelling Accessibility               Form MO-DAT 
              Preservation Act - (573) 522-8004                 Certificate*                         ERD  Ethanol Retailer and Distributor                  Form 5885
  REC  Qualified Research Expense - (573) 526-3285              Certificate*                          FPT  Food Pantry Tax                                  Form MO-FPT
  RTC  Remediation - (573) 522-8004                             Certificate*                         SHC  Self-Employed Health Insurance                    Form MO-SHC
  SBI         Small Business Incubator - (573) 526-6708         Certificate*                         SSC  Public Safety Officer Surviving Spouse            Form MO-SSC
  SEC  Sporting Event Credit - (573) 522-8004                   Certificate*                         SPA   SALT Parity                                      Pass Through Entity  
  SPC  Sporting Contribution Credit - (573) 522-8004            Certificate*                                                                                  Report
  YOC  Youth Opportunities - (573) 522-4216                     Certificate*      
              Missouri Development Finance Board                                                     Missouri Agricultural and Small Business Development Authority
              P.O. Box 567, Jefferson City, MO 65102-0567                                                    P.O. Box 630, Jefferson City, MO 65102-0630
                             mdfb.org  •  (573) 751-8479                                                     agriculture.mo.gov  •  (573) 751-2129
  Alpha                                                         Attach to                            Alpha                                                  Attach to 
  Code  Name of Credit                                          Form MO-TC                            Code  Name of Credit                                  Form MO-TC
 BEC  Bond Enhancement                                          Certificate*                         APU  Agricultural Product Utilization Contributor      Certificate* 
 BUC  Missouri Business Use Incentives for Large                Certificate*                          FFC  Family Farms Act                                 Certificate* 
              Scale Development (BUILD)                                                              MPF  Meat Processing Facility Investment Tax Credit    Certificate*
 DRC  Development Reserve Contribution Credit                   Certificate*                         NGC  New Generation Cooperative Incentive              Certificate*
  EFC         Export Finance                                    Certificate*                         QBC  Qualified Beef                                    Certificate* 
  IDC         Infrastructure Development                        Certificate*                         SAC    Specialty Agriculture Crops Loan                Certificate*
                                                                                                      UFT  Urban Farms                                      Certificate*
              Missouri Housing Development Commission                                                        Missouri Department of Natural Resources
              920 Main Street, Suite 1400, Kansas City, MO 64105                                             P.O. Box 176, Jefferson City, MO 65102-0176
                                       mhdc.com                                                                                 dnr.mo.gov
 Alpha                                                          Attach to
  Code  Name of Credit and Phone Number                         Form MO-TC                           Alpha                                                  Attach to 
 AHC  Affordable Housing Assistance - (816) 759-6878            Certificate*                          Code  Name of Credit and Phone Number                 Form MO-TC
  LHC         Missouri Low Income Housing - (816) 759-6878      Allocation Schedule                  WEC  Processed Wood Energy - (573) 751-6981            Certificate*

                                                                                                             Missouri Department of Social Services
              Missouri Department of Health and Senior Services
                                                                                                             P.O. Box 1082, Jefferson City, MO 65102-1082
              P.O. Box 570, Jefferson City, MO 65102-0570                                                 dss.mo.gov/dfas/taxcredit/index.htm  •  (573) 751-7533
                                       health.mo.gov                                                 Alpha                                                  Attach to 
  Alpha                                                         Attach to 
  Code  Name of Credit and Phone Number                         Form MO-TC                            Code  Name of Credit                                  Form MO-TC
 MPT  Medical Preceptorship                                     Certificate*                         DBC  Diaper Bank                                       Certificate* 
 SCT          Shared Care - (573) 751-4842                        Must Register Each                 DDC  Developmental Disability Care Provider            Certificate*
                                                                Year With Division of                DVC  Shelter for Victims of Domestic Violence          Certificate*
                                                                Senior and Disability                MHC  Maternity Home                                    Certificate* 
*23000000001*                                                   Services - Attach                    PRC  Pregnancy Resource                                Certificate*
                       23000000001                              Form MO-SCC                           RTA  Residential Treatment Agency                     Certificate* 
                                                                                                     SCH  School Children Health and Hunger                 Certificate*
Pursuant to Section 105.1500, RSMo, the Department of Revenue is prohibited from requir-
ing any entity exempt from federal income tax under Section 501(c) of the Internal Revenue                             Missouri State Treasurer’s Office
Code, or any individual, to provide the Department with any list, record, register, registry, roll, 
roster, or other compilation of data of any kind that directly or indirectly identifies a person             P.O. Box 210, Jefferson City, MO 65101
as a member, supporter, volunteer of, or donor of financial or nonfinancial support to, any                  mo.scholars@treasurer.mo.gov  •  (573) 751-8533
entity exempt from federal income tax under Section 501(c) of the Internal Revenue Code.            Alpha                                         Attach to 
Nothing in this form should be read or understood as a requirement that you provide any               Code  Name of Credit                                  Form MO-TC
such information. Notwithstanding any publication, webpage, form, instruction, regulation,          MES    MO Scholars                                      Receipt
or statement shared by the Department, you are not required to include such information on 
this form. If you encounter any technical difficulty in submitting this form without including             * Must be approved by the issuing agency
information that you believe is protected by Section 105.1500, RSMo, feel free to contact the 
Department by email at corporate@dor.mo.gov or by phone at 573-751-4541.                                   Individuals with speech or hearing impairments may
                                                                                                           call TTY (800) 735-2966 or fax (573) 522-1762.
                                                                                                 2                                                       Form MO-TC (Revised 12-2023)






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