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           Form                                                                        (MM/DD/YY)
 MO-SSC           Public Safety Officer Surviving Spouse Credit

Taxpayer Social Security Number

                -               -
Taxpayer Name

Taxpayer Address                                                  City                                               State  ZIP Code

                                                    Public Safety Officer Information
Name of Public Safety Officer                                                          Social Security Number

                                                                                                          -             -
Public Safety Officer’s Place of Employment

                                                                     Property
Address (if different than Taxapayer Address)                     City                                               State  ZIP Code

                                                                  Qualifications
If you are a surviving spouse of a public safety officer who was killed in the line of duty, you may be eligible for a credit equal to the amount of property 
taxes paid on your homestead.
The following qualifications must be met to claim the credit:
  •  The surviving spouse must own a homestead in Missouri and pay property taxes on the dwelling and surrounding land. If the homestead includes  
    land in excess of five acres, an Assessor Certification (Form 948) must be completed by the county assessor to determine the appropriate credit.
  •  Eligible public safety officers are any firefighter, police officer, capitol police officer, parole officer, probation officer, correctional employee, water  
    patrol officer, park ranger, conservation officer, commercial motor vehicle enforcement officer, emergency medical responder, emergency medical    
    technician, first responder, or highway patrolman employed by the state of Missouri or a political subdivision in Missouri, who was killed in the line  
    of duty.
  •  The marriage shall have been recognized under Missouri law and surviving spouse may not be remarried.
  •  The homestead may not be occupied by more than two families.
If you meet all the qualifications mentioned above, report on the Total Property Taxes Paid Line below the amount of property taxes you paid for any 
year beginning on or after January 1, 2008. You may only claim a credit for taxes paid in the year they were paid. For example, if you paid 2008 property 
taxes in December of 2008, you may only report those taxes paid on the MO-SSC filed with your 2008 Missouri Individual Income Tax Return. If your 
homestead includes more than 5 acres of land, you must have your assessor complete Assessor Certification (Form 948) and report the amount from 
Line 4 of the MO-948 on the Total Property Taxes Paid line below. Attach a copy of your property tax receipt, Form MO-SSC, and Miscellaneous Income 
Tax Credits (Form MO-TC) with your Missouri Individual Income Tax Return.
Total Property Taxes Paid: Enter the amount of property taxes paid on your home here and on Form MO-TC. If you have more than five acres, enter the 
amount from Line 4 of Form MO-948 here $ _______________________________.

           I am aware of any applicable reporting requirements of Section 135.805 RSMo and the penalty provisions of Section 135.810 RSMo.
           Taxpayer’s Signature                        Printed Name                                                  Date (MM/DD/YYYY)
 Signature                                                                                                           __ __ / __ __ / __ __ __ __

                                 Attach your completed Form MO-SSC to your Missouri Income Tax Return.
                                                                                                                        Form MO-SSC (Revised 09-2022)
Taxation Division                          Phone: (573) 526-6864
P.O. Box 27                                TTY: (800) 735-2966                         Visit dor.mo.gov/tax-credits/ssc.html
Jefferson City, MO 65105-0027              Fax: (573) 522-1762                               for additional information.
                                           E-mail:   income@dor.mo.gov
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