Massachusetts Quality Review Check List Health Care Basic Questions (confirm as correct) Health Plan Information (Enter only one / Ensure correct ID #s) Basic Information New Address/Name Change (Yes / No) Mass Election Campaign Fund (Yes / No) Income Subject to Tax Mass Tax-Exempt Pensions (entered as NEGATIVE) Sch B Additions: Taxable Interest + Description (from worksheet) Sch B Subtractions: Non-taxable Interest + Description (from worksheet) Sch B. Short Term Loss carryover (entered as NEGATIVE) Sch D: Long Term Loss carryover (entered as NEGATIVE) Additions to Income Mass Bank interest (from worksheet) Taxable IRA (from worksheet) Deductions Contributions to Municipal / Gov’t pensions (from worksheet) Non-Mass State Pension Exclusion (see Mass Manual Appendix A) Student Loan Interest Certain Gambling Losses Other Deductions Child under 13 / Disabled care Rental College Tuition Credits Senior Circuit Breaker 65 or over (Click Yes) Renter/Homeowner (Pick one)
Massachusetts Quality Review Check List Health Care Basic Questions (confirm as correct) Health Plan Information (Enter only one / Ensure correct ID #s) Basic Information New Address/Name Change (Yes / No) Mass Election Campaign Fund (Yes / No) Income Subject to Tax Mass Tax-Exempt Pensions (entered as NEGATIVE) Sch B Additions: Taxable Interest + Description (from worksheet) Sch B Subtractions: Non-taxable Interest + Description (from worksheet) Sch B. Short Term Loss carryover (entered as NEGATIVE) Sch D: Long Term Loss carryover (entered as NEGATIVE) Additions to Income Mass Bank interest (from worksheet) Taxable IRA (from worksheet) Deductions Contributions to Municipal / Gov’t pensions (from worksheet) Non-Mass State Pension Exclusion (see Mass Manual Appendix A) Student Loan Interest Certain Gambling Losses Other Deductions Child under 13 / Disabled care Rental College Tuition Credits Senior Circuit Breaker 65 or over (Click Yes) Renter/Homeowner (Pick one)