Missouri Certification of Rent Paid

Certification of Rent Paid
Form MO-CRP - 2023 Certification of Rent Paid
Reset Form

Print Form

One Form MO-CRP must be provided for each rental location in which you resided.
Failure to provide landlord information will result in denial or delay of your claim.

Form

MO-CRP

2023 Certification of Rent Paid

Spouse’s Social Security Number

1.	 Social Security Number

-

-

-

-

Select this box if related to your landlord. If so, explain.
2.	 Name (First, Last)

Physical Address of Rental Unit (P.O. Box Not Allowed)

Apartment Number

City

State

ZIP Code

3.	 Landlord’s Name (First, Last)

Landlord’s Street Address (Must be completed)

Apartment Number

City

State

4.	Landlord’s Phone Number (Must be completed)
From:	
5.	 Rental Period During Year (MM/DD/YY)

ZIP Code

To:
(MM/DD/YY)

2023

2023

6.	 Enter your gross rent paid. Attach a completed Verification of Rent Paid (Form 5674). If you received housing
	 assistance, enter the amount of rent you paid. Note: If you rent from a facility that does not pay property tax, 	
	 you are not eligible for a Property Tax Credit  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

6

.

7.	 Select the appropriate box below and enter the corresponding percentage on Line 7 . . . . . . . . . . . . . . . . . . . . . . . . 

7

%

A.	 Apartment, House, Mobile Home, or Duplex - 100%

00

F.	 Low Income Housing - 100% (Rent cannot exceed 40% of total
	
household income.)

B.	 Mobile Home Lot - 100%
G.	 Shared Residence – If you shared your rent with relatives or friends
	
(other than your spouse or children under 18), select the appropriate
	
box based on the additional person(s) sharing rent:

C. Boarding Home or Residential Care - 50%
D. Skilled or Intermediate Care Nursing Home - 45%

1 (50%)

2 (33%)

3 (25%)

E. Hotel - 100%; if meals are included - 50%
8.	 Net rent paid - Multiply Line 6 by the percentage on Line 7 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
9.	 Multiply Line 8 by 20%. Enter amount here and on Line 10 of Form MO-PTC or Line 12 of Form MO-PTS  . . . . . . .

8

.

00

9

.

00

*23315010001*
23315010001
For Privacy Notice, see instructions.
Taxation Division
Attach to Form MO-PTC or MO-PTS and
mail to the Missouri Department of Revenue.

Form MO-CRP (Revised 12-2023)

Ever served on active duty in the United States Armed Forces?
If yes, visit dor.mo.gov/military/ to see the services and benefits we offer to all
eligible military individuals. A list of all state agency resources and benefits can be
found at veteranbenefits.mo.gov/state-benefits/.