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New Mexico Free Printable  for 2024 New Mexico Rural Health Care Practitioner Tax Credit Claim Form

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Rural Health Care Practitioner Tax Credit Claim Form
Form RPD-41326

RPD-41326 Rev. 07/15/2015 State of New Mexico - Taxation and Revenue Department RURAL HEALTH CARE PRACTITIONER TAX CREDIT CLAIM FORM WHO MUST FILE THIS FORM: Effective January 1, 2007, a taxpayer who files a New Mexico personal income tax return, who is not a dependent of another individual, who is an eligible health care practitioner and who has provided health care services in New Mexico in a rural health care underserved area in a tax year, may claim a credit against personal income tax liability. The rural health care practitioner tax credit may be claimed and allowed in an amount up to $5,000 for all eligible physicians, osteopathic physicians, dentists, clinical psychologist, podiatrists, and optometrists who qualify, and up to $3,000 for all eligible dental hygienists, physician assistants, certified nurse-midwives, certified registered nurse anesthetists and clinical nurse specialists who qualify. If the amount of the credit claimed exceeds a taxpayer’s tax liability for the tax year in which the credit is being claimed, the excess may be carried forward for three consecutive tax years. To qualify for the rural health care practitioner tax credit, an eligible health care practitioner shall have provided health care during a tax year for at least 2,080 hours at a practice site located in an approved rural health care underserved area. An eligible rural health care practitioner who provides health care services for at least 1,040 hours, but less than 2,080 hours, at a practice site located in an approved rural health care underserved area during a tax year is eligible for one-half of the credit amount. Before an eligible health care practitioner may claim the rural health care practitioner tax credit, the practitioner shall submit an application to the New Mexico Department of Health (NMDOH) that describes the practitioner’s clinical practice and contains additional information that NMDOH may require. NMDOH will determine whether an eligible health care practitioner qualifies for the rural health care practitioner tax credit, and will issue a certificate to each qualifying eligible health care practitioner. To apply for certification of eligibility, contact NMDOH at (505) 841-5849, by e-mail at [email protected], or visit their website at www.health.state.nm.us. HOW TO CLAIM THIS CREDIT: Compute the credit amount on the worksheet below and submit this Form RPD-41326, Rural Health Care Practitioner Tax Credit Claim Form, with the New Mexico personal income tax return during the tax year the credit is certified by NMDOH or the tax year in which a carryforward is claimed against a personal income tax liability. During the tax year the credit is certified by NMDOH, you must also submit a copy of the certificate of eligibility issued by NMDOH. Include Schedule A if you have unused rural health care practitioner tax credit eligible to be carried forward from prior years. For assistance completing this form or claiming the credit, call (505) 827-0792. Social security number (SSN) Name of taxpayer Mailing address Name of contact City, state and ZIP code E-mail address Phone number 1. Enter the beginning and ending date of the tax year of this claim. From _____________ to _____________ 2. Enter the Net New Mexico income tax calculated before applying any credit. 3. Enter the portion of total credit available (from Schedule A) claimed on your current New Mexico personal or fiduciary income tax return. Do not enter more than the amount of Net New Mexico personal or fiduciary income tax due. In a tax year the credit used may not exceed the amount of personal or fiduciary income tax otherwise due. Also attach a completed Schedule CR for the applicable tax return. 2. $ 3. $ Under penalty of perjury, I delare I have examined this claim, including accompanying returns, schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete. Signature of Taxpayer or Agent Title Date RPD-41326 Rev. 07/15/2015 State of New Mexico - Taxation & Revenue Department RURAL HEALTH CARE PRACTITIONER TAX CREDIT CLAIM FORM Schedule A Once a credit application is approved by NMDOH, complete and attach Form RPD-41326, Rural Health Care PractitionerTax Credit Claim Form, including Schedule A, to your New Mexico income tax return along with the applicable tax credit Schedule CR for the tax program you are applying the credit towards. Attach a copy of your certificate from NMDOH. (a) Certification number (b) Date of approval (c) Amount of credit approved (d) Total credit claimed in previous tax years (e) Unused credit [(c) - (d)] TOTAL credit available Enter the sum of column (f) here and on line 3 of Form RPD-41326, page 1. (f) Applied to the attached return RPD-41326 Rev. 07/15/2015 State of New Mexico - Taxation & Revenue Department RURAL HEALTH CARE PRACTITIONER TAX CREDIT CLAIM FORM Schedule A Instructions For each rural health care practitioner tax credit approved by the New Mexico Department of Health (NMDOH) complete a row in Schedule A. Do not include credits approved in a tax year that is more than four years prior to the tax year for which this claim is filed. Unused rural health care practitioner tax credit may not be carried forward for more than three consecutive tax years following the tax year for which the credit was approved. Do not include credits which have been claimed in full in prior tax years.. COLUMN INSTRUCTIONS (a) Certification number. Enter the certification number for each rural health care practitioner tax credit shown on the credit approval document issued by NMDOH. Do not enter a credit if the certificate of eligibility is for a tax year more than four years from the tax year of this claim or if the credit was not approved by NMDOH. Unused credit may only be carried forward for three years following the tax year for which the credit was approved. (b) Date of approval. Enter the date the rural health care practitioner tax credit was approved as indicated on the certificate issued by NMDOH. (c) Amount of credit approved. For each credit, enter the amount approved, as indicated on the certificate issued by NMDOH. (d) Total credit claimed in previous tax years. For each credit listed, enter the total amount of credit claimed in all tax years prior to the current tax year. (e) Unused credit. For each credit, subtract the amount in column (d) from the amount in column (c). (f) Applied to the attached return. For each credit, enter in column (f) the amount that is applied to the attached New Mexico income tax return. When calculating the amount in column (f), apply the following rules: • Applying credits: Apply rural health care practitioner tax credit in the order that they were approved. The oldest credit should be applied first. If you have both a carry forward credit and a credit approved in the current tax year, apply the older credits first. • The maximum amount of credit claimed in a tax year. The sum of tax credits applied to the tax due on the return may not exceed the income tax claimed on the New Mexico income tax return. That amount is the net New Mexico income tax calculated before applying any tax credits claimed. IMPORTANT DEFINITIONS “Eligible health care practitioner” means: (a) a certified nurse-midwife licensed by the board of nursing as a registered nurse and licensed by the public health division of the New Mexico Department of Health to practice nurse-midwifery as a certified nurse-midwife; (b) a dentist or dental hygienist licensed pursuant to the Dental Health Care Act; (c) an optometrist licensed pursuant to the provisions of the Optometry Act; (d) an osteopathic physician licensed pursuant to the provisions of Chapter 61, Article 10 NMSA 1978, or an osteopathic physician assistant licensed pursuant to the provisions of the Osteopathic Physicians’ Assistants Act; (e) a physician or physician assistant licensed pursuant to the provisions of Chapter 61, Article 6 NMSA 1978; (f) a podiatrist licensed pursuant to the provisions of the Podiatry Act; (g) a clinical psychologist licensed pursuant to the provisions of the Professional Psychologist Act; and (h) a registered nurse in advanced practice who has been prepared through additional formal education as provided in Sections 61-3-23.2 through 61-3-23.4 NMSA 1978 to function beyond the scope of practice of professional registered nursing, including certified nurse practitioners, certified registered nurse anesthetists and clinical nurse specialists. “Health care underserved area” means a geographic area or practice location in which it has been determined by the New Mexico Department of Health, through the use of indices and other standards set by the New Mexico Department of Health, that sufficient health care services are not being provided. “Practice site” means a private practice, public health clinic, hospital, public or private non-profit primary care clinic or other health care service location in a health care underserved area. “Rural” means an area or location identified by the New Mexico Department of Health as falling outside of an urban area.
Extracted from PDF file 2023-new-mexico-form-rpd-41326.pdf, last modified July 2015

More about the New Mexico Form RPD-41326 Other Tax Credit TY 2023

We last updated the Rural Health Care Practitioner Tax Credit Claim Form in January 2024, so this is the latest version of Form RPD-41326, fully updated for tax year 2023. You can download or print current or past-year PDFs of Form RPD-41326 directly from TaxFormFinder. You can print other New Mexico tax forms here.


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Other New Mexico Other Forms:

TaxFormFinder has an additional 80 New Mexico income tax forms that you may need, plus all federal income tax forms.

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Download all NM tax forms View all 81 New Mexico Income Tax Forms


Form Sources:

New Mexico usually releases forms for the current tax year between January and April. We last updated New Mexico Form RPD-41326 from the Taxation and Revenue Department in January 2024.

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Form RPD-41326 is a New Mexico Other form. States often have dozens of even hundreds of various tax credits, which, unlike deductions, provide a dollar-for-dollar reduction of tax liability. Some common tax credits apply to many taxpayers, while others only apply to extremely specific situations. In most cases, you will have to provide evidence to show that you are eligible for the tax credit, and calculate the amount of the credit to which you are entitled.

Historical Past-Year Versions of New Mexico Form RPD-41326

We have a total of thirteen past-year versions of Form RPD-41326 in the TaxFormFinder archives, including for the previous tax year. Download past year versions of this tax form as PDFs here:



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