Fillable Form 80105198 80105198 80105198.pdf (Mississippi)

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Form 80105198 80105198 80105198.pdf (Mississippi)

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Married - Filing Separate Returns ($12,000)
Spouse SSN
County Code
ZipCity
Taxpayer First Name
SSN
Spouse First Name
Initial
Taxpayer Blind
Taxpayer Age 65 or Over Spouse Age 65 or Over
Spouse Blind
12 Total (line 10 plus line 11)7 Total number of dependents (from line 6 and Form 80-491)
9 Total dependents line 7 plus number of boxes checked line 8
14 Standard or itemized deductions (if itemized, attach Form 80-108)
15 Exemptions (from line 12; if married filing separately use 1/2 amount)
18 Credit for tax paid to another state (from Form 80-160, line 14; attach other state return)
19 Other credits (from Form 80-401, line 1)
21 Consumer use tax (see instructions)
17 Income tax due (from Schedule of Tax Computation, see instructions)
16 Mississippi taxable income (line 13 minus line 14 and line 15)
Mailing Address (Number and Street, Including Rural Route)
State
Last Name
4
1
5
2
Married - Combined or Joint Return ($12,000)
Head of Family ($8,000)
Single ($6,000)
3
Mississippi
Resident Individual Income Tax Return
2019
Married - Spouse Died in Tax Year ($12,000)
801051981000
Form 80-105-19-8-1-000 (Rev. 07/19)
8
Amended
20 Net income tax due (line 17 minus line 18 and line 19)
(C) Dependent SSN(A) Name
6
(B)
MISSISSIPPI INCOME TAX
23 Total Mississippi income tax due (line 20 plus line 21 and line 22)
24 Mississippi income tax withheld (complete Form 80-107)
25 Estimated tax payments, extension payments and/or amount paid on original return
27 Total payments (line 24 plus line 25 minus line 26)
26 Refund received and/or amount carried forward from original return (amended return only)
28 Overpayment (if line 27 is more than line 23, subtract line 23 from line 27)
30 Adjusted overpayment (line 28 minus line 29)
31 Overpayment to be applied to next year estimated tax account
32 Voluntary contribution (from Form 80-108, part III)
10
10 Line 9 x $1,500
11 Enter filing status exemption
Dependents (in column B, enter "C" for child, "P" for parent or "R" for relative)
13 Mississippi adjusted gross income (from page 2, line 65)
34 Balance due (if line 23 is more than line 27, subtract line 27 from line 23)
29 Interest and penalty (from Form 80-320, line 11 and/or line 12)
Initial
PAYMENTS
REFUND OR BALANCE DUE
REFUND
BALANCE DUE
PLEASE SIGN THIS TAX RETURN ON THE BOTTOM OF PAGE 2
Installment Agreement Request
(see instructions for eligibility; attach Form 71-661)
.00
.00
.00
.00
.00
.00
.00
.00
.00
.00
.00
.00
.00
.00
.00
.00
.00
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.00
.00
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.00
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.00
.00
.00
11
12
13A
14A
15A
16A
22
13B
14B
15B
16B
18
19
20
21
23
24
25
26
28
29
30
31
32
Farmers or Fishermen
(see instructions)
35 Interest and penalty (from Form 80-320, line 19)
.00
33
36 Total due (line 34 plus line 35)
34
.00
Column A (Taxpayer)
Column B (Spouse)
17
Last Name
33 Overpayment refund (line 30 minus line 31 and line 32)
.00
35
AMOUNT YOU OWE
(If no overpayment is due on line 28, skip to line 34)
22 Catastrophe savings tax (from Form 80-360, line 14)
.00
27
36
.00
EXEMPTIONS
Reset Form
Print Form
Mississippi
Resident Individual Income Tax Return
2019
Page 2
801051982000
Form 80-105-19-8-2-000 (Rev. 07/19)
SSN
Column A (Taxpayer) Column B (Spouse)
Paid Preparer Signature
Date
Paid Preparer Address
Date
Taxpayer Signature
Taxpayer Phone Number
Paid Preparer PTIN
Paid Preparer Phone Number
City State Zip Code
Spouse Signature
Date
Paid Preparer Email Address
I declare, under penalties of perjury, that I have examined this return and accompanying schedules and statements, and to the best of my knowledge and belief,
this is a true, correct and complete return. Declaration of preparer (other than taxpayer) is based on all information of which preparer has any knowledge.
48 Total income (add lines 37 through 47)
46 Unemployment compensation (complete Form 80-107)
44 Alimony received
45 Taxable pensions and annuities (complete Form 80-107)
47 Other income (loss) (from Form 80-108, part V, line 10)
42 Interest income (from Form 80-108, part II, line 3)
43 Dividend income (from Form 80-108, part II, line 6)
39 Capital gain (loss) (attach Federal Schedule D, if applicable)
40 Rent, royalties, partnerships, S corporation trusts, etc.
(from Form 80-108, part IV)
38 Business income (loss) (attach Federal Schedule C or C-EZ)
41 Farm income (loss) (attach Federal Schedule F)
50 Payments to self-employed SEP, SIMPLE and qualified retirement plans
51 Interest penalty on early withdrawal of savings
52 Alimony paid (complete below)
49 Payments to IRA
53 Moving expense (attach Federal Form 3903)
54 National Guard or Reserve pay (enter the lesser of amount or $15,000)
55 Mississippi Prepaid Affordable College Tuition (MPACT)
58 Health savings account deduction
57 Self-employed health insurance deduction
64 Total adjustments (add lines 49 through 63)
56 Mississippi Affordable College Savings (MACS)
This return may be discussed with the preparer Yes No
37 Wages, salaries, tips, etc. (complete Form 80-107)
65 Mississippi adjusted gross income (line 48 minus line 64; enter
on page 1, line 13)
INCOME
Name
State
SSN
Mail REFUND returns to: Department of Revenue, P.O. Box 23058, Jackson, MS 39225-3058
Mail all other returns to: Department of Revenue, P.O. Box 23050, Jackson, MS 39225-3050
Column A (Taxpayer) Column B (Spouse)
ADJUSTMENTS
.00
.00
.00
.00
.00 .00
.00
.00
.00
.00
.00
.00
.00
.00
.00
.00
.00.00
.00
.00
.00
.00
.00
.00
.00
.00
.00
.00
.00
.00
.00
.00
.00
.00
59A
37A
38A
39A
40A
41A
42A
43A
44A
59B
37B
38B
39B
40B
41B
42B
43B
44B
47A
48A
47B
48B
51A
52A
53A
54A
55A
56A
51B
52B
53B
54B
55B
56B
Duplex and Photocopies NOT Acceptable
AMENDED RETURN - EXPLANATION OF CHANGES TO ORIGINAL RETURN (attach additional statement if needed)
.00 .00
64A 64B
.00 .00
45A 45B
.00 .00
49A 49B
.00 .00
57A 57B
.00 .00
46A 46B
.00 .00
50A 50B
.00 .00
58A 58B
59 Catastrophe savings account deduction
.00
60B
.00
60A
.00
65B
.00
65A
60 Self-employment tax deduction
.00
61B
.00
61A
61 First-time home buyer savings account deduction
62 Agricultural disaster program compensation deduction
.00 .00
63A 63B
Date of Divorce
.00
62B
.00
62A
63 Mississippi Achieving a Better Life Experience (ABLE) Act deduction
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Form 80105198 80105198 80105198.pdf (Mississippi)

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Completed 20 July 2020

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