Fillable Form 80107198 80107198 80107198.pdf (Mississippi)

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Form 80107198 80107198 80107198.pdf (Mississippi)

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Mississippi
Income / Withholding Tax Schedule
2019
Duplex and Photocopies NOT Acceptable
801071981000
Form 80-107-19-8-1-000 (Rev. 06/19)
Primary Taxpayer Name (as shown on Forms 80-105, 80-205 and 81-110)
C - Employer or Payer InformationA - Statement Information B - Income and Withhholding
Employer or Payer ID from W-2, 1099, K-1
City, State, ZIP
Address
Employer or payer nameState Wages, Tips, Etc.
Taxpayer Social Security Number
If 1099-R, Code in Box 7
State
MS
Check appropriate box
W-2 1099 K-1
Mississippi Withholding Only
.00
.00
State Income from Other State
.00
Taxpayer Name
W-2G
C - Employer or Payer InformationA - Statement Information B - Income and Withhholding
Employer or Payer ID from W-2, 1099, K-1
City, State, ZIP
Address
Employer or payer name
Taxpayer Social Security Number
If 1099-R, Code in Box 7
State
MS
Check appropriate box
Mississippi Withholding Only
.00
.00
State Income from Other State
.00
Taxpayer Name
C - Employer or Payer Information
A - Statement Information
B - Income and Withhholding
Employer or Payer ID from W-2, 1099, K-1
City, State, ZIP
Address
Employer or payer name
Taxpayer Social Security Number
If 1099-R, Code in Box 7
State
MS
Check appropriate box
Mississippi Withholding Only
.00
.00
State Income from Other State
.00
Taxpayer Name
Employer or Payer ID from W-2, 1099, K-1
City, State, ZIP
Address
Employer or payer name
Taxpayer Social Security Number
If 1099-R, Code in Box 7
State
MS
Check appropriate box
Mississippi Withholding Only
.00
.00
State Income from Other State
.00
Taxpayer Name
W-2 1099 K-1
W-2G
W-2 1099 K-1
W-2G
W-2 1099 K-1
W-2G
State Wages, Tips, Etc.
State Wages, Tips, Etc.
State Wages, Tips, Etc.
THIS FORM MUST BE FILED EVEN IF YOU HAVE NO MISSISSIPPI WITHHOLDING
A - Statement Information
B - Income and Withhholding
C - Employer or Payer Information
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Form 80107198 80107198 80107198.pdf (Mississippi)

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Completed 16 July 2020

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