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FORM MO-1040P

PAGE 2

14. Total Missouri taxable amount from Line 13 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yourself

Spouse

15. Multiply Line 14 by the percentages you determined on Line 5.

Do this for you and your spouse. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

16. Use the tax table on page 3 of Form MO-1040P to figure the

tax on amounts from Line 15 for you and your spouse. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

17. TOTAL TAXES — Add your tax and your spouse’s tax from Line 16. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

18. Missouri withholding for you and your spouse from your Forms W-2(s)

and 1099(s). Attach copies of Forms W-2(s) and 1099(s). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18

19. Any Missouri estimated tax payments for 2003 (Be sure to include

any amount of your 2002 overpayment credited to your 2003 Missouri tax return.) . . . . . . . . . . . . . . . . . . . 19

Attach

Form MO-PTS.

20. PROPERTY TAX CREDIT — Enter amount from Form MO-PTS,

Line 14. Attach Form MO-PTS. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20

21. TOTAL PAYMENTS AND CREDITS

Add Lines 18, 19, and 20 and enter amount here. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21

22. If amount of TOTAL PAYMENTS AND CREDITS (Line 21) is larger than amount of

TOTAL TAXES (Line 17), enter the difference here. You have overpaid.

If not, enter the amount on Line 26. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22

23. Enter the amount from Line 22 you want applied to next year’s taxes. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23

Children’s

Veterans

Elderly

Missouri

General

Workers’

General

Home

National

Revenue

Memorial

Workers

Revenue

24. You may donate part of your refund

Delivered

Guard

or contribute additional payments to

Meals

any or all of the trust funds listed to

the right. Please indicate your

choices and the amount of your donations

for each fund in the appropriate boxes. . . . . . 24

25. Subtract Lines 23 and 24 from Line 22 and enter here. This is your refund. Sign below and

mail to:

Department of Revenue, P.O. Box 3385, Jefferson City, MO 65105-3385.

. . . . . . . .

.REFUND

26. If Line 21 is less than Line 17, enter the difference here. You have an amount due. Sign below and

mail to:

Department of Revenue, P.O. Box 3395, Jefferson City, MO 65105-3395. . . . . .AMOUNT DUE

The Department of Revenue may collect checks returned for insufficient or uncollected funds electronically.

Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my

S E P

DOR

knowledge and belief it is true, correct, and complete. Declaration of preparer (other than taxpayer) is based on all information of which he/she

ONLY

has any knowledge. As provided in Chapter 143, RSMo, a penalty of up to $500 shall be imposed on any individual who files a frivolous return.

I authorize the Director of Revenue or delegate to discuss my return and

PREPARER’S PHONE NUMBER

attachments with the preparer or any member of the preparer’s firm.

YES

SIGNATURE

DATE

PREPARER’S SIGNATURE

FEIN, SSN, OR PTIN

SPOUSE’S SIGNATURE

DAYTIME TELEPHONE

PREPARER’S ADDRESS AND ZIP CODE

DATE

MO 860-2954 (11-2003)

Form Mo-1040p - Missouri Individual Income Tax Return And Property Tax Credit Claim/pension Exemption - Short Form - 2003 Page 2

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