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FORM MO-1040P

14. Total Missouri taxable income 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. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

15Y

15S

16. Use the tax chart on page 18 or 22 of the instructions to figure the

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

16Y

16S

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 and 1099.

Attach copies of Forms W-2 and 1099. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

19. Any Missouri estimated tax payments for 2016 (Be sure to include

any amount of your 2015 overpayment credited to your 2016 Missouri tax return.) . . . . . . . . . . . . . . . . . . . .

Attach

Form MO-PTS.

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

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

21. TOTAL PAYMENTS AND CREDITS

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

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

. . . . . . . . . . . 22

(Line 17), enter the difference here. You have overpaid. If not, enter the amount on Line 27

23. Enter the amount from Line 22 you want applied to your 2017 estimated tax.. . . . . . . . . . . . . . . . . . . . . . . .

Enter the amount of your

24.

Workers

Additional

donation in the trust fund

eneral

LEAD

Missouri

Fund Code

evenue

Military

Elderly Home

Workers’

boxes to the right. See

National Guard

Childhood

General

(See Instr.)

Children’s

Veterans

Delivered Meals

Family Relief

Memorial

Trust Fund

Lead Testing

Organ Donor

Revenue

instructions for trust fund

Trust Fund

Fund

______|______

Fund

Program Fund

Fund

codes.

25. Amount from Line 22 to be deposited into a Missouri 529 College Savings Plan (MOST) account.

Enter amount from Line E of Form 5632. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

26. REFUND - Subtract Lines 23, 24, and 25 from Line 22 and enter here. This is your refund.

Sign below and mail to: Department of Revenue, P.O. Box 2800, Jefferson City, MO 65105-2800 . . . .

27. AMOUNT DUE - 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.

See instructions for Line 27. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

If you pay by check, you authorize the Department of Revenue to process the check electronically.

Any check returned unpaid may be presented again electronically.

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

correct, and complete. Declaration of preparer (other than taxpayer) is based on all information of which he or she 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 also declare under penalties of perjury that I employ no illegal or unauthorized aliens as defined under

federal law and that I am not eligible for any tax exemption, credit or abatement if I employ such aliens.

E-MAIL ADDRESS

PREPARER’S PHONE NUMBER

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

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

YES

(__ __ __)__ __ __-__ __ __ __

SIGNATURE

DATE (MMDDYYYY)

PREPARER’S SIGNATURE

FEIN, SSN, OR PTIN

__ __/__ __/__ __ __ __