Form Mo-1040a Draft - Individual Income Tax Return Single/married (One Income)

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2007 FORM MO-1040A
MISSOURI DEPARTMENT OF REVENUE
INDIVIDUAL INCOME TAX RETURN
VENDOR CODE
000
SINGLE/MARRIED (ONE INCOME)
SOCIAL SECURITY NUMBER
SPOUSE’S SOCIAL SECURITY NUMBER
NAME (LAST)
(FIRST)
M.I. JR, SR
SPOUSE’S (LAST)
(FIRST)
M.I. JR, SR
IN CARE OF NAME (ATTORNEY, EXECUTOR, PERSONAL REP., ETC.)
PRESENT ADDRESS (INCLUDE APARTMENT NO. OR RURAL ROUTE)
COUNTY OF RESIDENCE
SCHOOL DISTRICT NO.
CITY, TOWN, OR POST OFFICE
STATE
ZIP CODE
PLEASE CHECK THE APPROPRIATE BOXES THAT APPLY TO YOURSELF OR YOUR SPOUSE.
AGE 65 OR OLDER
BLIND
100% DISABLED
NON-OBLIGATED SPOUSE
YOURSELF
YOURSELF
YOURSELF
YOURSELF
SPOUSE
SPOUSE
SPOUSE
SPOUSE
1. Federal adjusted gross income from your 2007 Federal Forms 1040—Line 37;
1
00
1040A—Line 21; or 1040EZ—Line 4 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2 –
00
2. Any state income tax refund included in your 2007 federal income . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
3 =
00
3. Total Missouri Adjusted Gross Income — Subtract Line 2 from Line 1. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
4. Mark your filing status box below and enter the appropriate exemption amount on Line 4.
A. Single — $2,100 (See Box B before checking.)
D. Married filing separate — $2,100
B. Claimed as a dependent on another person’s federal
E. Married filing separate (spouse
tax return — $0.00
NOT filing) — $4,200
C. Married filing joint federal & combined Missouri — $4,200
F. Head of household — $3,500
G. Qualifying widow(er) with
Check which spouse had income:
4
00
dependent child — $3,500
Yourself
Spouse
5. Tax from federal return (Do not
Enter this amount on Line 5 or $5,000, whichever is less.
enter amount from your Form W-2(s)—
If married filing combined, enter this amount on Line 5
5
00
NOT federal tax withheld.)
00 or $10,000, whichever is less. . . . . . . . . . . . . . . . . . . . . .
+
6. Missouri standard deduction or itemized deductions. Single — $5,350; Head of Household — $7,850;
Married Filing Separate — $5,350; Married Filing a Combined Return or Qualifying Widow(er) — $10,700
6 +
00
If claimed as a dependent, age 65 or older, or blind, see federal return or page 6. If itemizing, see back of form. . .
Federal Form 1040 OR 1040A, Line 6c
7. Number of dependents you claimed on your
7 +
00
(Do not include yourself or your spouse.) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
x $1,200 = . . . . . . .
8 +
00
8. Long-term care insurance deduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
9 =
00
9. Total Deductions — Add Lines 4 through 8. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
10
00
10. Missouri Taxable Income — Subtract Line 9 from Line 3. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
11
00
11. Tax — Use the tax table on the back of this form to figure the tax. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
12. Missouri tax withheld from your Form W-2(s) and Form 1099(s). Attach copies
12
00
of Form W-2(s) and Form 1099(s). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
13
00
13. Any Missouri estimated tax payments made for 2007 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
14
00
14. Total Payments — Add Lines 12 and 13. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
15. If Line 14 (Total Payments) is more than Line 11 (Total Tax), enter the difference (amount of
15
00
overpayment) here. (If Line 14 is less than Line 11, skip to Line 19.) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
16
00
16. Amount from Line 15 that you want applied to next year’s taxes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Elderly
17. Enter the amount of your
Children’s
Veterans
Missouri
Workers’
Childhood
Missouri
General
Addl. Trust
Addl. Trust
LEAD
G
Home
Military
Revenue
Fund Code
Fund Code
eneral
National
Memorial
Lead
Workers
donation in the trust fund
R
Delivered
Family
(See Instr.)
(See Instr.)
evenue
Guard
Testing
Meals
Relief Fund
_____|_____
_____|_____
boxes to the right. See the
17
00
00
00
00
00
00
00
00
00
00
instructions for fund codes.
18. Subtract Lines 16 and 17 from Line 15 and enter here. This is your refund. Sign below and
18
00
mail to: Department of Revenue, P.O. Box 3222, Jefferson City, MO 65105-3222. . . . . . . . . . . . . .REFUND
19. If Line 14 is less than Line 11, enter the difference here. You have an amount due. Sign below and
19
00
mail to: Department of Revenue, P.O. Box 3370, Jefferson City, MO 65105-3370. . . . . .AMOUNT YOU OWE
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/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.
E-MAIL ADDRESS
PREPARER’S PHONE
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
NO
SIGNATURE
DATE
PREPARER’S SIGNATURE
FEIN, SSN, OR PTIN
X
SPOUSE’S SIGNATURE
DAYTIME TELEPHONE
PREPARER’S ADDRESS AND ZIP CODE
DATE
For Privacy Notice, see the instructions.
MO 860-2205 (11-2007)

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