Form Mo-Nri - Missouri Income Percentage - 2000
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1
2Enclosure Sequence No. 1040-04 and 1040C-02
2000
MISSOURI DEPARTMENT OF REVENUE
DLN
MISSOURI INCOME
FORM
MO-NRI
PERCENTAGE
FEDERAL RETURN MUST BE ENCLOSED
• If your home of record is Missouri or you had Missouri source income, complete this form only after Form MO-1040, Lines 1 through 25 or Form MO-1040C, Lines 1
through 15 are completed.
• If you filed a joint federal return, you must file a combined Missouri return (even if only one of you had Missouri income) and complete each column below. Do not
combine Missouri source income for yourself and your spouse.
• Military pay of a nonresident stationed in Missouri should not be included in Missouri source income.
• If you are a nonresident stationed in Missouri or you moved into Missouri after December 31, 2000 and neither you nor your spouse had Missouri source income, check this
box
and complete Part A and Part B below. You are not required to file a Missouri return. Sign Form MO-NRI on reverse side and send Form MO-NRI along with all
Form W-2(s) to: Missouri Department of Revenue, P.O. Box 3900, Jefferson City, MO 65105-3900. Military personnel must enclose a Leave and Earnings Statement.
PART A — CHECK YOUR STATUS ON EITHER LINE 1, LINE 2 OR LINE 3 BELOW.
NAME OF YOURSELF OR ONE INCOME FILER
NAME OF SPOUSE (ON A COMBINED RETURN)
ADDRESS
ADDRESS
CITY, STATE, ZIP CODE
SOCIAL SECURITY NUMBER
CITY, STATE, ZIP CODE
SOCIAL SECURITY NUMBER
1. NONRESIDENT OF MISSOURI
1. NONRESIDENT OF MISSOURI
WHAT WAS YOUR STATE OF RESIDENCE DURING 2000?
WHAT WAS YOUR STATE OF RESIDENCE DURING 2000?
2. PART-YEAR MISSOURI RESIDENT
2. PART-YEAR MISSOURI RESIDENT
a. INDICATE THE DATE YOU WERE A
DATE FROM:
DATE TO:
a. INDICATE THE DATE YOU WERE A
DATE FROM:
DATE TO:
MISSOURI RESIDENT IN 2000.
MISSOURI RESIDENT IN 2000.
b. INDICATE YOUR OTHER STATE OF
DATE FROM:
DATE TO:
b. INDICATE YOUR OTHER STATE OF
DATE FROM:
DATE TO:
RESIDENCE AND THE DATE YOU
RESIDENCE AND THE DATE YOU
RESIDED THERE.
RESIDED THERE.
3. MILITARY/NON-RESIDENT TAX STATUS — Indicate your tax status
3. MILITARY/NON-RESIDENT TAX STATUS — Indicate your tax status
below and complete Part B—Missouri Income Percentage.
below and complete Part B—Missouri Income Percentage.
a. Missouri Domicile
a. Missouri Domicile
I did not at any time during the 2000 tax year maintain a permanent place of
I did not at any time during the 2000 tax year maintain a permanent place of
abode in Missouri nor did I spend more than 30 days in Missouri during the
abode in Missouri nor did I spend more than 30 days in Missouri during the
year. I did maintain a permanent place of abode in the state of _______________
year. I did maintain a permanent place of abode in the state of _____________
___________________________.
_____________________________.
b. Non-Missouri Domicile
b. Non-Missouri Domicile
I resided in Missouri during 2000 solely because I was stationed at __________
I resided in Missouri during 2000 solely because I was stationed at _________
____________________ on military orders, my home of record is in the state
____________________ on military orders, my home of record is in the state
of ________________________________.
of ________________________________.
If you qualified as a nonresident and you had no Missouri source income, enter
If you qualified as a nonresident and you had no Missouri source income, enter
0% on Form MO-NRI, Part B, Line 3 below, and on Form MO-1040, Line 27 or
0% on Form MO-NRI, Part B, Line 3 below, and on Form MO-1040, Line 27 or
Form MO-1040C, Line 17. If you have wages in Missouri (other than military
Form MO-1040C, Line 17. If you have wages in Missouri (other than military
pay), you must complete Part B and include your Missouri wages on Line 1. If
pay), you must complete Part B and include your Missouri wages on Line 1. If
you are a military nonresident stationed in Missouri and neither you nor your
you are a military nonresident stationed in Missouri and neither you nor your
spouse had Missouri source income, enter 0 on Part B, Line 1 below and enter
spouse had Missouri source income, enter 0 on Part B, Line 1 below and enter
your federal adjusted gross income on Part B, Line 2.
your federal adjusted gross income on Part B, Line 2.
PART B — MISSOURI INCOME PERCENTAGE
Complete ONLY PART B, if income consists of only wages or salaries with no adjustments on Federal Form 1040A,
Line 18 or Federal Form 1040, Line 32. Otherwise, complete Part C and then complete Part B.
YOURSELF OR
SPOUSE (ON A
ONE INCOME FILER
COMBINED RETURN)
00
00
1. Missouri income — enter wages, salaries, etc. from Missouri. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1
2. Taxpayer’s total adjusted gross income (from Form MO-1040, Line 5 or Form MO-1040C, Line 3 or from
00
00
your federal form if you are a military nonresident and you are not required to file a Missouri return). . . . . . . .
2
3. MISSOURI INCOME PERCENTAGE (divide Line 1 by Line 2). If greater than 100%, enter 100%.
(Round to a whole percent such as 91% instead of 90.5% and 90% instead of 90.4%. However, if
percentage is less than 0.5%, use the exact percentage.) Enter percentage here and on Form MO-1040,
Line 27 or Form MO-1040C, Line 17. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
%
3
%
MO 860-1096 (11-2000)
This publication is available upon request in alternative accessible format(s).
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