Form 89-215 - Annual Information Return
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1Form 89-215 (Rev. 02/00)
Mississippi
Annual Information Return
Tax Year
See below for more detailed instructions.
This return must be filed by March 15.
Instructions
Due Date
Federal Employer Identification Number
Name of Person or Organization Rendering this Return
-
Date Received
Address
City
State
Zip Code
County
Important Notice
These information returns include payments made during the calendar year only. One blank Federal Form 1099 must be filled out for
each payee. DO NOT SUBMIT A LIST OF SUCH PAYMENTS. The paying organization may print or stamp name in the proper
column of Federal Form 1099 and on this form. This return must be certified to as follows: INDIVIDUAL by such individual or duly
authorized agent; PARTNERSHIP by a member of the firm; CORPORATION by an officer of the corporation.
(A) Paper Reporters:
Number of accompanying Federal Forms 1099..................................................................
OR
(B) Magnetic Media Reporters:
Number of accompanying tapes, diskettes, or cartridges..........................................................
Magnetic media specifications and format for Form 1099 are found in the Internal Revenue Publication 1220.
Diskette reporting is on 3 1/2 and 5 1/4 inch diskettes. Cartridges used should be 3480 and 3490. Tapes, diskettes
and cartridges should be adequately labeled and identified. All tapes, diskettes and cartridges become the property
of the State of Mississippi and will not be returned. All tapes, diskettes and cartridges are due by March 15th.
I certify that to the best of my knowledge and belief that the foregoing return and accompanying reports constitute a true and complete
statement of payments of income made by the above named taxpayer during the calendar year _________ .
Signature
Date
Title
Instructions
WHEN AND WHERE TO FILE: This return along with Federal
SOCIAL SECURITY OR FEDERAL IDENTIFICATION NUMBER:
Forms 1099 must be filed not later than March 15, with the
The Social Security
number
or
the Federal
Employer
Mississippi Tax Commission, P. O. Box 960, Jackson, MS
Identification number of the payor must be shown on Federal
39205.
Form 1099. Organizations other than individuals must use their
Federal Employer Identification number. If you have neither a
REPORTING SALARIES AND WAGES:
Every person or
social security number nor other Federal identification number,
organization making payments of salaries, wages, fees,
write the word "none" in the blank for social security number.
commissions or other compensation for personal services
totaling $3,000 or more to any individual which are not reported
TWO PAYEES: If a payment is made to multiple payees with
on Federal Form W-2 shall report such payments on Federal
different surnames (last names), underscore the surname to
Form 1099.
whom the social security number on Federal Form 1099 applies.
REPORTING
OTHER
PAYMENTS:
Every
person
or
LIABILITY AS WITHHOLDING AGENT: All employers required
organization making any of the following types of payments to
to withhold Federal income tax from employees are required to
any person or organization in excess of $600 shall report such
withhold Mississippi income tax and remit to the State Tax
payments on Federal Form 1099:
Commission. If you are a withholding agent for Federal income
(a) Dividends
tax purposes but do not withhold Mississippi income tax, you
(b) Interest
should apply immediately to register as a withholding agent for
(c) Rents
Mississippi income tax purposes.
(d) Royalties
(e) Annuities and Pensions
You may not substitute Federal Transmittal Form 1096 for this
(f) Premiums
form.
(g) Corporate Liquidations
(h) Payments made to nonresident contractors not
subject to withholding
(i) Other annual or periodic payments
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