Mississippi Special Tax Return Form

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Mississippi
MS
SP
Special Tax Return
Instructions: See reverse. Due 1st to 20th; Delinquent
DIRECT 030
Form 72-205-01-3-1-000 (Rev. 7/01)
722050131000
after 20th.This form must be filed even if no fee is due.
Copies or reproductions of the official form are NOT
Tax Calculation
acceptable.
ACCOUNT NUMBER
TAX PERIOD
Address Change
Taxable Amount
Rate of Tax
Amount of Tax
AD
Make changes below
AC
TP
x 1/2%=
1.
Rate 1
Final Return
FN
x 1% =
Close account
2.
Rate 2
FILING STATUS
DUE ON OR BEFORE
x 1 1/2%=
3.
Rate 3
Amended Return
AM
FS
DD
x 2% =
Replace original return
4.
Rate 4
x 2 1/2%=
5.
Rate 5
Additional Tax
AT
x 3% =
Supplement original return
6.
Rate 6
7.
Net Tax Due
8.
Late Filing Penalty (See Instructions)
9.
Credit Adjustments (See Instructions)
I declare, under the penalties of perjury, that this return (including any accompanying
schedules) has been examined by me and to the best of my knowledge and belief is a
10.
Additional Assessments (See Instructions)
true, correct and complete return.
11.
Total Due
Signature of Taxpayer or Agent
Phone
Date
Cut on Dotted Line Before Filing

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