Form 80-105-01-5-2-000 - Resident Individual Income Tax Return - 2001
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1
2Mississippi
MS
Resident Individual Income Tax Return
For Official Use Only
IS B
2001
801050151000
Page 1 of 2
Form 80-105-01-5-1-000 (Rev.5/01)
7A
RC
11
18A
18B
25
30K
7B
FS
12
19A
19B
26
30Z
7C
8
13
20A
20B
27
31
7D
9
14
21A
21B
28
32
10
15A
15B
22
29
33
16A
16B
23
30L
34
17A
17B
24
30M
35
TS
N1
N2
N3
SS
TY
A
For Computer Use Only - Do Not Write Above This Line
C
1.
Married - Combined or Joint Return - Enter $12,000 on Line 12.
County Code
2.
Married - Spouse Died in 2001 - Enter $12,000 on Line 12.
Your SSN
Married - Filing Separate Returns - Enter $12,000 on Line 12.
3.
Spouse SSN
Spouse's Name_______________________ & SSN______________
Your Occupation
Head of Family - Enter $8000 on Line 12. Provide Name, SSN, and
4.
Spouse's Occupation
Relationship of the Dependent Living in the Home with You on Line 6.
8.
Number of Dependents Listed on Line 6
8.
5.
Single - Enter $6,000 on Line 12.
9.
Number of Boxes Marked "X" on Line 7
9.
Dependents (Do NOT Claim Yourself or Your Spouse)
10.
Total of Line 8 plus Line 9.
10.
6.
$ 1,500
(a) Name
(b) Dependent's SSN
(c) Relationship
11.
=
11.
Line 10 x
12.
12.
Enter Amount from Lines 1-5.
13. Total (Line 11 plus 12).
13.
14. If Married-Filing Separate Returns,
14.
Enter 1/2 of Line 13.
Taxpayer Age
Taxpayer
Spouse Age
Spouse Blind
7. Mark "X" if
65 or Over
Blind
65 or Over
Column A (Taxpayer)
Column B (Spouse)
15.
Wages, salaries, tips, etc. (Attach W-2s. )
15.
16.
16.
Other Income (Amount from Line 45, Page 2 of this Form.)
17.
17.
Adjustments to Gross Income (Amount from Line 54, Page 2 of this Form.)
18.
Mississippi Adjusted Gross Income (Line 15 plus Line 16 minus line 17).
18.
(P)
(B)
19.
19.
Standard or Itemized Deductions (If Itemized, see Schedule A, Form 80-135.)
(F)
(H)
20.
Amount of Exemption (Line 13 or Line 14 if Married Filing Separately.)
20.
Mississippi Taxable Income (Line 18 Less Lines 19 and 20).
21.
21.
See Instructions. If less than 0, enter 0.
22.
Total Income Tax Due (From Schedule of Tax Computation, Page 2 of this form)
22.
23.
Mississippi Income Tax Withheld (Attach W-2s or W-2Gs.)
23.
(W)
24.
2001 Estimated Tax Payments and/or Amount Paid with Extension
24.
(E)
25.
Credit for Income Tax Paid to Another State (Attach Copy of Return filed with other States.)
25.
(S)
26.
Other Credit (From Form 80-135, Page 2, Part 1, Line H.)
26.
(O)
27.
Total Credits (Add Lines 23 through 26.)
27.
28.
If Line 27 is Larger than Line 22, Enter the Amount of Overpayment.
28.
OVERPAYMENT
29.
Amount of Overpayment to be Applied to Your 2002 Estimated Tax Account.
29.
(C)
Voluntary Contribution Check-offs (From Form 80-135, Page 2, Part 2
30.
30.
(L)
(M)
(K)
(Z)
31.
Amount of Overpayment to be Refunded to You (Subtract Lines 29 and 30 from Line 28.)
31.
(R)
REFUND
32.
If Line 22 Is Larger Than Line 27, Enter Balance Due.
32.
BALANCE DUE
33.
Interest on Underpayment of Estimated Tax Payments (Attach Form 80-320.)
33.
(I)
34.
Interest and Penalty (See Instructions)
34.
(T)
TOTAL DUE (Add Lines 32, 33, and 34.) Attach Check or Money Order for Total Due payable to:
TOTAL DUE
35.
35.
(V)
State Tax Commission
>ENCLOSE PAYMENT VOUCHER<
PLEASE SIGN THIS TAX RETURN IN THE SIGNATURE AREA PROVIDED ON THE BOTTOM OF PAGE 2
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