Form Mo 860-2111 - Instructions To Annuitant - Missouri Department Of Revenue
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1INSTRUCTIONS TO ANNUITANT
•
You may have state taxes withheld for only ONE state at a time. To change from one state to another, you MUST first cancel your old
request with that state and then request the new state to begin withholding.
•
You DO NOT have to participate in this program. If you DO NOT wish to participate, DO NOT COMPLETE THIS FORM.
•
If you DO wish to participate, complete the form in its entirety. Incomplete forms will delay the processing of your request. Unsigned
forms will be returned to you.
•
A Civil Service Claim Number must be obtained before submitting this form.
•
State income tax will only be withheld from regular, recurring, monthly annuity payments.
•
Your withholding request MUST be in whole dollar amounts and not less than ten dollars ($10.00).
•
You may change the amount withheld or cancel this withholding at any time by completing a new MO-W4CS form and sending it to the
address below.
•
At the end of the year, you will receive a 1099-R statement indicating the total amount withheld. This 1099-R statement must be used
when filing your Missouri state income tax return.
Mail this completed form and all inquiries to:
MISSOURI DEPARTMENT OF REVENUE
TAX ADMINISTRATION BUREAU
OR CALL
P.O. BOX 3333
(573) 751-5752
TDD (800) 735-2966
JEFFERSON CITY, MISSOURI 65105-3333
This publication is available upon request in alternative accessible format(s).
MO 860-2111 (11-96)
INSTRUCTIONS TO ANNUITANT
•
You may have state taxes withheld for only ONE state at a time. To change from one state to another, you MUST first cancel your old
request with that state and then request the new state to begin withholding.
•
You DO NOT have to participate in this program. If you DO NOT wish to participate, DO NOT COMPLETE THIS FORM.
•
If you DO wish to participate, complete the form in its entirety. Incomplete forms will delay the processing of your request. Unsigned
forms will be returned to you.
•
A Civil Service Claim Number must be obtained before submitting this form.
•
State income tax will only be withheld from regular, recurring, monthly annuity payments.
•
Your withholding request MUST be in whole dollar amounts and not less than ten dollars ($10.00).
•
You may change the amount withheld or cancel this withholding at any time by completing a new MO-W4CS form and sending it to the
address below.
•
At the end of the year, you will receive a 1099-R statement indicating the total amount withheld. This 1099-R statement must be used
when filing your Missouri state income tax return.
Mail this completed form and all inquiries to:
MISSOURI DEPARTMENT OF REVENUE
TAX ADMINISTRATION BUREAU
OR CALL
P.O. BOX 3333
(573) 751-5752
TDD (800) 735-2966
JEFFERSON CITY, MISSOURI 65105-3333
This publication is available upon request in alternative accessible format(s).
MO 860-2111 (11-96)
INSTRUCTIONS TO ANNUITANT
•
You may have state taxes withheld for only ONE state at a time. To change from one state to another, you MUST first cancel your old
request with that state and then request the new state to begin withholding.
•
You DO NOT have to participate in this program. If you DO NOT wish to participate, DO NOT COMPLETE THIS FORM.
•
If you DO wish to participate, complete the form in its entirety. Incomplete forms will delay the processing of your request. Unsigned
forms will be returned to you.
•
A Civil Service Claim Number must be obtained before submitting this form.
•
State income tax will only be withheld from regular, recurring, monthly annuity payments.
•
Your withholding request MUST be in whole dollar amounts and not less than ten dollars ($10.00).
•
You may change the amount withheld or cancel this withholding at any time by completing a new MO-W4CS form and sending it to the
address below.
•
At the end of the year, you will receive a 1099-R statement indicating the total amount withheld. This 1099-R statement must be used
when filing your Missouri state income tax return.
Mail this completed form and all inquiries to:
MISSOURI DEPARTMENT OF REVENUE
TAX ADMINISTRATION BUREAU
OR CALL
P.O. BOX 3333
(573) 751-5752
TDD (800) 735-2966
JEFFERSON CITY, MISSOURI 65105-3333
This publication is available upon request in alternative accessible format(s).
MO 860-2111 (11-96)
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