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Mississippi

Schedule A - Itemized Deductions

Schedule B - Interest & Dividends and Schedule N - Other Income

2002

801350251000

Form 80-135-02-5-1-000 Rev. (8/02)

Name

Social Security Number

Page 1

A1a

A2c

A6b

N2a

A1b

A6c

N2b

A1c

A7a

A2a

A7b

A2b

A6a

A7c

For Computer Use Only-Do Not Write Above This Line

SCHEDULE A - Itemized Deductions - (From Federal Form 1040 Schedule A, enter the amount from the line indicated)

If the amount of AGI on Form 1040, is more than $137,300 (more than $68,650 if married filing separately), you CANNOT use this Schedule A. You must use Federal Schedule A and

complete the worksheet provided in the Instructions on Page 13. In the event you filed using the standard deduction on your Federal Return and wish to itemize for Mississippi purposes,

please use Federal Form 1040 Schedule A as a worksheet and transfer the information from the specific lines indicated to this Schedule A.

a. Medical and Dental Expenses (Form 1040 Schedule A)

1a.

b. AGI from Federal Form 1040: $________________________ X 7.5% (.075)

1b.

c. Medical & Dental Expense Deduction (Subtract line 1b from line 1a.)

1c.

a. Total Taxes Paid (Form 1040 Schedule A)

2a.

b. Less State Income Taxes (Federal From 1040 Schedule A)

2b.

c. Total Taxes Paid Deduction (Subtract Line 2b From Line 2a.)

2c.

Total Interest Paid (Form 1040, Schedule A)

Charitable Contributions (Form 1040 Schedule A)

Total Casualty or Theft Loss(es) (Form 1040 Schedule A)

a. Employee Expenses & Misc. Deductions Subject to 2% Limitation (Form 1040 Schedule A)

b. AGI from Federal Form 1040: $__________________________ X 2% (.02)

6b.

c. Subtract line 6b from line 6a.

6c.

a. Miscellaneous Deductions not subject to Federal 2% AGI Limit (Form 1040 Schedule A)

7a.

Schule A)

b. Less Gambling Losses (Federal Form 1040 Schedule A)

7b.

c. Other Miscellaneous Deductions (Subtract Lne 7b from Line 7a.)

7c.

Mississippi Itemized Deductions - (Add Lines 1c, 2c, 3, 4, 5, 6c, and 7c.) Enter here and on Form 80-105, Page 1, Line

19 or Form 80-205, Page 1, Line 16a.

Mississippi Itemized Deductions (Allowance for Limitation due to AGI over $137,300 or $68,650 if married filing

separately) Enter the amount here and on Form 80-105, Page 1, Line 19 or Form 80-205, Page 1, Line 16a.

SCHEDULE B - Interest and Dividend Income (From Federal Form 1040 Schedule B, enter the amount from the line indicated)

If you received capital gain distributions but do not need SCHEDULE D to report any other gains or losses, then enter the gain on Form 80-105, Page 2, Line 40

or Form 80-205, Page 2, Line 39. Total interest and dividend amounts on Lines 4 & 5 below, from jointly owned accounts, may be split between taxpayer and

spouse before the amounts are transferred to Form 80-105, Page 2, Lines 36 and 37, respectively.

Dividends

Interest

Interest Income (Form 1040 Schedule B)

Interest from obligations of the U. S. Government included in Line 1 above.

Interest on obligations of other countries, states, cities, or political subdividisons OUTSIDE Mississippi

Total Interest (Line 1 minus Line 2, plus Line 3). Enter here & on Form 80-105, Page 2, Line 36 or Form

80-205, Page 2, Line 35.

Total Ordinary Dividends. (Form 1040 Schedule B)

Amount of Nontaxable Distributions Reported in Line 5.

Ordinary Dividends for Mississippi. (Line 5 minus Line 6) Enter here and on Resident Form 80-105, Page 2, Line 37 or

Non-Resident Form 80-205, Page 2, Line 36.