Form 80-105-98-5 - Resident Individual Income Tax Return - 1998 Page 5
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12Mississippi
MS
Resident Individual Income Tax Return
For Official Use Only
IS B
199
1998
25 1 5
801059851000
Page 1 of 2
Form 80-105-98-5-1-000 (Rev.7/98)
N
25
7500
103000
28000
0
0
Y
1
9500
30000
2500
0
3725
Y
2
17000
8500
8500
0
0
N
3
0
64500
17000
3725
0
Y
0
106000
28000
3775
0
0
5
-3000
0
7500
0
0
0
0
0
0
3214567893
1324657982
Doe
John P
Jean P
1998
123 Redbud Lane
Jackson
MS
39212-1230
For Computer Use Only - Do Not Write Above This Line
X
Check Box If Address Changed From Last Year
1.
Married - Combined or Joint Return - Enter $10,000 on Line 13.
321-45-6789
2.
Married - Spouse Died in 1998 - Enter $10,000 on Line 13.
Your SSN
Married - Filing Separate Returns - Enter $10,000 on Line 13.
132-46-5798
3.
Spouse SSN
Head of Family - Enter $9,500 on Line 13.
Provide Name, SSN, and
Doctor
4.
Your Occupation
Relationship of the Dependent Living in the Home with You on Line 6.
Nurse
Spouse's Occupation
2
5.
Single - Enter $6,000 on Line 13.
8.
Number of Dependents Listed on Line 6...............
3
9.
Number of Boxes Marked "X" on Line 7................
Dependents (Do NOT Claim Yourself or Your Spouse)
10.
If You Checked Line 4, Enter a "1" Here...............
6.
5
(a) Name
(b) Dependent's SSN
(c) Relationship
11.
Total of Line 8 plus Line 9 minus Line 10..............
Jon Doe
123-45-6987
Son
$ 1,500
7,500
=
Line 11 x
...........................
12.
Jan Doe
123-65-4789
Dau
9,500
13.
Enter Amount from Lines 1 through 5..
17,000
14. Total (Line 12 plus 13)..............
15. If Married-Filing Separate Returns,
Taxpayer Age
Taxpayer
Spouse Age
Spouse Blind
Enter 1/2 of Line 14.........................
X
X
X
7.
Mark "X" if
65 or Over
Blind
65 or Over
Column A (Taxpayer)
Column B (Spouse)
106,000
28,000
16.
Wages, salaries, tips, etc. (Attach W-2s ).............................................................
-3,000
17.
Other Income (Amount from Line 48, Page 2 of this Form) ...............................
18.
Adjustments to Gross Income (Amount from Line 56, Page 2)..........................
19.
Mississippi Adjusted Gross Income (Line 16 plus Line 17 minus line 18).
103,000
28,000
(P)
(B)
If Less Than 0, Enter 0.........................................................................................
30,000
2,500
(F)
(H)
20.
Standard or Itemized Deductions (If Itemized, see Form 80-135 Schedule A)... .....
8,500
8,500
21.
Amount of Exemption (Line 14 or Line 15 if Married Filing Separately).......
22.
Mississippi Taxable Income (Line 19 Less Lines 20 and 21).
64,500
17,000
See Instructions. If less than 0, enter 0............................................................
3,775
23.
Total Income Tax Due (From Page 9 of Instructions, Schedule of Tax Computation, Line 5)........................................................
7,500
(W)
24.
Mississippi Income Tax Withheld (Attach W-2s or W-2Gs)....................................................................................................
(E)
25.
1998 Estimated Tax Payments and/or Amount Paid with Extension.....................................................................................
(S)
26.
Credit for Income Tax Paid to Another State (Attach Copy of Other State Return).............................................................
(O)
27.
Other Credit (See Instructions for Line 27)................................................................................................................................
28.
Total Credits (Add Lines 24 through 27)..................................................................................................................................................
3,725
OVERPAYMENT
29.
If Line 28 is Larger than Line 23, Enter the Amount of Overpayment.................................................................
(C)
30.
Amount of Overpayment to be Applied to Your 1999 Estimated Tax Account....................................................................
(L)
31.
Mississippi Wildlife Heritage Fund....................................
{
I Wish to Contribute
32.
(M)
( )$1, ( )$5, ( )$10, or ( ) Other $ ______
Mississippi Educational Trust Fund...................................
of my Overpayment on Line 29 to:
(K)
Mississippi Commission for Volunteer Service Fund.......
33.
3,725
(R)
34.
Amount of Overpayment to be Refunded to You (Subtract Lines 30, 31, 32, and 33 from Line 29).............................
REFUND
35.
If Line 23 Is Larger Than Line 28, Enter Balance Due.........................................................................................
BALANCE DUE
(I)
36.
Interest on Underpayment of Estimated Tax Payments (Attach Form 80-320)....................................................................
(T)
37.
Interest and Penalty (See Instructions)......................................................................................................................................
TOTAL DUE (Add Lines 35, 36, and 37). Attach Check or Money Order for Total Due payable to:
(V)
TOTAL DUE
State Tax Commission ...............................>ENCLOSE PAYMENT VOUCHER<........................................
38.
PLEASE SIGN THIS TAX RETURN IN THE SIGNATURE AREA PROVIDED ON THE BOTTOM OF PAGE 2
PLEASE SIGN THIS TAX RETURN IN THE SIGNATURE AREA PROVIDED ON THE BOTTOM OF PAGE 2
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