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DRAFT * DRAFT * DRAFT * DRAFT * DRAFT * DRAFT

Yourself

Spouse

26. Taxable income amount from Lines 25Y and 25S .................................................................. 26Y

00 26S

27. Tax. (See tax chart on page 25 of the instructions.) ............................................................... 27Y

00 27S

28. Resident credit — Attach Form MO-CR and other states’ income tax return(s). .................. 28Y

00 28S

29. Missouri income percentage — Enter 100% unless you are completing Form MO‑NRI.

Attach Form MO-NRI and a copy of your federal return if less than 100%. ..................... 29Y

% 29S

30. Balance — Subtract Line 28 from Line 27; OR

Multiply Line 27 by percentage on Line 29. ............................................................. 30Y

00 30S

31. Other taxes (Check box and attach federal form indicated.)

Lump sum distribution (Form 4972)

Recapture of low income housing credit (Form 8611) ....................................................... 31Y

00 31S

32. Subtotal — Add Lines 30 and 31

........................................................................................ 32Y

00 32S

33. Total Tax — Add Lines 32Y and 32S. ......................................................................................................................... 33

34. MISSOURI tax withheld — Attach Forms W-2 and 1099. ............................................................................................... 34

35. 2016 Missouri estimated tax payments (include overpayment from 2015 applied to 2016) ............................................... 35

36. Missouri tax payments for nonresident partners or S corporation shareholders — Attach Forms MO-2NR and MO-NRP. ...... 36

37. Missouri tax payments for nonresident entertainers — Attach Form MO-2ENT........................................................ 37

38. Amount paid with Missouri extension of time to file (Form MO‑60) ............................................................................. 38

39. Miscellaneous tax credits (from Form MO‑TC, Line 13) — Attach Form MO-TC. ..................................................... 39

40. Property tax credit — Attach Form MO-PTS. ............................................................................................................ 40

41. Total payments and credits — Add Lines 34 through 40 ............................................................................................ 41

Skip Lines 42–44 if you are not filing an amended return.

42. Amount paid on original return .................................................................................................................................... 42

43. Overpayment as shown (or adjusted) on original return ............................................................................................. 43

INDICATE REASON FOR AMENDING.

M M D D Y Y

A. Federal audit ...................................................................Enter date of IRS report.

B. Net operating loss carryback .....................................................Enter year of loss.

C. Investment tax credit carryback .............................................. Enter year of credit.

D. Correction other than A, B, or C ..... Enter date of federal amended return, if filed.

44. Amended Return — total payments and credits. Add Line 42 to Line 41 or subtract Line 43 from Line 41. .............

45. If Line 41, or if amended return, Line 44, is larger than Line 33, enter difference (amount of OVERPAYMENT) here. ...... 45

46. Amount of Line 45 to be applied to your 2017 estimated tax ..................................................................................... 46

47.

Enter the amount of your

Elderly Home

Missouri

Additional

Children’s

Veterans

Workers’

Childhood Lead

Missouri Military

General

Organ Donor

donation in the trust fund

Delivered Meals

National Guard

Fund Code

Trust

Workers

Testing

Revenue

Program

Memorial

Family Relief

LEAD

Trust Fund

(See Instr.)

Fund

eneral

Fund

boxes to the right. See

evenue

______|______

instructions for trust fund

codes

....................................

48. Amount of Line 45 to be deposited into a Missouri 529 College Savings Plan (MOST) account.

Enter amount from Line E of Form 5632....................................................................................................................... 48

49. REFUND - Subtract Lines 46, 47, and 48 from Line 45 and enter here. Sign below and mail return to:

Department of Revenue, PO Box 3222, Jefferson City, MO 65105‑3222

If you would like your refund deposited directly to your checking or savings account, complete boxes a, b, and c below.

a. Routing Number

b. Account Number

Checking

Savings

50. If Line 33 is larger than Line 41 or Line 44, enter the difference (amount of UNDERPAYMENT) here and go to

instructions for Line 51.. .............................................................................................................................................. 50

51. Underpayment of estimated tax penalty — Attach Form MO-2210. Enter penalty amount here.............................. 51

52. AMOUNT DUE - Add lines 50 and 51 and enter here. Sign below and mail to:

Department of Revenue, PO Box 3370, Jefferson City, MO 65105‑3370. See instructions for Line 52 .................... 52

If you pay by check, you authorize the Department of Revenue to process the check electronically.

Any check returned unpaid may be presented again electronically.

Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief it is true, correct, and complete. Declaration of

preparer (other than taxpayer) is based on all information of which he or she has any knowledge. As provided in Chapter 143, RSMo, a penalty of up to $500 shall be imposed on any individual who files a frivolous

return. I also declare under penalties of perjury that I employ no illegal or unauthorized aliens as defined under federal law and that I am not eligible for any tax exemption, credit or abatement if I employ such aliens.

PREPARER’S TELEPHONE

E‑MAIL ADDRESS

I authorize the Director of Revenue or delegate to discuss my return and attachments

with the preparer or any member of the preparer’s firm.

YES

(

)

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SIGNATURE

DATE (MMDDYYYY)

PREPARER’S SIGNATURE