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Form Mo-1nr (Draft) - Income Tax Payments For Nonresident Individual Partners Or S Corporation Shareholders - 2016

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Missouri Department of Revenue

Form

2016 Income Tax Payments for Nonresident

MO-1NR

Individual Partners or S Corporation Shareholders

For calendar year 2016 or fiscal year beginning _________________, 2016 and Ending __________________, _______

Name of Partnership or S Corporation

Missouri Tax ID Number

Address

Federal Employer ID Number

City or Town

State

Zip Code

Type of entity filing this return:

Partnership

S Corporation

Limited Liability Company (Treated as a Partnership)

Select if filing under extension (see instructions)

Number of Statement of Income Tax Payments for Nonresident Individual Partners or

S Corporation Shareholders forms

(Form(s)

MO-2NR) attached ..................................... 1

Total Missouri income tax withheld (total of all Form(s) MO-2NR) .................................... 2

Under penalties of perjury, I declare that the above information and any attached supplement is true, complete, and correct. I

have direct control, supervision, or responsibility for filing this report and payment of the tax due.

Signature

Title

Phone Number

(

)

___ ___ ___

___ ___ ___ ___

E-mail Address

Date (MM/DD/YYYY)

___ ___ / ___ ___ / ___ ___ ___ ___

Attach a copy of each Form MO-2NR issued. Make your check payable to the Missouri Department of Revenue. 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.

Form MO-1NR (Revised 12-2016)

Mail to:

Taxation Division

Phone: (573) 751-3505

P.O. Box 555

TTY: (800) 735-2966

Visit

Jefferson City, MO 65105-0555

Fax: (573) 526-7939

for additional information.

E-mail:

income@dor.mo.gov

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Form Mo-1nr (Draft) - Income Tax Payments For Nonresident Individual Partners Or S Corporation Shareholders - 2016

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