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Form 80-180 - Application For Automatic Extension Of Time To File Individual Or Fiduciary Income Tax Return - 1998 Page 2

1998

Mississippi

Application for Automatic Extension of Time to File

Individual or Fiduciary Income Tax Return

Form 80-181-98-3-1-000 (Rev. 6/98)

1. Separate the form at the perforation below.

2. Send the bottom portion, along with payment in full of any additional tax due, on or before April 15, 1999.

3. Keep a photocopy of Form 80-180 for your records. It is not necessary to attach a copy of the form to your return.

4. Fiduciary Taxpayers: Enter Trust/Estate name in Taxpayer block, Name & Title of Fiduciary in Taxpayer Spouse block.

NOTE: Form 80-180 does not extend the time for payment of taxes.

IMPORTANT: Form 80-180 below must be filed with your payment by April 15, 1999. You must file your Individual

or Fiduciary Income Tax Return by August 15, 1999.

PAY IN FULL

Make check payable to: State Tax Commission

IF NO PAYMENT IS DUE, DO NOT FILE THIS FORM.

USE THE FORM AT BOTTOM OF PAGE IF PAYMENT IS DUE APRIL 15,

1999. ROUND PAYMENT AMOUNT TO WHOLE DOLLARS.

DO NOT ATTACH THIS OR ANY OTHER EXTENSION FORM TO YOUR RETURN

WHEN FILED.

Tear along perforation

Mississippi

Individual & Fiduciary Income

FOUR MONTH EXTENSION REQUEST

The automatic extension is valid until August 15, 1999.

1998

Payment of tax is due April 15, 1999.

Form 80-180-98-3-1-000 (Rev. 6/98)

Tax payer's Social Security Number

Spouse's Social Security Number

Fiduciary FEIN

Mail to:

Return this form with check or

Print Social Security

Total amount of this payment

money order payable to: State

Bureau of Revenue

Number on check.

Tax Commission

Include Spouse's SSN

P. O. Box 23075

if JOINT RETURN

Jackson, MS 39225-3075

Form 80-180 - Application For Automatic Extension Of Time To File Individual Or Fiduciary Income Tax Return - 1998 Page 2