Form 80-135-98-5-1-000 - Schedule A - Itemized Deductions Schedule B - Interest & Dividends And Schedule N - Other Income - 1998 Page 5

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Mississippi

Schedule A - Itemized Deductions

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

1998

Form 80-135-98-5-1-000 Rev. (4/98)

Name

Smith, John P

321-45-6789

Social Security Number

Page 1

6000

1000

200000

1000

8300

700

200000

2300

9300

700

1000

3214567893

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 on Form 1040, Line 32, is more than $124,500 (more than $62,250 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 10. 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 (Line 1, Form 1040 Schedule A).............................................................................

b. Amount from Federal Form 1040, Line 32: $________________________ X 7.5% (.075).................................

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

2,300

Total Taxes Paid (Form 1040 Schedule A, Line 9) ....................................................................................................

6,000

Total Interest Paid (Form 1040, Schedule A, Line 14) ...............................................................................................

1,000

Charitable Contributions (Form 1040 Schedule A, Line 18) .......................................................................................

Total Casualty or Theft Loss(es) (Form 1040 Schedule A, Line 19) ..........................................................................

a. Employee Expenses & Misc. Deductions Subject to 2% Limitation (Form 1040 Schedule A, Line 23)....................

b. Amount from Federal Form 1040, Line 32: $__________________________ X 2% (.02) ...................................

c. Subtract line 6b from line 6a ..................................................................................................................................

Miscellaneous Deductions (including gambling losses ) not subject to Federal 2% AGI Limit (Form 1040 Schedule

A, Line 27)...................................................................................................................................................................

9,300

Total Itemized Deductions (Add Lines 1c, 2, 3, 4, 5, 6c, and 7) ................................................................................

1,000

Total Amount of State Income Tax Included in Line 2 Above (From Form 1040 Schedule A, Line 5)..........................

10.

Mississippi Itemized Deductions -Subtract Ln 9 from Ln 8. Enter the amount here and on Form 80-105, Page 1,

Line 20 or Form 80-205, Page 1, Line 17a..................................................................................................................

8,300

11.

Mississippi Itemized Deductions (Allowance for Limitation due to AGI over $124,500) Enter the amount here

and on Form 80-105, Page 1, Line 20 or Form 80-205, Page 1, Line 17a ................................................................

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

Capital gain distributions received should be reported on Federal SCHEDULE D. Enter the total gains or losses from Schedule D on Form 80-105, Page 2,

Line 43 or Form 80-205, Page, Line 40. 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 39 and 40, respectively.

Dividends

Interest

700

Interest Income (Form 1040 Schedule B, Line 2) .............................................................................

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

700

Total Interest (Line 1 minus Line 2, plus Line 3). Enter here & on Form 80-105, Page 2, Line 39 or Form 80-205, Page 2, Line 36.

Total Ordinary Dividends. (Form 1040 Schedule B, Line 6) Enter here and on Resident Form 80-105, Page 2, Line 40 or

Nonresident Form 80-205, Page 2, Line 37..................................................................................................................

1,000

SCHEDULE N- Other Income or Losses and Supplemental Income

200,000

Gambling winnings. (Attach W-2Gs. List all gambling losses on Schedule A, line 7) ..................................................

2. Other income or (loss). List type

Total other income or (loss)-Combine lines 1 and 2. Enter amount here and on Form 80-105, Page 2, Line 46

or Form 80-205, Page 2, Line 44 ...............................................................................................................................

200,000