Form 90-145-10-8-1-000 - Mississippi Prepaid Wireless E911 Charge

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Mississippi
Prepaid Wireless E911 Charge
General Instructions
You must use the same filing period that you use for filing
your sales tax returns.
This return is for reporting the Prepaid Wireless E911 Charge
only.
Filling in the return
Please use black ink when preparing this return. Print your
Line by line instructions
numbers like this:
Line 1. Enter number of Prepaid Wireless Transactions
0 1
2 3
4 5
6
8 9
7
Line 2. The fee is $1.00 per transaction.
Sending in the return
Line 3. Multiply the number of transactions sold on Line 1 by
the $1.00 fee on Line 2 and enter the result.
Include this return and your check or money order for the
amount on Line 7 and mail to Department of Revenue, P O
Line 4. Multiply the amount of fees on line 3 by 2%.
Box 23075, Jackson, MS 39225
Line 5. Subtract Line 4 from Line 3 and enter the result.
Account Number
Line 6. Enter the applicable penalty if this return is filed late.
The minimum penalty is 10%.
Enter your sales tax account number.
Line 7. Enter the net totals of lines 5, and 6. This is the
Filing Period
amount you should pay.
Enter the month(s) and year this return covers in the boxes
using numbers to indicate the month and year. For example,
July, 2001 would be entered as:
0
7
0
1
Fold & Tear on Perforation Below
Mississippi
DIRECT 414
Form 90-145-10-8-1-000 (Rev. 6/10)
Prepaid Wireless E911 Charge
INSTRUCTIONS: See reverse. This form must be filed even if no fee is
due. Copies or reproductions of the official form are not acceptable.
Fee Calculation
901451081000
Number of Prepaid
1.
Wireless Transactions
Monthly
Name
$1.00
Month
Year
2. Fee .......................................................................................
,
.
m
m
y
y
00
Address
3. Fees Due
,
.
00
OR
4. Discount of 2%
,
.
ZIP
City
State
Quarterly OR Annual
00
5. Balance of Tax Due
,
.
First Month
Last Month
Year
Sales Tax Account Number
00
m m
m m
y
y
6. Late Filing Penalty (See
to
.
,
Instructions)
-
-
00
7. Total Due
Amended
Additional
Final Return -
Address Change
Change of Status
Return
Tax
Close Account
Make changes above
I declare, under the penalties of perjury, that this return (including any
accompanying schedules) has been examined by me and to the best of
my knowledge and belief is a true, correct and complete return.
Signature of Taxpayer or Agent
Signature of Taxpayer or Agent
Phone
Phone
Date
Date
Fold & Tear on Perforation Below

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