Mississippi Amended Individual Income Tax Return (Page 2 of 2) in pdf

Mississippi

Amended Individual Income Tax Return

801700252000

Form 80-170-02-5-2-000 (Rev. 07/02)

Page 2

DS1

8aLine

8eLine

8d-A

8c-C

DS2

8bLine

8a-A

8e-A

8d-C

DS3

8cLine

8b-A

8a-C

8e-C

DS4

8dLine

8c-A

8b-C

For Computer Use Only - Do Not Write Above This Line

Filing Status and Exemption Amounts

Complete Number 7 only if the number of dependents claimed increased or

decreased. If you are claiming an additional dependent place an "X" in column "A"

AMENDED -

If your filing status or number of

and complete the row. If removing a dependent, place an "R" in column "A" and

Mark as Shown on

Complete only if

exemptions changed, complete

complete the row.

Original Return

different than

the amended column.

original.

Dependents (Do NOT Claim Yourself or Your Spouse)

(B) Name

(D) Dependent's SSN

Mark "X" in only one.

Married - Filing Combined or Joint Retun

Married - Spouse Died in Tax Year

Married - Filing Separate

Head of Family

If there is a change in your amount of exemption, an entry must be made on line 8

Single

indicating the original amount reported, net change, and corrected amount. The line

Mark "X" ONLY if:

entry code is 20.

6a.

Taxpayer Age 65+

6b.

Spouse Age 65+

6c.

Taxpayer Blind

6d.

Spouse Blind

Changes to Taxable Income, Exemptions, or Deductions

Enter each amended item on a separate line. First enter the effected line number from MS Form 80-105. Second enter the amount as reported on

the original line (Form 80-105) or as last adjusted. Third enter the NET CHANGE in Column B. Fourth, enter the CORRECT (Column A + B) amount

in Column C. For each line item changed, provide a description below. Attach additional. explanation if needed.

The following is an abridged list of Form 80-105 line references: wages, salaries, tips = 15; exemption = 20; standard or itemized deduction = 19;

withholding = 23; estimated tax payments = 24; credit for income taxes paid to another state = 25; other credits = 26; interest income = 36; alimony

received = 38; business income/loss (federal schedule C) = 39; capital gains = 40; pensions/retirement income = 41; farm income = 42; other

income = 44; payments to a regular IRA or SEP = 46; payments to a Keogh plan = 47; alimony paid =49; moving expense = 50; MPACT or MACS

payments = 52; Self-employed health insurance deduction =53.

A. As Originally Reported or

B. Net Change - Increase/Decrease

Form 80-105 Line

C. Correct Amount

)

(Indicate decrease by using brackets

Reference

Adjusted

8a.

Description:

8b.

Description:

8c.

Description:

8d.

Description:

8e.

Description:

Net Change to Mississipi Taxable Income (Enter the Total of Column B).

PRORATION: Nonresidents and Part-Year Residents Only

The Exemption and Deduction (Standard or Itemized) Must be Prorated According to the Ratio of Mississippi Income to Total Income of Taxpayer and

Spouse from all Sources. This part must be completed any time there is a change in the exemption or deduction claimed, or there is a change in gross income.

10.

11.

12.

Ratio Computation:

Deduction Computation:

Exemption Computation:

a. MS AGI

a. Itemized Deductions or

a. Total Exemption

Standard Deduction

b. Total AGI

b. MS Exemption 12a

MS Deduction 11a

c. Ratio Line 10a / 10b

multiplied by 10c.

Enter the amount of line 11b on line 8 column C. Enter the amount reported on the original return (Form 80-205 line 16b) on line 8 column A. Enter the

amount of line 12b on line 8 column C. Enter the original MS exemption reported on the original return (Form 80-205 line 17b) on line 8 column A.