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FORM MO-1040P

14. Total Missouri taxable income amount from Line 13. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yourself

Spouse

15. Multiply Line 14 by the percentages you determined on Line 5.

15Y

15S

Do this for you and your spouse. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

16. Use the tax chart on page 18 or 22 of the instructions to figure the

16Y

16S

tax on amounts from Line 15 for you and your spouse.. . . . . . . . . . . . . . . . . . . . . . . . . . . . .

17. TOTAL TAXES — Add your tax and your spouse’s tax from Line 16. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

18. Missouri withholding for you and your spouse from your Forms W-2 and 1099.

Attach copies of Forms W-2 and 1099. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

19. Any Missouri estimated tax payments for 2016 (Be sure to include

any amount of your 2015 overpayment credited to your 2016 Missouri tax return.) . . . . . . . . . . . . . . . . . . .

20. PROPERTY TAX CREDIT — Enter amount from Form MO-PTS,

Attach

Line 14. Attach Form MO-PTS.. . . . . . . . . . . . . . . . . . . . . . . . . . . .

Form MO-PTS.

21. TOTAL PAYMENTS AND CREDITS

Add Lines 18, 19, and 20 and enter amount here. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

22. If amount of TOTAL PAYMENTS AND CREDITS (Line 21) is larger than amount of

TOTAL TAXES (Line 17), enter the difference here. You have overpaid.

If not, enter the amount on Line 27. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

23. Enter the amount from Line 22 you want applied to your 2017 estimated tax.. . . . . . . . . . . . . . . . . . . . . . .

24. Enter the amount of your

Elderly Home

Missouri

Additional

Children’s

Veterans

Workers’

Childhood Lead

Missouri Military

General

Organ Donor

donation in the trust fund

Trust

Delivered Meals

National Guard

Workers

Testing

Fund Code

Memorial

Family Relief

Revenue

Program

LEAD

boxes to the right. See

Trust Fund

Fund

(See Instr.)

Fund

eneral

instructions for trust

______|______

evenue

fund codes. . . . . . . . 24

25. Amount from Line 22 to be deposited into a Missouri 529 College Savings Plan (MOST) account.

Enter amount from Line E of Form 5632. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

26. REFUND - Subtract Lines 23, 24, and 25 from Line 22 and enter here. This is your refund. Sign below

and mail to: Department of Revenue, P.O. Box 3385, Jefferson City, MO 65105-3385. . . . . . . . . . . . . .

If you would like your refund deposited directly to your checking or savings account, complete boxes a, b, and c below.

Checking

a. Routing Number

b. Account Number

Savings

27. AMOUNT DUE - If Line 21 is less than Line 17, enter the difference here. You have an amount due.

Sign below and mail to: Department of Revenue, P.O. Box 3395, Jefferson City, MO 65105-3395.

See instructions for Line 27. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

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.

Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief it is true,

correct, and complete. Declaration of preparer (other than taxpayer) is based on all information of which he or she has any knowledge. As provided in Chapter 143, RSMo, a

penalty of up to $500 shall be imposed on any individual who files a frivolous return. I also declare under penalties of perjury that I employ no illegal or unauthorized aliens as

defined under federal law and that I am not eligible for any tax exemption, credit or abatement if I employ such aliens.

E-MAIL ADDRESS

PREPARER’S PHONE NUMBER

I authorize the Director of Revenue or delegate to discuss my return and

attachments with the preparer or any member of the preparer’s firm.

(__ __ __)__ __ __-__ __ __ __

YES

SIGNATURE

DATE (MMDDYYYY)

PREPARER’S SIGNATURE

FEIN, SSN, OR PTIN

__ __/__ __/__ __ __ __