Form Mo-1040 - Individual Income Tax Return Long Form - 2015 Page 2

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Yourself

Spouse

24. Taxable income amount from Lines 23Y and 23S .................................................................. 24Y

00 24S

Line 25

25. Tax. (See tax chart on page 25 of the instructions.) ............................................................... 25Y

00 25S

26. Resident credit — Attach Form MO-CR and other states’ income tax return(s). .................. 26Y

Line 26

00 26S

MO-CR

27. Missouri income percentage — Enter 100% unless you are completing Form MO‑NRI.

Attach Form MO-NRI and a copy of your federal return if less than 100%. ..................... 27Y

100

% 27S

Line 27

MO-NRI

100

28. Balance — Subtract Line 26 from Line 25; OR

Multiply Line 25 by percentage on Line 27. ............................................................. 28Y

00 28S

29. Other taxes (Check box and attach federal form indicated.)

Line 29

Lump sum distribution (Form 4972)

Recapture of low income housing credit (Form 8611) ....................................................... 29Y

00 29S

30. Subtotal — Add Lines 28 and 29. ........................................................................................ 30Y

00 30S

31. Total Tax — Add Lines 30Y and 30S. ......................................................................................................................... 31

32. MISSOURI tax withheld — Attach Forms W-2 and 1099. ............................................................................................... 32

Line 32

Line 33

33. 2015 Missouri estimated tax payments (include overpayment from 2014 applied to 2015) ............................................... 33

Line 34

34. Missouri tax payments for nonresident partners or S corporation shareholders — Attach Forms MO-2NR and MO-NRP. ...... 34

Line 35

35. Missouri tax payments for nonresident entertainers — Attach Form MO-2ENT........................................................ 35

Line 36

36. Amount paid with Missouri extension of time to file (Form MO‑60) ............................................................................. 36

Line 37

37. Miscellaneous tax credits (from Form MO‑TC, Line 13) — Attach Form MO-TC. ..................................................... 37

MO-TC

Line 38

38. Property tax credit — Attach Form MO-PTS. ............................................................................................................ 38

MO-PTS

39. Total payments and credits — Add Lines 32 through 38. ........................................................................................... 39

Skip Lines 40–42 if you are not filing an amended return.

40. Amount paid on original return .................................................................................................................................... 40

Line 40

41. Overpayment as shown (or adjusted) on original return ............................................................................................. 41

Line 41

INDICATE REASON FOR AMENDING.

M M D D Y Y

These fields are locked.

A. Federal audit ...................................................................Enter date of IRS report.

To unlock them, Click on

B. Net operating loss carryback .....................................................Enter year of loss.

the "amended" check box

C. Investment tax credit carryback .............................................. Enter year of credit.

on page 1 of this form (top

D. Correction other than A, B, or C ..... Enter date of federal amended return, if filed.

left).

42. Amended Return — total payments and credits. Add Line 40 to Line 39 or subtract Line 41 from Line 39. .............

43. If Line 39, or if amended return, Line 42, is larger than Line 31, enter difference (amount of OVERPAYMENT) here. ...... 43

Line 43

44. Amount of Line 43 to be applied to your 2016 estimated tax ..................................................................................... 44

Line 44

45.

Enter the amount of your

Children’s

Veterans

Elderly Home

Missouri

Workers’

Childhood Lead

Missouri Military

General

Additional

Organ Donor

donation in the trust fund

Trust

Delivered Meals

National Guard

Workers

Testing

Revenue

Fund Code

Memorial

Family Relief

Program

LEAD

Trust Fund

(See Instr.)

Fund

eneral

Fund

boxes to the right. See

Line 45

evenue

______|______

instructions for trust fund

45.

codes

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

45 part2

46. Amount of Line 43 to be deposited into a Missouri 529 College Savings Plan (MOST) account.

Enter amount from Line E of Form 5632....................................................................................................................... 46

MOST

47. REFUND - Subtract Lines 44, 45, and 46 from Line 43 and enter here. Sign below and mail return to:

Line 46

Department of Revenue, PO Box 3222, Jefferson City, MO 65105‑3222

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

a. Routing Number

b. Account Number

Checking

Savings

48. If Line 31 is larger than Line 39 or Line 42, enter the difference (amount of UNDERPAYMENT) here and go to

instructions for Line 49.. .............................................................................................................................................. 48

49. Underpayment of estimated tax penalty — Attach Form MO-2210. Enter penalty amount here.............................. 49

Line 48

50. AMOUNT DUE - Add lines 48 and 49 and enter here. Sign below and mail to:

Line 49

Department of Revenue, PO Box 3370, Jefferson City, MO 65105‑3370. See instructions for Line 50 .................... 50

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.

PREPARER’S TELEPHONE

E‑MAIL ADDRESS

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