Form Mo-99 Misc. - Information Return For Receipts Of Miscellaneous Income

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MISSOURI DEPARTMENT OF REVENUE
FORM
TAXATION DIVISION
20
MO-99 MISC.
P O BOX 2200, JEFFERSON CITY, MO 65105-2200
INFORMATION RETURN FOR RECEIPTS OF MISCELLANEOUS INCOME
(REV. 11-2010)
3. COMMISSIONS AND FEES
4. PRIZES AND AWARDS TO
5. OTHER FIXED OR
1. RENTS
2. ROYALTIES
TO NONEMPLOYEES (NO
NONEMPLOYEES (NO
DETERMINABLE INCOME
FORM W-2 ITEMS)
FORM W-2 ITEMS)
(SPECIFY)
Recipient’s tax identifying number
PAID TO Name, address, and ZIP code. If account is for multiple payees with different
surname or it includes the name of a fiduciary, trust, or estate, place an asterisk (*) by the
name of the individual or entity to whom the identifying number belongs.
PAID BY Name, address ZIP code, and identifying number.
This publication is available upon request in alternative accessible format(s).
MO 860-1105 (11-2010)

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