Form Mo-Wtif - Tax Increment Financing Net New Job Salary Report
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MISSOURI DEPARTMENT OF REVENUE
TAXATION DIVISION
Questions? Contact us at:
FORM
PO BOX 3375
(573) 751-8741
JEFFERSON CITY, MO 65105-3375
MO-WTIF
FAX (573) 522-6816
TAX INCREMENT FINANCING
withholding@dor.mo.gov
(REV 01-2009)
NET NEW JOB SALARY REPORT
1. Business Name
2. Owner’s Name
3. TIF/MODESA MO Tax I.D. Number (MITS #)
___ ___ ___ ___ ___ ___ ___ ___
4. Reporting Location Street Address
5. Federal Employer I.D. Number (FEIN)
___ ___ ___ ___ ___ ___ ___ ___ ___
6. City, State, and Zip Code
7. TIF/MODESA Name (Assigned by Missouri Dept. of Economic Development)
8. Tax Period (Example: July 2008 is 2008/07)
Did you electronically file your MO-941 return for this tax period? Yes
No
9.
NET NEW JOB SALARY INFORMATION
Department of Revenue Use Only
Annual Gross
Number of Net Full-Time
Average Gross
Salary Range
Equivalent Employees (FTE’s)
Annual Salary
Income Tax Percentage
Increment Payment
Less than $5,000
$
% $
$5,000 - $9,999
$
% $
$10,000 – $14,999
$
% $
$15,000 - $19,999
$
% $
$20,000 - $24,999
$
% $
$25,000 - $29,999
$
% $
$30,000 - $34,999
$
% $
$35,000 - $39,999
$
% $
$40,000 - $44,999
$
% $
$45,000 - $49,999
$
% $
$50,000 - $54,999
$
% $
$55,000 - $59,999
$
% $
$60,000 - $64,999
$
% $
$65,000 - $69,999
$
% $
$70,000 - $74,999
$
% $
$75,000 - $99,999
$
% $
$100,000 - $199,999
$
% $
$200,000 - $499,999
$
% $
$500,000 -$1,000,000
$
% $
Greater than $1,000,000
$
% $
TOTAL
$
Your completed Form MO-941 must accompany this form unless electronically filed.
Under penalties of perjury, I declare that the information contained on this form and any attachments is true, accurate, and complete.
Signature
Printed Name
Phone Number
Date
(__ __ __) __ __ __ - __ __ __ __ __ __ /__ __ /__ __ __ __
Instructions on other page
MO-WTIF (01-2009)
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