Form 80-106-12-8-1-000 - Mississippi Individual / Fiduciary Income Tax Payment Voucher

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Form 80-106-12-8-1-000 (Rev. 05/12)
Mississippi
Individual / Fiduciary Income Tax Voucher
Instructions
Who Must File
Estimates
Every individual taxpayer who does not have at least eighty percent (80%) of his/her annual tax liability prepaid through withholding
must make estimated tax payments if his/her annual tax liability exceeds two hundred dollars ($200). For more information about the
payment and calculation of estimated income tax payments, please see the Individual Income Tax Return Instructions, Form 80-100.
Return Payments
This voucher may be used to make return payments for tax due on the Individual Income Tax Return (Form 80-105), Non-Resident
Income Tax Return (Form 80-205), EZ Individual Income Tax Return (Form 80-110) and the Fiduciary Income Tax Return (Form
81-110).
Extension Payments
This voucher may be used to make extension payments for tax due on the Individual Income Tax Return (Form 80-105), Non-Resident
Income Tax Return (Form 80-205), EZ Individual Income Tax Return (Form 80-110) and the Fiduciary Income Tax Return (Form
81-110). This should be filed and paid on or before April 15th.
Payment Options
•
Pay this amount online. Go to , click on Taxpayer Access Point (TAP) and follow the instructions for paying
online. You may also view and update account information through TAP.
• Make your check or money order payable to the Department of Revenue, remove the payment coupon below and mail both the
check/money order and coupon to P.O. Box 23075, Jackson, MS 39225-3075.
- Check the appropriate box on the voucher for the payment type you are remitting.
- Write the identification number on the check or money order.
- Duplex Forms or Photocopies are NOT acceptable.
• Pay by credit card or electronic check. Call 1-800-272-9829, or go to
- There is a 2 ½ % fee for credit cards, or a $3.00 fee for E-checks charged by Official Payments.
- Visa, MasterCard, Discover and American Express cards are accepted.
- Jurisdiction code for Mississippi is 3400.
Cut Along the Dotted Line
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Form 80-106-12-8-1-000 (Rev. 05/12)
MS
Mississippi
Individual / Fiduciary Income Tax
Payment Voucher
801061281000
IIT
Taxpayer
__ __ __ - __ __ - __ __ __ __
__ __ __ __
Tax Year
SSN/ITIN
__ __ __ - __ __ - __ __ __ __
Spouse
__ __ - __ __ __ __ __ __ __
Fiduciary
SSN/ITIN
FEIN
Taxpayer Last Name
First Name
Middle Initial
Name of Estate / Trust if Fiduciary Payment
Spouse Last Name
First Name
Middle Initial
Payment Type
Account Type
Check One
Check One
Address
Quarterly Estimate Payment
Individual Income
Return Payment
City
State
Zip +4
Extension Payment
Fiduciary Income
•
Duplex or Photocopies NOT Acceptable
Mail To: Department of Revenue
•
Print SSN or FEIN on Check
•
Return this form with check or money
P.O. Box 23075
Amount Paid
__ __ __ , __ __ __ , __ __ __
order payable to Department of Revenue
Jackson, MS 39225-3075
or see instructions for electronic payment options.
Duplex and Photocopies NOT Acceptable

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