Form 94-101-99-1 - Mississippi Estate Tax Return

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Mississippi
Form 94-101-99-1(Rev. 9/99)
Estate Tax Return
This return must be typed.
Round to the nearest whole dollar. The
Instructions
Copies or reproductions of the official form are not acceptable.
executor or administrator must complete the following for the entire
Failure to submit your return on the original form may result in a penalty.
estate. Attach a copy of the Federal Form 706 with all accompanying
This return must be filed within 9 months from the date of death of
schedules, copies of any gift tax returns filed, a copy of the death
Due Date
the decedent when the gross value of the estate exceeds the
certificate and a certified copy of the will if the decedent died testate.
specific exemption, unless an approved extension has been
If decedent died testate, enter an X in the box labeled TESTATE.
granted. Attach a copy of the approved IRS and MS extensions.
Decedent's First Name, Middle, and Maiden
Decedent's Last Name
Domicile City, County and State
Decedent's Social Security Number
Date of Death
Amended
Address Change
Make changes below.
/
/
Testate
First Name
Address
Phone
Executor's Last Name
Co-Executor's Last Name
First Name
Address
Phone
Attorney of Record
Phone
Address
Accountant of Record
Address
Phone
1. Gross Estate per the Federal Form 706...................................................................................
1.
2. Mississippi Estate......................................................................................................................
2.
3. Percentage of Estate in Mississippi (Line 2 divided by Line 1)................................................
3.
%
4. Adjustments to Gross Estate shown on Federal Form 706
Gifts made within 3 years of date of death (Year, Value)
Total Gifts................
4.
5. Total Mississippi Gross Estate..................................................................................................
5.
6.
6. Deductions from Gross Estate..................................................................................................
Residents (Line 2 of Federal Form 706)
Nonresidents (Multiply Line 2 of the Federal Form 706 by Line 3 above)
7.
Exemption (see Instructions on page 2)...................................................................................
7.
Residents (Exemption from page 2)
Nonresidents (Multiply Available Exemption from page 2 by Line 3 above)
8.
8. Adjustments .............................................................................................................................
9.
9. Taxable Estate..........................................................................................................................
10.
Tax Due from the Mississippi Tax Tables........................................
10.
11.
State Death Tax Credit allowable (Line 15 of 706 * Line 3 above)..
11.
12.
12.
Tax Due (Greater of Line 10 or Line 11)....................................................................................
13.
Less Tax Previously Paid.........................................................................................................
13.
14.
14.
Tax Due with this Return .........................................................................................................
15.
15.
Interest 1/2 of 1% per month from due date until paid)..........................................................
(
16.
16.
10 % Penalty if applicable (Multiply Line 14 by 10%)...............................................................
Section 6166
TOTAL DUE..........................................................................................
17.
17.
Installment
I declare, under the penalties of perjury, that this return (including any
Make check payable to
State Tax Commission
accompanying schedules) has been examined by me and to the best of my
Mail return to
Post Office Box 1033
knowledge
and
belief
is
a
true,
correct
and
complete
return.
Jackson, MS 39215
Signature of Executor or Co-Executors
Signature of Preparer
Date
Telephone of Preparer

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