Form 81-110-12-8-1-000 - Mississippi Fiduciary Income Tax Return (For Estates And Trusts) - 2012

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Form 81-110-12-8-1-000 (Rev. 5/12)
MS
Mississippi
Fiduciary Income Tax Return
Page 1
811101281000
(For Estates and Trusts)
2012
Tax Year Ending
__ __
__ __
__ __ __ __
Tax Year Beginning
__ __
__ __
__ __ __ __
m
m
d
d
y
y
y
y
m
m
d
d
y
y
y
y
__ __ __ - __ __ - __ __ __ __
Estate / Trust FEIN
__ __ - __ __ __ __ __ __ __
Decedent / Debtor SSN
Name of Estate or Trust
Check All That Apply:
ype of Entity:
1.
2. T
Title of Fiduciary
Initial Return
Simple Trust
Amended Return
Complex Trust
Name of Fiduciary
Final Return
Grantor Trust
Mailing Address
Short Period Return
Bankruptcy Estate
Estate
State
Zip +4
City
__ __ __
3a. Number of MS K-1 Schedules Attached:
__ __ __ __ __ __ __ __
3b. Date of decedent death or date trust established:
__ __
3c. Enter County Code (See Instructions)
m
m
d
d
y
y
y
y
A COMPLETE COPY OF FEDERAL FORM 1041 MUST BE ATTACHED TO THIS RETURN
Round All Amounts to the Nearest Dollar
4. Total Income Tax Due (See Instructions Form 80-100 for Tax Computation Table)
__, __ __ __, __ __ __.
00
5. Other Credits (See Instructions Form 80-100) Must Attach Form 80-401
__, __ __ __, __ __ __.
00
6. Net Income Tax Due (Line 4 minus Line 5)
__, __ __ __, __ __ __.
00
__, __ __ __, __ __ __.
00
7. Overpayments From Prior Year, Estimated Tax Payments, & Amount Paid With Extension.
8. Enter Amount of Overpayment (If Line 7 is Larger than Line 6)
__, __ __ __, __ __ __.
00
9. Overpayment (Line 8) to be Applied to next year Estimate Tax Account
__, __ __ __, __ __ __.
00
10. Overpayment (Line 8 minus 9) to be REFUNDED
__, __ __ __, __ __ __.
00
11. Balance Due (Line 6 minus Line7)
__, __ __ __, __ __ __.
00
12. Interest and Penalty (See Instructions)
__, __ __ __, __ __ __.
00
__, __ __ __, __ __ __.
00
13.
Total Due (Line 11 plus Line 12
)
Yes
No
This Return may be discussed with the preparer.
I declare, under penalties of perjury, that I have examined this return and accompanying schedules and statements, and to the best of my knowledge and belief,
this is a true, correct and complete return. Declaration of preparer (other than taxpayer) is based on all information of which preparer has any knowledge.
__ __ __ __ __ __ __ __ __
Date
Phone Number
Signature of Fiduciary or Officer Representing Fiduciary
Paid Preparer PTIN
FEIN of Fiduciary
Paid Preparer Phone Number
Paid Preparer Signature
Date
State
Paid Preparer Address
City
Zip Code
Mail REFUND To: Department of Revenue, P.O. Box 23058, Jackson, MS 39225-3058
Mail All Other Returns To: Department of Revenue, P.O. Box 23050, Jackson, MS 39225-3050
Duplex and Photocopies are NOT Acceptable

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