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Form Mo-Nrs - S Corporation Nonresident

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Department Use Only

Missouri Department of Revenue

(MM/DD/YY)

Form

S Corporation Nonresident Form

MO-NRS

Reporting Period

Attachment Sequence No. 1120S-03

(MM/DD/YY)

Complete this form for each nonresident shareholder who has Missouri source income. Each item shown in Parts 1 and 2, Columns (d) and (e) should

be entered on the appropriate lines of

Form MO-NRI

of each nonresident shareholder.

Corporation

Name

*14108010001*

Missouri Tax I.D.

14108010001

Number

Charter

Federal Employer

Number

I.D. Number

Nonresident

Social Security

Shareholder’s Name

Number

(a)

(b)

(c)

(d) Federal

(e)

Federal

Schedule K

Missouri Source

MO-MSS %

Schedule K-1

Missouri Source

1. Ordinary business income (loss) .................

2. Net rental real estate income (loss) ..............

3. Other net rental income (loss)

(Federal Schedule K, Line 3c) ......................

4. Interest income ..............................................

5a. Ordinary dividends......................................

5b. Qualified dividends .....................................

6. Royalties .......................................................

7. Net short-term capital gain (loss)..................

8a. Net long-term capital gain (loss) .................

8b. Collectibles (28%) gain (loss) ....................

8c. Unrecaptured section 1250 gain .................

9. Net section 1231 gain (loss) .........................

10. Other income (loss) ....................................

11. Section 179 deduction ................................

12a. Contributions .............................................

12b. Investment interest expense .....................

12c. Section 59 (e)(2) expenditures .................

12d. Other deductions ......................................

Form Mo-Nrs - S Corporation Nonresident

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