Form 80-205-12-8-1-000 Non-Resident / Part-Year Resident Individual Income Tax Return 2012 printable pdf download

Mississippi

Form 80-205-12-8-1-000 (Rev. 05/12)

Non-Resident / Part-Year Resident

Page 1

Individual Income Tax Return

2012

Amended

802051281000

Non-Resident

Part-Year

From

__ __ __ __

Taxpayer Last Name

Middle Initial

First Name

YOU MUST ENTER SSN

Spouse First Name

Middle Initial

Spouse Last Name

__ __ __ - __ __ - __ __ __ __

SSN

Mailing Address (Number & Street, Including Rural Route)

__ __ __ - __ __ - __ __ __ __

Spouse SSN

State

Zip

City

__ __

Residence County Code - See Instructions

Married - Combined or Joint Return

Mark "X" ONLY if:

(Enter $12,000 on Line 12.)

Married - Spouse Died in Tax Year - Enter surviving spouse first as taxpayer

Taxpayer Blind

Taxpayer Age 65 or Over

(Enter $12,000 on Line 12. Enter Spouse Name and SSN in boxes provided above.

Spouse Age 65 or Over

Spouse Blind

Married - Filing Separate Returns

(Enter $12,000 on Line 12. Enter Spouse Name and SSN in

boxes provided above. Cannot change from Joint to Separate after due date.)

8. Number of Boxes Marked "X" on Line 7.

Head of Family

(Enter $8,000 on Line 12. Provide Name, SSN, and Relationship of the Dependent

__ __

9. Number of Dependents Listed on Line 6.

Living in the Home with You on Line 6.)

(List additional dependents on Form 80-491)

Single -

(Enter $6,000 on Line 12)

__ __

10. Total of Line 8 plus Line 9.

Dependents (In column (B ) Must enter C for child, P for parent, or R for relative)

__ __, __ __ __.

(B)

$1,500

(A) Name

11. Line 10 x

___

__ __ __ - __ __ - __ __ __ __

12. Enter Amount from

__ __, __ __ __.

Lines 1 through 5.

__ __ __ - __ __ - __ __ __ __

___

__ __, __ __ __.

13. Total (Line 11 plus 12).

14. If Filing MFS Returns,

__ __ __ - __ __ - __ __ __ __

__ __, __ __ __.

___

Enter 1/2 of Line 13.

COMPLETE SCHEDULE OF INCOME ON PAGE 2 BEFORE PROCEEDING FURTHER. (See Instructions)

15a. MS Adjusted Gross Income

17a. Exemption, Line 13 above or Line 14 if MFS

16a. Standard or Itemized Deduction

__, __ __ __, __ __ __.

b. MS Exemption 17a Times 15c

b. Total Adjusted Gross Income From All Sources

b. MS Deduction, 16a Times 15c

__, __ __ __, __ __ __.

c. Line 15a Divided by 15b

__ __ __ . __ __

Column A (Taxpayer)

Column B (Spouse)

Round to Nearest Dollar

18. Mississippi Adjusted Gross Income

(From Line

__, __ __ __, __ __ __.

61 or 62, Page 2)

__, __ __ __, __ __ __.

19. Standard or Itemized Deductions

__, __ __ __, __ __ __.

Enter Amount From

16b (If Itemized,Must Attach Schedule A, Form 80-108,)

__, __ __ __, __ __ __.

20. Amount of Exemption

(Line 17b)

21. Mississippi Taxable Income (L

ine 18 minus Line 19

__, __ __ __, __ __ __.

and 20) See Instructions (If less Than 0, Enter 0)

__, __ __ __, __ __ __.

22. Total Income Tax Due (From Schedule of Tax Computation, Form 80-100)

__, __ __ __, __ __ __.

23. Credit for Tax Paid to Another State (See Instructions Form 80-100 for Eligibility)

__, __ __ __, __ __ __.

24. Other Credits (From Form 80-401, Line 1)

__, __ __ __, __ __ __.

25. Net Income Tax Due (Line 22 minus Line 23 and 24)

__, __ __ __, __ __ __.

26. Consumer Use Tax (See Instructions, Form 80-100)

__, __ __ __, __ __ __.

27. Total Tax Due (Line 25 plus Line 26)

28. Mississippi Income Tax Withheld (Must complete Form

__, __ __ __, __ __ __.

80-107)

__, __ __ __, __ __ __.

29. Estimated Tax Payments and/or Amount Paid for Original Return

__, __ __ __, __ __ __.

30. Total Payments (Line 28 plus Line 29)

__, __ __ __, __ __ __.

31. Refund Received And/Or Amount Carried Forward from Original Return (Amended Return Only)

__, __ __ __, __ __ __.

32. Overpayment (If Line 30 is larger than Line 27 plus Line 31)

__, __ __ __, __ __ __.

33. Overpayment to be Applied to Next Year Estimated Tax Account

__, __ __ __, __ __ __.

34. Refund (Line 32 minus Line 33)

__, __ __ __, __ __ __.

35. Balance Due (If Line 27 plus Line 31 is larger than Line 30)

__, __ __ __, __ __ __.

36. Interest and Penalty (Including Interest on Underpayment of Estimated Tax, Form 80-320)

__, __ __ __, __ __ __.

37. Total Due (Line 35 plus Line 36)

Duplex and Photocopies NOT Acceptable

Form 80-205-12-8-1-000 Non-Resident / Part-Year Resident Individual Income Tax Return 2012

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