Form 80-205-17-8-1-000 - Mississipi Non-Resident/part-Year Resident Individual Income Tax Return - 2017

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Mississippi
Form 80-205-17-8-1-000 (Rev. 10/17)
Print Form
Non-Resident / Part-Year Resident
Individual Income Tax Return
Amended
802051781000
2017
Non-Resident
Part-Year, Tax Year Beginning ________________ and Ending ________________
Taxpayer First Name
Initial
Last Name
SSN
Spouse SSN
Spouse First Name
Initial
Last Name
1
Married - Combined or Joint Return ($12,000)
Mailing Address (Number and Street, Including Rural Route)
2
Married - Spouse Died in Tax Year ($12,000)
3
Married - Filing Separate Returns ($12,000)
City
State
Zip
County Code
4
Head of Family ($8,000)
5
Single ($6,000)
EXEMPTIONS
Dependents
(in column B, enter "C" for child, "P" for parent or "R" for relative)
6
Taxpayer Age 65 or Over
Spouse Age 65 or Over
(A) Name
(B)
(C) Dependent SSN
8
Taxpayer Blind
Spouse Blind
9
Total dependents line 7 plus number of boxes checked line 8
.
10 Line 9 x $1,500
10
00
.
11 Enter filing status exemption
11
00
.
12 Total (line 10 plus line 11)
12
00
7
Total number of dependents (from line 6 and Form 80-491)
PRORATION
(COMPLETE PAGE 2 BEFORE PROCEEDING FURTHER)
13a Mississippi adjusted gross income
14a Standard or itemized deductions
15a Exemptions (from line 12; if married
filing separate, use 1/2 amount)
.
.
00
00
.
b Adjusted gross income from all sources
b Mississippi deductions
00
(line 14a multiplied by line 13c)
.
b Mississippi exemption
00
(line 15a multiplied by line 13c)
.
c Line 13a divided by line 13b
00
.
.
________
______ %
00
MISSISSIPPI INCOME TAX
Column A (Taxpayer)
Column B (Spouse)
.
.
16
Mississippi adjusted gross income (from page 2, line 63 or line 64)
16A
16B
00
00
.
.
17
Deductions (from line 14b; if itemized, attach Form 80-108)
17A
17B
00
00
.
.
18
Exemptions (from line 15b)
18A
18B
00
00
.
.
19
Mississippi taxable income (line 16 minus line 17 and line 18)
19A
19B
00
00
.
20
Income tax due (from Schedule of Tax Computation, see instructions)
20
00
.
.
21
Other credits (from Form 80-401, line 1)
21
00
00
.
22
Net income tax due (line 20 minus line 21)
22
00
.
23
Consumer use tax (see instructions)
23
00
.
24
Catastrophe savings tax (from Form 80-360, line 11)
24
00
.
25
Total Mississippi income tax due (line 22 plus line 23 and line 24)
25
00
.
26
Mississippi income tax withheld (complete Form 80-107)
26
00
.
27
Estimated tax payments, extension payments and/or amount paid on original return
27
00
.
28
Refund received and/or amount carried forward from original return (amended return only)
28
00
.
29
Total payments (line 26 plus line 27 minus line 28)
29
00
(If no overpayment is due on line 30, skip to line 35)
.
30
Overpayment (if line 29 is more than line 25, subtract line 25 from line 29)
30
00
.
31
Interest on underestimated tax (from Form 80-320, line 11)
Farmers or Fishermen
31
00
(see instructions)
.
32
Adjusted overpayment (line 30 minus line 31)
32
00
.
33
Overpayment to be applied to next year estimated tax account
33
00
.
34
Overpayment refund (line 32 minus line 33)
REFUND
34
00
.
35
Balance due (if line 25 is more than line 29, subtract line 29 from line 25)
BALANCE DUE
35
00
.
36
Interest, penalty and interest on underestimated tax (from Form 80-320, line 18)
36
00
.
37
Total due (line 35 plus line 36)
AMOUNT YOU OWE
37
00
Installment Agreement Request
(see instructions for eligibility; attach Form 71-661)
PLEASE SIGN THIS TAX RETURN ON THE BOTTOM OF PAGE 2

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