Form 72-110-22-3-1-000 (Rev. 07/22)
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04                                                                                                                                                                                                                              04
                                                    Mississippi
05                                                                                                                                                                                                                              05
06     721102231000                                Use Tax Return                                                                                                                                                               06
07                                                                                                                                                                                                                              07
08                                                                                                                                                                                                                              08
09 1a. TAX CODE - GENERAL USE                      75 Name:  X9X9X9X9X9X9X9X9X9X9X9X9X9X9X9X9 09
10                                                                                                                                                                                                                              10
11 2a. Taxable Income or Purchases          999999    Account ID:    99999999                                                                                                                                                   11
12                                                                                                                                                                                                                              12
13 3a. Rate of Tax                                 7% Filing Period Ending:        MMDDYYYY                                                                                                                                     13
14                                                                                                                                                                                                                              14
15 4a. Amount of Tax                                                                                                                                                                                                            15
                                            999999
16                                                    X Close Account              X      Amended Return             X Address Change                                                                                           16
17 5a. Credit for Tax Paid to Another State                                                                                                                                                                                     17
                                            999999
18                                                                                                                                                                                                                              18
19 6a. Tax Calculated                       999999      If Change of Address is marked, list new address here:                                                                                                                  19
       To Line 7
20                                                                                                                                                                                                                              20
21                                                      X9X9X9X9X9X9X9X9X9X9X9X9X9X9X9X9X9X 21
22 1b. TAX CODE (FROM TABLE)                       99   Mailing Address (Number & Street, Including Rural Route)                                                                                                                22
23                                                      XXXXXXXXXXXXXXXXXXXXXXXXX XX                                       99999 23
24 2b. Taxable Income or Purchases                      City                                                         State Zip                                                                                                  24
                                            999999
25                                                                                                                                                                                                                              25
26 3b. Rate of Tax (From Table)                                                                                                                                                                                                 26
                                            9.99%
27                                                                                        TAX SUMMARY                                                                                                                           27
28 4b. Amount of Tax                                                                      * Required Fields                                                                                                                     28
                                            999999
29                                                                                                                                                                                                                              29
30 5b. Credit for Tax Paid to Another State 999999    *7. Tax Due for Tax Codes 3, 4, 29,                            999999                                                                                                     30
                                                      57, 66, 68, 75, 77, 78
31                                                                                                                                                                                                                              31
32 6b. Tax Calculated                       999999       8. Excess Collections                                       999999                                                                                                     32
       To Line 7 or Line 10
33                                                                                                                                                                                                                              33
34                                                    9. Balance (Line 7 plus Line 8)                                  999999                                                                                                   34
35 1c. TAX CODE (FROM TABLE)                       99                                                                                                                                                                           35
36                                                    *10. Discount (2% of Line 9,                                         99                                                                                                   36
                                                      Limited to $50.00 per Return)
37 2c. Taxable Income or Purchases                                                                                                                                                                                              37
                                            999999
38                                                    *11. Balance of Tax Due (Line 9 minus 10)                                                                                                                                 38
                                                                                                                     999999
39 3c. Rate of Tax (From Table)                                                                                                                                                                                                 39
                                            9.99   %
40                                                    *12. Tax Due for Rate Code 76                                                                                                                                             40
                                                                                                                       999999
41 4c. Amount of Tax                                                                                                                                                                                                            41
                                            999999
42                                                     13. Net Tax Due (Line 11 plus Line 12)                                                                                                                                   42
                                                                                                                     999999
43 5c. Credit for Tax Paid to Another State                                                                                                                                                                                     43
                                            999999
44                                                     14. Penalty                                                                                                                                                              44
                                                                                                                     999999
45 6c. Tax Calculated                       999999                                                                                                                                                                              45
46     To Line 7 or Line 10                            15. Interest                                                                                                                                                             46
                                                                                                                     999999
47                                                                                                                                                                                                                              47
48 1d. TAX CODE (FROM TABLE)                       99 *16. Total Due                                                 999999                                                                                                     48
49                                                                                                                                                                                                                              49
50 2d. Taxable Income or Purchases                                                                                                                                                                                              50
                                            999999
51                                                                                                                                                                                                                              51
52 3d. Rate of Tax (From Table)                       I declare, under the penalties of perjury, that this return (including any                                                                                                52
                                            9.99%
                                                      accompanying schedules) has been examined by me and to the best  
53 4d. Amount of Tax                                  of my knowledge and belief is a true, correct and complete return.                                                                                                        53
54                                          999999                                                                                                                                                                              54
55                                                                                                                                                                                                                              55
56 5d. Credit for Tax Paid to Another State                                                                                                                                                                                     56
                                            999999
57                                                                                    Signature of Taxpayer or Agent                                                                                                            57
58 6d. Tax Calculated                       999999                                                                                                                                                                              58
59     To Line 7 or Line 10                                          Phone                                           Date                                                                                                       59
60                                                                                                                                                                                                                              60
61                                                                                                                                                                                                                              61
62                                                                                                                                                                                                                              62
63                                                                                                                                                                                                                              63
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  Form 72-110-22-3-2-000 (Rev. 07/22)
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04                                                                                                                                                                                                                                04
                                                                    Mississippi
05                                                                                                                                                                                                                                05
06                                                                 Use Tax Return                                                                                                                                                 06
  DO NOT STAPLE THIS RETURN
07                                                                                                                                                                                                                                07
08                                                                  Instructions                                                                                                                                                  08
09                                                                                                                                                                                                                                09
10Filling in the return                                                    Tax Summary                                                                                                                                            10
11Use black ink when preparing your return. Print your numbers like this:  Line 7                                                                                                                                                 11
12                                                                         Enter the Total of Lines 6a, 6b, 6c, and 6d for tax categories to which                                                                                12
                                                                           the vendor discount applies (Tax Codes 3, 4, 29, 57, 66, 68, 75, 77, 
13                1 0 0 0 - 1 2 3 4                                        and 78).                                                                                                                                               13
14                                                                                                                                                                                                                                14
15Sending in the return                                                    Line 8                                                                                                                                                 15
16                                                                         Enter Excess Collections.                                                                                                                              16
17 Include this return and your check or money order for the amount on                                                                                                                                                            17
   Line 14 to the Department of Revenue,P.O. Box 960, Jackson, MS
18 39205.                                                                  Line 9                                                                                                                                                 18
19                                                                         Enter the result of Line 7 plus Line 8.                                                                                                                19
20Account Number                                                                                                                                                                                                                  20
21                                                                         Line 10                                                                                                                                                21
22 If your return does not have your account number preprinted, enter      Enter the result of Line 9 multiplied by 2%. The Vendor Discount is not                                                                                22
   your account number in the field provided beneath the area for your     allowed if your return is not filed and paid on time.
23 name.                                                                                                                                                                                                                          23
24                                                                         Line 11                                                                                                                                                24
25Filing Period                                                            Enter the result of Line 9 minus 10.                                                                                                                   25
26                                                                                                                                                                                                                                26
27 Enter the month, last day of the month, and year this return            Line 12                                                                                                                                                27
   covers in the boxes using numbers to indicate the month and year. For   Enter the total of lines 6b, 6c, and 6d for tax categories for Rate Code  
28 example, September, 2022 would be entered as                            76. The Vendor Discount does not apply.                                                                                                                28
29                                                                                                                                                                                                                                29
30 Filing Period Ending:                            0 9 3 0 2 0 2 2        Line 13                                                                                                                                                30
31                                   m m d        d        y y y y         Enter the result of Line 11 plus Line 12.                                                                                                              31
32                                                                                                                                                                                                                                32
33 Quarterly filers will enter their period the same way.                  Line 14                                                                                                                                                33
34                                                                         Enter the applicable 10% penalty if the return is filed late.                                                                                          34
35Tax Categories                                                                                                                                                                                                                  35
36                                                                         Line 15                                                                                                                                                36
37 The Use Tax Return is divided into four Tax Category sections and a     Enter the applicable interest from the due date of the return if the return37
   Tax Summary section. The Tax Category sections are used to report       is filed late:
38 your sales, purchases, tax credit paid to another state, and tax by the                                                                                                                                                        38
39 category in which they occurred. Use only as many Tax Category          Before January 1, 2015:  1%                                                                                                                            39
40 sections as you have different categories. If you need to report more   January 1, 2015-December 31st, 2015: 9/10 of 1%                                                                                                        40
41 than four tax categories, you will need to file on TAP.                 January 1, 2016-December 31st, 2016: 8/10 of 1%                                                                                                        41
                                                                           January 1, 2017-December 31st, 2017: 7/10 of 1% 
42 Lines 1a, 1b, 1c, and 1d                                                January 1, 2018-December 31st, 2018: 6/10 of 1%                                                                                                        42
43 Enter the Tax Code from the Tax Category Table that is assigned to      After January 1, 2019: 1/2 of 1%                                                                                                                       43
   the category of tax you are reporting. Only one Tax Code should be 
44 used for each Tax Category. If you have more than four categories,                                                                                                                                                             44
45 you will need to file on TAP.                                           Line 16                                                                                                                                                45
46                                                                         Enter the net total of Lines 12, 13, and 14.  This is the amount that                                                                                  46
47 Lines 2a, 2b, 2c, and 2d                                                you should pay.                                                                                                                                        47
48 Enter the total gross sales or purchases for the category of tax you                                                                                                                                                           48
   are reporting.                                                                                      Tax Category Table
49                                                                                                                                                                                                                                49
50                                                                                       Tax Category                       Tax Code     Tax Rate                                                                                 50
51 Lines 3a, 3b, 3c, and 3d                                                Electric Power Associations                          3        1%                                                                                       51
   Enter the Tax Rate from the Tax Category Table that corresponds to 
52 the category of tax you are reporting.                                  Manufacturing Machinery, Industrial Fuel, Farm                                                                                                         52
                                                                                                                                66       1 1/2%
53                                                                         Implements, Farm Tractors including repair parts                                                                                                       53
54 Lines 4a, 4b, 4c, and 4d                                                Industrial Rate Incentive                            68       3/4%                                                                                     54
55 Lines 2a, 2b, 2c, and 2d times Lines 3a, 3b, 3c, and 3d.                Trucks (greater than 10,000 lbs.),                                                                                                                     55
                                                                                                                                4        3%
56                                                                         Mobile Homes, Semitrailers, Aircraft, etc.                                                                                                             56
57 Lines 5a, 5b, 5c, and 5d                                                Autos, Light Trucks (10,000 lbs. or less)            57       5%                                                                                       57
   Enter the tax credit being claimed for tax paid to another state.
58                                                                         Sales or Construction of Floating                                                                                                                      58
                                                                                                                                29       3 1/2%
59                                                                         Vessels - Non-Transportation                                                                                                                           59
   Lines 6a, 6b, 6c, and 6d
60                                                                         General Use Tax Rate                                 75       7%                                                                                       60
   Lines 4a, 4b, 4c, and 4d minus Lines 5a, 5b, 5c, and 5d.
61                                                                         Utility - Nonindustrial Use                          76       7%                                                                                       61
62                                                                         Seller's Use Tax                                     77       7%                                                                                       62
63                                                                         General Use Tax Incentive                            78       3 1/2%                                                                                   63
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