Enlarge image | Form 80-401-22-3-1-000 (Rev. 08/22) 0606 0707 080 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 808 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 0404 Mississippi 0404 0505 0505 Tax Credit Summary Schedule 0606 804012231000 0606 0707 2022 0707 0808 (* Carryover Not Available) 0808 0909 SSN 999999999 0909 1010 1010 1111 FEIN 999999999 1111 1212 1212 1313 TAX CREDIT CODES 1313 1414 CODE CREDIT CODE CREDIT 1414 1515 02 Premium Retaliatory 24 Alternative Energy Jobs 1515 1616 03 Finance Company Privilege 25 Child Adoption 1616 1717 05 Jobs Tax 26 Historic Structure Rehabilitation (Attach Statement) 1717 1818 06 National or Regional Headquarters 27 Long Term Care 1818 1919 07 Research and Development Skills 28 New Markets 1919 2020 08 Employer Child / Dependent Care 29 Biomass Energy Investment 2020 2121 10 Reforestation 30 Wildlife Land Use 2121 2222 11 Gambling License Fee 31 Prekindergarten Credit 2222 2323 12 Financial Institution Jobs 32 Headquarters Relocation Credit 2323 2424 13 Mississippi Revenue Bond Service 34 Qualifying Charitable Contribution Credit Approved by DOR 2424 2525 14 Ad Valorem Inventory 35 Qualifying Foster Care Charitable Credit Approved by DOR 2525 2626 15 Export Port Charges 36 Business Contributions to Eligible Charitable Organizations 2626 2727 16 Insurance Guaranty 37 Endowment Fund Charitable Credit 2727 2828 17 Import Credit 38 Inland Water Transportation 2828 2929 18 Land Donation 39 Pregnancy Resource Charitable Contribution Credit 2929 3030 19 Broadband Technology 40 Railroad Infrastructure Tax Credit 3030 3131 21 Brownfield Credit 41 Blood Donation 3131 3232 22 Airport Cargo Charges 50 Bank Share 3232 3333 23 Manufacturing Investment Tax Credit 3333 3434 3434 3535 INCOME TAX CREDITS 3535 3636 A B C D E F G 3636 3737 CREDIT 3737 3838 CODE CREDIT CREDIT RECEIVED CREDIT CREDIT USED CREDIT EXPIRED CARRYOVER 3838 3939 EARNED THIS FROM CARRYOVER THIS YEAR THIS YEAR AVAILABLE 3939 YEAR PASS-THROUGH FROM PRIOR FOR NEXT 4040 ENTITY YEAR YEAR 4040 4141 (B+C+D-E-F) 4141 4242 4242 4343 99 9999999999 9999999999 9999999999 9999999999 9999999999 9999999999 4343 4444 4444 4545 99 9999999999 9999999999 9999999999 9999999999 9999999999 9999999999 4545 4646 4646 4747 99 9999999999 9999999999 9999999999 9999999999 9999999999 9999999999 4747 4848 4848 4949 99 9999999999 9999999999 9999999999 9999999999 9999999999 9999999999 4949 5050 5050 5151 1 9999999999 5151 1 Total income tax credit used this year (total column E; enter on Form 80-105, line 20 5252 or Form 80-205, line 22) 5252 5353 5353 54542 Total income tax credit available for next year (total column G) 2 9999999999 5454 5555 5555 56563 If code 25 is selected, enter adoptee SSN(s) here 999999999 5656 5757 5757 5858 999999999 5858 5959 5959 60604 If code 34, 35, 36 or 39 is selected, enter name of charitable organization X9X9X9X9X9X9X9X9X9X9 6060 6161 (attach statement if needed) 6161 6262 X9X9X9X9X9X9X9X9X9X9 6262 6363 6363 0606 0707 008 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32Duplex33 34 35 36and37 38Photocopies39 40 41 42 43 44 45NOT46 47 48Acceptable49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 808 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 |