Form 83-105-22-8-1-000 (Rev. 07/22)                                                                             Reset Form

                                                               Mississippi                                      Print Form
                                      Corporate Income and Franchise Tax Return
     831052281000
                                                                 2022
Tax Year Beginning                                                                                              Tax Year Ending   
                         mm  dd  yyyy                                                                                             mm  dd  yyyy 
FEIN                                                                                       Mississippi Secretary of State ID   

Legal Name and DBA
                                                                                     CHECK ALL THAT APPLY                      CHECK ONE
Address
                                                                                           Amended Return       100% Mississippi

City                                              State   Zip +4                           Final Return                        Multistate Apportioning

County Code                         NAICS Code                                             Non Profit                          Multistate Direct  
                                                                                                                               Accounting
   FRANCHISE TAX                                                                                               (ROUND TO THE NEAREST DOLLAR)

1     Taxable capital (from Form 83-110, line 18)                                            1                                                     00
                                                                                                                                                  .

2     Franchise tax (minimum tax $25)                                            Fee-In-Lieu 2                                                     00
                                                                                                                                                  .

3     Franchise tax credit (from Form 83-401, line 1)                                        3                                                     00
                                                                                                                                                  .

4     Net franchise tax due (line 2 minus line 3)                                            4                                                     00
                                                                                                                                                  .
   INCOME TAX

     Combined income tax return (enter FEIN of reporting corporation)

5     Mississippi net taxable income (from Form 83-122, line 30 or Form 83-310,  
       line 5, column C)                                                                     5
                                                                                                                                                  .00
6     Income tax                                                                             6
                                                                                                                                                  .00
7     Credit for tax paid on an electing Pass-Through Entity Tax Return (must attach K-1s)   7
                                                                                                                                                  .00
8     Income tax credits (from Form 83-401, line 3 or Form 83-310, line 5, column B)         8
                                                                                                                                                  .00
9     Net income tax due (line 6 minus line 7 and line 8)                                    9
                                                                                                                                                  .00
   PAYMENTS AND TAX DUE
10   Total franchise and income tax (line 4 plus line 9)                                     10
                                                                                                                                                  .00
11   Overpayments from prior year                                                            11 
                                                                                                                                                  .00
12   Estimated tax payments and payment with extension                                       12 
                                                                                                                                                  .00
13   Total payments (line 11 plus line 12)                                                   13
                                                                                                                                                  .00
14   Net total franchise and income tax  (line 10 minus line 13)                             14
                                                                                                                                                  .00
15   Interest and penalty on underestimated income tax payments (from Form 83-305, line 19)  15 
                                                                                                                                                  .00
16   Late payment interest                                                                   16
                                                                                                                                                  .00

Form 83-105-22-8-2-000 (Rev. 07/22)

                                                           Mississippi                                                                                              Page 2 
                                       Corporate Income and Franchise Tax Return
      831052282000
                                                      2022
FEIN

17   Late payment penalty                                                                                               17 
                                                                                                                                                                              .00
18   Late filing penalty 
      (minimum income tax penalty $100)                                                                                 18                                                    .00

19    
     Total balance due (if line 10 is larger than line 13, add line 14 through line 18)                                 19                                                    .00

20   Total overpayment  (if line 13 is larger than line 10 plus line 15, subtract line 10                               20
 and line 15 from line 13)                                                                                                                                                    .00
21   
Overpayment credited to next year  (from line 20)                                                                       21                                                    .00

22   
Overpayment to be refunded  (line 20 minus line 21)                                                                     22                                                    .00

PART l:  CORPORATE INFORMATION

1     Is this a publicly traded corporation?          Yes    If yes, under what symbol?                                                                                   No

2     If final return, enter reason and date effective:                                                                                                         Date

3     If the corporation has been sold, merged, or converted to a Single-Member LLC (SMLLC), complete the following: Name, address and FEIN of the     
       new existing corporation or owner of the SMLLC:
                                                                                                                           FEIN

4     If amended return, check reason.        Mississippi Correction                     Federal Correction                Other

5     Check if the company has been audited by the IRS.              If the company has been audited, what year(s) are involved?

6     Principal business activity in Mississippi                                                               6a    County location in Mississippi

7     Principal product or service in Mississippi                                                                       

8    Contact person for this return                                                                                8a    Location and phone number    

PART lI:  CORPORATE OFFICER INFORMATION

  List the owners, officers, directors or partners who have a responsibility in the fiscal management of the organization. 

OFFICER NAME AND TITLE                        SSN                                         ADDRESS                                                                   OWNERSHIP 
                                                                                                                                                                    PERCENTAGE

Form 83-105-22-8-3-000 (Rev. 07/22)

                                              Mississippi                                                                       Page 3
                                   Corporate Income and Franchise Tax Return
    831052283000                                       2022
FEIN

PART lII:  CORPORATE AFFILIATION SCHEDULE

  List all entities owned by and affiliated with the corporation.  See page 4 for supplemental schedule if needed.

    ENTITY NAME                    FEIN                         ADDRESS                                                 ENTITY TYPE

    Check box if return may be discussed with preparer

I declare, under penalties of perjury, that I have examined this return and accompanying schedules and statements, and to the best of my knowledge and belief, 
this is a true, correct and complete return.  Declaration of preparer (other than taxpayer) is based on all information of which preparer has any knowledge. 

Officer Signature and Title                                Date                 Business Phone

Paid Preparer Signature            Date                    Paid Preparer Address

Paid Preparer PTIN                 Paid Preparer Phone     City                                                   State Zip Code

                                    Mail Return To: Department of Revenue  P.O. Box 23191 Jackson, MS 39225-3191 

Form 83-105-22-8-4-000 (Rev. 07/22)

                                             Mississippi                                         Page 4
                                   Corporate Income and Franchise Tax Return
    831052284000
                                           2022
FEIN

SUPPLEMENTAL CORPORATE AFFILIATION SCHEDULE

List all entities owned by and affiliated with the corporation.  Continued from page 3, part III.

    ENTITY NAME                    FEIN                  ADDRESS                                 ENTITY TYPE

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