Form0606 0707 08080-106-22-3-1-00009 10 11 12 13 14 15(Rev.16 1707/22)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
0606 Individual / Fiduciary Income Tax Voucher 0606
0707 0707
0808 Instructions 0808
0909 0909
1010 Who Must Make Estimated Tax Payments 1010
1111 Every individual taxpayer who does not have at least eighty percent (80%) of his/her annual tax liability prepaid through withholding must make 1111
1212 estimated tax payments if his/her annual tax liability exceeds two hundred dollars ($200). For more information about the payment and calculation of 1212
1313 estimated income tax payments, please see the Individual Income Tax Return Instructions, Form 80-100. 1313
1414 1414
1515 1515
1616 Return Payments 1616
1717 This voucher may be used to make return payments for tax due on the Individual Income Tax Return (Form 80-105), Non-Resident Income Tax Return 1717
1818 (Form 80-205) and the Fiduciary Income Tax Return (Form 81-110). 1818
1919 1919
2020 Extension Payments 2020
2121 2121
2222 This voucher may be used to make extension payments for tax due on the Individual Income Tax Return (Form 80-105), Non-Resident Income Tax 2222
2323 Return (Form 80-205) and the Fiduciary Income Tax Return (Form 81-110). Extension payments should be filed and paid on or before April 15th. 2323
2424 2424
2525 Payment Options 2525
2626 • To pay this amount online, go to www.dor.ms.gov, click on Taxpayer Access Point (TAP) and follow the instructions. 2626
2727 2727
2828 • To pay by check or money order, complete the payment coupon below: 2828
2929 2929
- Make the check or money order payable to Department of Revenue
3030 3030
3131 - Mail the payment coupon and check/money order with return to: P.O. Box 23050, Jackson, MS 39225-3050 3131
3232 - Mail the payment coupon and check/money order without return to: P.O. Box 23192, Jackson, MS 39225-3192 3232
3333 - Check the appropriate box on the voucher for the payment type you are remitting. 3333
3434 - Check the amended return box on the voucher if you are making a payment with an amended return. 3434
3535 3535
- Write the identification number on the check or money order.
3636 3636
3737 - Duplex forms or photocopies are NOT acceptable. 3737
3838 3838
3939 3939
4040 4040
4141 4141
4242 4242
4343 4343
Cut Along the Dotted Line
__ __ 4444__ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ 4444 __
4545 4545
4646 Form 80-106-22-3-1-000 (Rev. 07/22) 4646
4747 Mississippi Tax Year Beginning 99 99 9999 4747
4848 Individual / Fiduciary Income Tax 4848
4949 801062231000 Payment Voucher Tax Year Ending 99 99 9999 4949
5050 5050
5151 Taxpayer SSN/ITIN 999999999 Trust FEIN 999999999 5151
5252 Spouse SSN/ITIN 999999999 Name of Estate / Trust X9X9X9X9X9X9X9X9X9X9X9X9 5252
(if fiduciary payment)
5353 5353
5454 Taxpayer First Name Initial Last Name Payment Type (Check One) Account Type (Check One) 5454
5555 XXXXXXXXXXXXXXXXX X XXXXXXXXXXXXXXXXX X Quarterly Estimate Payment 5555
5656 Spouse First Name Initial Last Name 5656
5757 XXXXXXXXXXXXXXXXX X XXXXXXXXXXXXXXXXX X Return Payment X Individual Income 5757
5858 Address 5858
5959 X9X9X9X9X9X9X9X9X9X9X9X9X9X9X9X9X9X9X9X9X9 X Extension Payment X Fiduciary Income 5959
6060 City State Zip 6060
6161 Amended Return Payment 6161
XXXXXXXXXXXXXXXXXXXXX XX 99999 X
6262 6262
6363 Amount Paid 9999999999 6363
0606 0707 080 09Mail10 11with12 13 14return15 16 17to18:19Department20 21 22 23 24 25of26Revenue,27 28 29 30 31P.O.32 33 34Box35 3623050,37 38 39 40Jackson,41 42 43 44MS45 4639225-305047 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
Mail without return to: Department of Revenue, P.O. Box 23192, Jackson, MS 39225-3192