PDF document
- 1 -
                          2023

Form 

MO-1040A

Single/Married (Income from One Spouse)

Short Form

 Complete a MO W-4 
 We encourage you to review and complete a new W-4 each year, especially 
 if your filing status has changed. Request a W-4 from your employer or print 
 it at dor.mo.gov/forms/. 

 Sign up to Receive Return Status Updates
 Get text or email notifications each time the status of 
 your return changes. See page 5 for more information.  
@

                                                            !

 File Electronically
 Electronic filing is fast and easy. See page 2 for details.

Tax Deadline is April 15. See page 4 for extensions.



- 2 -
 Electronic Filing Options for Federal and State E-File
                    Missouri, in cooperation with the Internal Revenue 
                    Service (IRS), offers a joint federal and state filing of 
                    individual income tax returns. There are two ways 
                    that you may e-file your federal and state income 
                    tax returns:
 1)  You can electronically file your federal and state returns online from 
 websites provided by approved software providers. Many providers 
 offer free filing if you meet certain conditions. A list of approved 
 providers can be found at dor.mo.gov/taxation/individual/tax-types/
 income/vendors.html#freeonline.

 2)  You can have a tax preparer (if approved by the IRS) electronically 
 file your federal and state returns for you, usually for a fee. A list of 
 approved tax preparers can be found at dor.mo.gov/taxation/indi-
 vidual/tax-types/income/.

 BENEFITS OF ELECTRONIC FILING
Convenience: You can electronically file 24 hours a day, 7 days a 
week. If you electronically file DO NOT mail a copy of your return. 
Security: Your tax return information is encrypted and  
transmitted over secure lines to ensure confidentiality.
Accuracy: Electronically filed returns have fewer errors than 
paper returns. 
Direct Deposit: You can have your refund directly deposited 
into your bank account. 
Proof of Filing: An acknowledgment is issued when your return 
is received and accepted.

 ASSISTANCE WITH PREPARING YOUR TAX RETURN
There are a large number of volunteer groups around Missouri providing 
tax assistance to elderly or lower income taxpayers. To locate a volunteer 
group near you that offers return preparation assistance: call 800-906-
9887, 888-227-7669 or visit dor.mo.gov/taxation/individual/tax-types/
income/.

You will find a larger volume of volunteer centers open during the filing 
season, which is typically January through April.

 2-D BARCODE RETURNS

If you plan to file a paper return, you should consider 2-D barcode filing. The software encodes all your tax 
information into a 2-D barcode, which allows your return to be processed with fewer errors compared to 
traditional paper returns. If you use software to prepare your return, check our website for approved 2-D 
barcode software companies. Also, check out the Department’s fill-in forms that automatically calculate 
and provide your return with a 2-D barcode. You can have your refund directly deposited into your bank 
account when you use the Department’s fill-in forms.
If your form has a 2-D barcode, mail your return to the Department of Revenue address as indicated below:
      Refund returns: P.O. Box 3222, Jefferson City, MO 65105-3222
      Balance due returns: P.O. Box 3370, Jefferson City, MO 65105-3370
      Email: Incometaxprocessing@dor.mo.gov (For submission of Individual Income Tax and Property  
      Tax Credit returns) 
                                                    2



- 3 -
WHAT’S INSIDE
Electronic Filing Options/Benefits  
of Electronic Filing  ............................... 2, 16              FORMS
Do You Have the Right Form? ...................... 3                    Diagram of Form W-2 ............................. 10
Important Filing Information ....................... 3-5                Form MO-1040A  ..................................... 11-14
Frequently Asked Questions ....................... 5                    Form MO-1040V  ................................. 15
Information to Complete Form MO-1040A .......... 5-9                     
Missouri Itemized Deductions .....................6, 8, 9
Tax Chart ........................................ 10

                             DO YOU HAVE THE RIGHT FORM?

You may use this tax form to file your 2023        c.  Exempt contributions made to                      to File (Form MO-60);
Missouri Individual Income tax return if you:         or earnings from the Missouri                 e.  A deduction for other federal tax
  1.   Are a one income filer (have income            for Tuition Program (MOST), or                    from Federal Form 1040 or  
    from one spouse, if married), or are              other qualified 529 plan.                         Federal Form 1040-SR and  
    single;                                        d.  Interest from federal exempt                     applicable schedules:
  2.   Were a Missouri resident, nonresident,         obligations;                                      • Schedule 2, Part 1, Line 3;
    or part year resident with Missouri            e.  Interest from state and local                    • Schedule 2, Part 2, Lines 8, 10,  
    income only;                                      obligations;                                        14, and 15; 
  3.   Claim the standard or itemized              f.  Capital gain exclusion;                          • Schedule 3, Part 1, Line 1; and
    deductions; and                                g.  Negative bonus depreciation                      • Any recapture taxes included  
  4.  Do not have any tax credits or                  adjustments;                                        on Schedule 2,  Part 2, Line 21.  
    modifications to your income.                  h.  Railroad retirement modifications;           f.  A Health Care Sharing Ministry  
                                                   i.  Achieving a Better Life                          deduction; 
Youcannot use this tax form if at least one of        Experience Program (ABLE)                     g.  A Bringing Jobs Home deduction; 
the following special filing situations apply:        modifications;                                h.   Farmland sold, rented, leased,  
  1.  You are filing an amended return;            j. Agriculture disaster relief income;               or crop-shared to a beginning  
  2.  Both you and your spouse have                k.  Employee Stock Ownership Plan                    farmer deduction;
    income;                                           (ESOP); or                                    i.  First-Time Home Buyers  
  3.  You have income from another state;          l.  Federal Broadband Grants                         deduction;
  4.  You have military pay;                          Income Tax Subtraction.                       j.  Foster Parent deduction; or
  5.  You have a Net Operating Loss (NOL);       7.  You are claiming:                              k.  Missouri Working Family Tax Credit.
  6.  You have any of the following Missouri       a.   Pension,  social security/social           8.  You owe a penalty for underpayment  
    modifications:                                    security disability, or military              of estimated tax;
    a.   Positive or negative adjustments             exemption;                                   9.  You owe tax on a lump sum      
     from partnerships, fiduciaries, S             b.  Miscellaneous Income Tax Credits             distribution included on your Federal  
     corporations, or other sources;                  (Form MO-TC);                                 Form 1040 or Federal Form 1040-SR,  
    b.  Nonqualified distribution received         c.  Property Tax Credit (Form                    Line 16;
     from the Missouri for Tuition                    MO-PTC or  Form MO-PTS);                     10.  You owe recapture tax on low income 
     Program (MOST), or other qualified            d.  Credit made with the filing of an            housing credit; or 
     529 Plan;                                        Application for Extension of Time            11.  You are a fiscal year filer.
  
   Visit the Department’s website at dor.mo.gov/personal/taxselector to use the Department’s form selector to obtain specific tax forms.

                                                                         b.  Are a nonresident with less than $600 of Missouri 
                                                                                   income; or 
IMPORTANT FILING 
                                                                              c.  Have Missouri adjusted gross income less than    
INFORMATION                                                                       the amount of your standard deduction for your  
                                                                                  filing status. 
This information is for guidance only and does not 
state the complete law.                                                Note: If you are not required to file a Mis souri return, but 
                                                                       you received a Wage and Tax Statement (Form W-2) 
   FILING REQUIREMENTS                                                 stating you had Missouri tax withheld, file your Missouri 
                                                                       return to claim a refund of your Missouri withholding. If 
You do not have to file a Missouri return if you are not               you are not required to file a Missouri return and you do 
required to file a federal return. If you are required to              not anticipate an increase in income, you may change your 
file a federal return, you may not have to file a Missouri             Employee Withholding Allowance Certificate (Form MO 
return if you:                                                         W-4) to “exempt” so your employer will not withhold 
    a.  Are a resident and have less than $1,200 of                    Missouri tax.
     Missouri adjusted gross income; 
                                                                 3



- 4 -
NONRESIDENT ALIEN SPECIAL                                       DEPARTMENT OF SOCIAL SERVICES FORM(S)
FILING INSTRUCTIONS                                            Select the box at the top of the form indicating you have 
If you do not have a social security number, enter your        attached a Department of Social Services eligibility review 
identifying number in the social security number space         form(s) (Temporary Assistance -TANF, Supplemental 
provided. Enter on Form MO-1040A, Line 1 the amount            Nutrition Assistance Program - SNAP, MoHealth Benefits, 
from U.S. Nonresident Alien Income Tax Return (Federal         and/or Childcare Subsidy Program) to your Missouri 
Form 1040NR), Line 11 or U.S. Income Tax Return for            return. Failure to check this box may result in processing 
Certain Nonresident Aliens With No Dependents.                 delays of benefit eligibility. For access to the Department 
                                                               of Social Service’s eligibility review form(s) visit:  
Filing Status - If you selected filing status single on the    dor.mo.gov/taxation/individual/dss-forms.html
Federal Form 1040NR, select single as your filing status 
on Form MO-1040A.                                               LATE FILING AND PAYMENT
If you selected filing status married filing separately on     Simple interest is charged on all delinquent taxes. The rate 
Federal Form 1040NR, select married filing separately as       will be updated annually and can be found on our website 
your filing status on Form MO-1040A.                           at dor.mo.gov/taxation/statutory-interest-rates.html. 
If you selected filing status qualifying widow(er) on Federal 
Form 1040NR, select qualifying widow(er) as your filing        For timely filed returns, an addition to tax of 5 per cent 
status on Form MO-1040A.                                       (of the unpaid tax) is added if the tax is not paid by the 
                                                               return’s due date. 
Itemized Deductions - Nonresident aliens who are required 
                                                               For returns not filed by the due date, an addition to tax of 
to itemize their deductions for federal purposes must also 
                                                               5 percent per month (of the unpaid tax) is added for each 
itemize deductions on their Missouri return. 
                                                               month the return is not filed. The addition to tax cannot 
Federal Tax Deduction - Enter on Form MO-1040A, Line           exceed 25 percent.
4a, the amount from the Form 1040NR, Line 22 minus 
the amount from Line 17, and the net premium tax credit        Note: If you file an extension, a 5 percent addition to tax 
(Schedule 3, Part 2, Line 9).                                  charge will still apply if the tax is not paid by the original 
                                                               return’s due date, provided your return is filed by the 
Note: At the time the Department finalized their tax           extension date. If you are unable to pay the tax owed in full on 
forms, the Internal Revenue Service had not finalized          the due date, please visit the Department’s website for your 
the federal income tax forms.                                  payment options at dor.mo.gov.
For all other lines of Form MO-1040A, see instructions  
starting on page 5.                                             WHERE TO SUBMIT YOUR CLAIM
                                                               If you are due a refund or have no amount due, mail your 
WHEN TO FILE                                                   return and all required attachments to: 
The 2023 returns are due April 15, 2024.                           Department of Revenue 
                                                                   P.O. Box 500 
EXTENSION OF TIME TO FILE                                          Jefferson City, MO 65105-0500 
                                                               If you have a balance due, mail your return, payment, 
You are not required to file an extension if you do not        voucher, and all required attachments to: 
expect to owe additional income tax or if you anticipate 
                                                                   Department of Revenue 
re ceiv ing a refund.
                                                                   P.O. Box 329 
If you wish to file a Missouri extension, and do not expect        Jefferson City, MO 65105-0329 
to owe Missouri income tax, you may file an extension by       2-D barcode returns, see page 2.
filing an Appli ca tion for Extension of Time to File (Form 
MO-60). An auto matic extension of time to file will be        Email: Incometaxprocessing@dor.mo.gov
granted until October 15, 2024.
                                                                DOLLARS AND CENTS
If you receive an extension of time to file your federal 
income tax return, you will automatically be granted           Rounding is required on your tax return. Zeros have been 
an extension of time to file your Missouri income tax          placed in the cents columns on your return. For 1 cent 
return, provided you do not expect to owe any additional       through 49 cents, round down to the previous whole 
Missouri income tax. Select the box at the top of Form         dollar amount. For 50 cents through 99 cents, round up to 
MO-1040A, indicating you have an approved federal              the next whole dollar amount. 
extension and attach a copy of your application for            Example:         Round $32.49 down to $32.00 
federal extension (Federal Form 4868) with your                                 Round $32.50 up to $33.00
Missouri income tax return when you file.
If you expect to owe Missouri income tax, file Form MO-60       AMENDED RETURN
with your payment by the original due date of the return.
                                                               You must use Individual Income Tax Return Long Form 
Remember: An extension of time to file does not extend         (Form MO-1040) for the year being amended. See 
the time to pay. A 5 percent addition to tax will apply if     information on page 3 on how to obtain Form MO-1040 
the tax is not paid by the original return’s due date.         and instructions.
                                                              4



- 5 -
                                                                   How do I determine my federal tax deduction? 
 FILL-IN FORMS THAT AUTOMATICALLY CALCULATE
                                                                   The tax on your federal return is your federal tax amount 
Go to dor.mo.gov/taxation/individual/tax-types/income/             minus certain credits. This amount may not exceed $5,000 
to enter your tax information and let us do the math for           for a single filer and $10,000 for a combined filer. See the 
you. No calculation errors means faster processing. Just           information and chart on page 6, Line 4a and 4b to assist 
complete, print, sign, and mail the return. These forms            you in determining the tax from your federal return. 
contain a 2-D barcode at the top right portion of the form. 
                                                                   How do I calculate my Missouri tax? 
This allows quicker processing of your return.
                                                                   Use the tax chart on page 10 to determine your tax.
 MISSOURI RETURN STATUS INQUIRY
To check the status of your 2018 through 2023 tax 
return(s) 24 hours a day visit dor.mo.gov/taxation/
return-status/ or call our automated individual income             INFORMATION TO 
tax inquiry line (573) 526-8299. To obtain the status of 
your return, you must know the fol lowing information: 1)          COMPLETE FORM 
the first social security number on the return; 2) the filing 
status shown on your return; and 3) the exact amount 
of the refund or balance due in whole dollars. Once this           MO-1040A
information is validated using the Missouri Return Inquiry         FEDERAL EXTENSION
System on our website, you will be given the option to 
sign up for text or email notifications. This will allow you       Select the box at the top of the form indicating you 
to be notified each time the status of your tax return             have an approved federal extension and attach a copy 
changes as it is being processed by the Department of              of your federal extension (Federal Form 4868) with 
Revenue.                                                           your Missouri income tax return when you file. Failure to 
                                                                   check this box may result in disallowing the extension.
 ADDRESS CHANGE
If you move after filing your return, notify both the Post Office  FILING STATUS
serving your old address and the Department of Revenue             Select the same filing status on your Missouri return as 
of your address change. Official address change forms can 
                                                                   claimed on the federal return.  If on your federal return 
be obtained at dor.mo.gov/how-do-i/change-address-                 you selected the checkbox “Someone can claim you as 
revenue-records.html.
                                                                   a dependent,” you will select claimed as a dependent  
Address change requests should be mailed to:                       on the Form MO-1040A. If on your federal return you 
                                                                   selected the checkbox “Someone can claim you as a 
      Depart ment of Revenue  
                                                                   dependent,” and your federal return status is married 
      P.O. Box 2200  
                                                                   filing jointly, you will select the filing status of married 
      Jefferson City, MO 65105-2200 
                                                                   filing combined on the Form MO-1040A.
This will help forward any refund check or correspondence 
to your new address. 
                                                                   AGE 65 OR OLDER OR BLIND
                                
 CONSUMER’S USE TAX                                                If you or your spouse were age 65 or older or blind and 
                                                                   qualified for these deductions on your 2023 federal return, 
Use tax is imposed on the storage, use or consumption of           select the appropriate boxes.
tangible personal property in this state. The state use tax 
rate is 4.225 percent. Cities and counties may impose an 
additional local use tax.                                          100 PERCENT DISABLED PERSON
Use tax does not apply if the purchase is subject to               You may select the 100 percent disabled box if you are 
Missouri sales tax or otherwise exempt. A purchaser                unable to engage in any substantial gainful activity by 
is required to file a use tax return if the cumulative             reason of any medically determinable physical or mental 
purchases on which tax was not paid to the seller exceed           impairment that can be expected to result in death or has 
$2,000 in a calendar year.                                         lasted or can be expected to last for a continuous period 
                                                                   of not less than 12 months.
You can use the Consumer’s Use Tax Return (Form 4340). 
The due date for Form 4340 is April 15, 2024.
                                                                   NON-OBLIGATED SPOUSE
                                                                   You may select the non-obligated spouse box if your spouse 
                                                                   owes the state of Missouri any child support pay ments, 
                                                                   back taxes, student loans, etc., and you do not want your 
FREQUENTLY                                                         portion of the refund used to pay the amounts owed by your 
                                                                   spouse. Debts owed to the Internal Revenue Service (IRS) 
ASKED QUESTIONS                                                    are excluded from the non-obligated spouse apportionment.
Can I file my return now, but pay later?  
Yes, we encourage you to file your return as early in the          NAME AND ADDRESS
tax filing season as possible. You may pay at any time             Print or type your name(s), address, and social security 
providing the payment is postmarked no later than April            number(s) in the spaces provided on the return.
15, 2024. See page 8, Line 19 for pay ment options.

                                                                  5



- 6 -
                                                                     Note: At the time the Department printed their tax 
 DECEASED TAXPAYER                                                   forms, the Internal Revenue Service had not finalized the 
If the taxpayer or spouse passed away in 2023, select the            2023 federal income tax forms. 
appropriate box. If a refund is due to a deceased taxpayer, 
attach the Statement of Person Claiming Refund Due a                 LINE 5 - STANDARD OR ITEMIZED DEDUCTIONS
Deceased Taxpayer (Form MO-1310D) , Power of Attorney 
(Form 2827), and the death certificate.                              Standard Deductions: If you claimed the standard 
                                                                     deduction on your federal return, enter the standard 
 LINE 1 - FEDERAL ADJUSTED GROSS INCOME                              deduction amount for your filing status. The amounts are 
                                                                     listed on Form MO-1040A, Line 5.
Use the chart below to locate your income on your  
federal return.                                                      Use the chart below to determine your standard deduction 
                                                                     if you or your spouse selected any of the boxes for: 65 or 
  Federal Form          Line                                         older, blind or claimed as a dependent.
 Federal Form 1040                                                   If you or your spouse claimed 65 or older or Blind, please 
 or 1040-SR             11
                                                                     click on the link provided to validate your additional 
 Federal Form 1040X     1                                            standard deduction amounts dor.mo.gov/taxation/
                                       
                                                                     individual/tax-types/income/documents/Standard-and-
 LINE 2 - STATE INCOME TAX REFUND                                    Additional-Standard-Deduction.pdf.
Subtract any state income tax refund included in your                                Federal Form           Line
federal adjusted gross income on Federal Form 1040 or                          Federal Form 1040  
Federal Form 1040-SR Schedule 1, Part 1, Line 1.                               or 1040-SR                   12
                                                                               Federal Form 1040X           2
 LINE 4A - TAX FROM FEDERAL RETURN
                                                                     Itemized Deductions: If you itemized on your federal 
Use the chart below to locate your tax on your federal               return, you may want to itemize on your Missouri return or 
return. Do not enter your federal income tax withheld as 
shown on your Form(s) W-2 or federal return.                         take the standard deduction, whichever re sults in a higher 
                                                                     deduction. If you were required to itemize on your federal 
If you have an earned income credit, you must subtract 
the credit from the tax on your federal return. If a negative        return, you must itemize on your Missouri return. 
amount is calculated, enter “0”. If you used a method 
other than the federal tax table to determine your federal           To figure your itemized deductions, complete the Itemized 
tax, attach the appropriate schedule.                                Deductions Section on page 14. If you are subject to 
                                                                     “additional Medicare tax” on your federal return, see 
  Federal Form                        Line                           the instructions on page 8 and 9, when computing your 
                    •  Federal Form 1040 or 1040-SR Line 22 minus;   Missouri itemized deductions.
                    •  Federal Form 1040 or 1040-SR,  
 Federal Form 1040    Line 27 and 29;                                Attach a copy of your federal return (pages 1 and 2) and 
  or 1040-SR        •  Schedule 2, Part 1, Line 3;                   Federal Schedule A.
                    •  Schedule 3, Part 2, Line 9.
                                                                     LINE 6 - HEAD OF HOUSEHOLD & QUALIFYING WIDOW(ER)
                    Line 8 minus Lines 14 and 15, except  
 Federal Form 1040X amounts from Forms 2439 and 4136.                If your filing status is head of household or qualifying 
                                                                     widow(er) enter the amount of $1,400 as your additional 
                                                                     exemption on Line 6. You must use the same filing status 
 LINE 4B - FEDERAL TAX PERCENTAGE
                                                                     as your federal return.
This percentage is based on the Missouri Adjusted
Gross Income reported on Line 3.  See below examples:                NOTE: If you claimed any filing status other than head of 
 Example 1:  If Line 3 is $22,450, enter 35% on Line 4b.             household or qualifying widow(er) on your federal return, 
 Example 2:  If Line 3 is $58,750, enter 15% on line 4b.             you do not qualify for the additional exemption. 
Missouri Adjusted Gross   Federal Tax 
Income Range (Line 3):    Percentage:                                LINE 7 - LONG-TERM CARE INSURANCE DEDUCTION
 $25,000 or less ..............................................35%
 $25,001 to $50,000 .....................................25%         If you paid premiums for qualified long-term care insurance 
 $50,001 to $100,000 ...................................15%          in 2023, you may be eligible for a deduction on your Missouri 
 $100,001 to $125,000 ..................................5%           income tax return. Qualified long-term care insurance 
 $125,001 or more ...........................................0%      is defined as insurance coverage for at least 12 months 
                                                                     for long-term care expenses should such care become 
 LINE 4C - FEDERAL INCOME TAX DEDUCTION                              necessary because of a chronic health condition or physical 
Multiply Line 4a by percentage on Line 4b.  If you selected          dis ability including cognitive impairment or the loss of 
any filing status other than married filing combined on the          functional capacity, thus ren dering an individual unable 
MO-1040A, your federal tax deduction may not exceed                  to care for themselves without the help of another person. 
$5,000.  If you selected married filing combined, your               Complete the following work sheet only if you paid premiums 
federal tax cannot exceed $10,000.
                                                                     for a qualified long-term care in sur ance policy; and the policy 
                                                                   6 is for at least 12 months coverage. 



- 7 -
Note: You cannot claim a deduction for amounts paid                               Funds                                          Codes
towards death benefits or extended riders. 
                                                                                  American Cancer Society Heartland  
                                                                                  Division, Inc. Fund ................................... 01
   Worksheet for Long-Term Care Insurance Deduction
                                                                                    American Diabetes Association  
 A.   Enter the amount paid for qualified 
   long-term care insurance policy.. . . . . . . . . . .  A) $_________           Gateway Area Fund. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .02 
   If you itemized on your federal return                                         American Heart Association Fund ...................03
   and your federal itemized deductions 
   included medical expenses, go to                                               Amyotrophic Lateral Sclerosis 
   Line B. If not, skip to H.                                                     (ALS-Lou Gehrig’s Disease) Fund ...................05
 B.   Enter the amount from Federal 
   Schedule A, Line 4.  .  .  .  .  .  .  .  .  .  .  .  .  .  .   B) $_________  Arthritis Foundation Fund ..........................09
 C.   Enter the amount from Federal                                               Foster Care and Adoptive Parents 
   Schedule A, Line 1 . . . . . . . . . . . . . . .  C) $_________
 D.   Enter the amount of qualified                                               Recruitment and Retention Fund .................... 14
   long-term care included on Line C  . . . . .  D) $_________                    March of Dimes Fund ..............................08
 E.   Subtract Line D from Line C  . . . . . . . . .  E) $_________
 F.   Subtract Line E from Line B.                                                Muscular Dystrophy Association Fund ...............07
   If amount is less than zero, enter “0”  . . . .  F) $_________                   National Multiple Sclerosis Society Fund ............. 10
   G.   Subtract Line F from Line A  . . . . . . . . .  G) $_________
 H.   Enter Line G on Form MO-1040A,                                              Pediatric Cancer Research Trust Fund ............... 18
   Line 7. Or enter Line A if you did not 
   have to complete Lines B through G.                                            The minimum contribution is $2, or $4 if married filing 
 Attach a copy of your federal return (pages 1 and 2) and Federal                 combined, for the fol low ing funds: Children’s Trust Fund, 
 Schedule A (if you itemized your deductions).                                    Veterans Trust Fund, Elderly Home Delivered Meals Trust 
                                                                                  Fund, Missouri National Guard Trust Fund, and Organ 
 LINE 10 - TAX                                                                    Donor Program Fund. 
Calculate your tax by using your taxable income from Form                         The minimum contribution is $1, or $2 if married filing 
MO-1040A, Line 9, the Tax Rate Chart (page 10, Section A),                        combined, for the following funds: Workers’ Memorial 
and the Tax Calculation Worksheet (page 10, Section B).                           Fund, Childhood Lead Testing Fund, Medal of Honor Fund, 
                                                                                  Missouri Military Family Relief Fund, General Revenue 
 LINE 11 - MISSOURI WITHHOLDING                                                   Fund, Foster Care and Adoptive Parents Recruitment and 
Include only Missouri withholding as shown on your Form(s)                        Retention Fund, Kansas City Regional Law Enforcement 
W-2, Miscellaneous Income (Federal Form 1099), and                                Memorial Foundation Fund, Soldiers Memorial Military 
Distributions From Pensions, Annuities, Retirement or                             Museum in St. Louis Fund, and Pediatric Cancer Research 
Profit-Sharing Plans (Federal Form 1099-R). Do not include                        Trust Fund.
withholding for federal taxes, local taxes, city earnings taxes, 
or another state’s withholding. Attach a copy of all Form(s)                      The minimum contribution is $1, not to exceed $200, 
W-2 and 1099.                                                                     for the following irrevocable trust funds: American 
                                                                                  Cancer Society Heartland Division, Inc. Fund, American 
 LINE 12 - ESTIMATED TAX PAYMENTS                                                 Diabetes Asso ci a tion Gateway Area Fund, American 
                                                                                  Heart Association Fund, ALS Lou Gehrig’s Disease Fund, 
Include any estimated tax payments made on your 2023 return 
                                                                                  Arthritis Foundation Fund, March of Dimes Fund; Muscular 
and any overpayment applied from your 2022 Missouri return.
                                                                                  Dys trophy Association Fund, and National Multiple 
 LINE 15 - APPLY OVERPAYMENT TO                                                   Sclerosis Society Fund. 
 NEXT YEAR’S TAXES                              
You may apply any portion of your refund to next                                  LINE 17 - MISSOURI 529 EDUCATION 
year’s taxes.                                                                     PLAN DEPOSIT
                                                                                  You can deposit all or a portion of your refund into a 
 LINE 16 - TRUST FUNDS                                                            Missouri 529 Education Plan (MOST) account. To make 
                                                                                  this choice, there must be an open account and the total 
You may donate part or all of your overpaid amount or 
                                                                                  deposit must be a minimum of $25. Please complete and 
contribute additional payments to any of the trust funds 
                                                                                  attach a Missouri 529 Education Plan Direct Deposit (Form 
listed on Form MO-1040A and any two additional funds.
                                                                                  5632). 
               Additional Funds
If you choose to give to any of the additional funds, enter                       LINE 18 - REFUND
the two-digit code in the spaces provided on Line 16.                             Subtract Lines 15, 16, and 17 from Line 14 and enter on Line 18.
If you want to give to more than two additional funds,                            If your refund is $100,000 or more, please file your return 
please submit a contribution directly to the fund.                                electronically to receive your refund by direct deposit to 
                                                                                  your bank account. For security purposes, all refunds over 
See the Department’s website for additional information at 
                                                                                  this amount must be electronically deposited.  
dor.mo.gov/taxation/individual/trust-funds.html.
                                                                                 7



- 8 -
If you do not file electronically with direct deposit, please   tax preparer and shall state the tax preparer’s Internal 
provide Form 5378 to prevent delay of your refund.              Revenue Service preparer tax identification number. Each 
Note: If you have any other liability due to the state of       failure by the paid tax return preparer to sign any income 
Missouri, such as child support payments, or a debt with        tax return or claim for refund, or failure of the tax return 
the Internal Revenue Service, your income tax refund may        preparer to provide a preparer tax identification number, 
be applied to that liability in accordance with Section         shall result in a penalty of $50 owed by the paid tax pre-
143.781, RSMo. You will be notified if your refund is offset    parer for each separate failure. The total amount of penal-
against any debt(s).                                            ties that may be assessed on any preparer with respect to 
                                                                returns or claims for refunds filed during a calendar year 
LINE 19 - AMOUNT DUE
                                                                shall not exceed $25,000.
If the amount due is greater than $500, you may owe an 
underpayment of estimated tax penalty. Complete an 
Underpayment of Estimated Tax for Individuals (Form 
MO-2210). If you owe a penalty, you cannot file a Form          MISSOURI ITEMIZED 
MO-1040A. You must file a Form MO-1040 and attach 
Form MO-2210.
                                                                DEDUCTIONS 
Payments must be postmarked by April 15, 2024, to avoid         You cannot itemize your Missouri deductions if you took the 
interest and late payment charges. The Department of            standard deduction on your federal return. See page 6, Line 
Rev e nue offers several options:                               5. You must itemize your Missouri deductions if you were 
                                                                re quired to itemize on your federal return.
Check or money order: Attach a check or money order 
(U.S. funds only), payable to Missouri Department of             LINE 1 - FEDERAL ITEMIZED DEDUCTIONS
Revenue. By submitting payment by check, you authorize 
the Department of Revenue to process the check                  Include your total federal itemized deductions from Federal 
electronically upon receipt.                                    Form 1040 or Federal Form 1040-SR, Line 12, and any 
                                                                approved cultural contributions (literary, musical, scholastic, 
Do not postdate. The Department of Revenue may 
electronically resubmit checks returned for insufficient        or artistic) to a tax exempt agency or institution that is 
or uncollected funds. If you mail your payment after your       operated on a not-for-profit basis. Cash contributions do not 
return is filed, attach your payment to the Individual          qualify.
Income Tax Payment Voucher (Form MO-1040V) found on 
page 15.                                                         LINE 2 - SOCIAL SECURITY TAX
Electronic Bank Draft (E-Check): By entering your bank          Social security tax is the amount in the social security tax 
routing number and check ing account number, you can pay        withheld box on Form(s) W-2. The amount cannot exceed 
on line at dor.mo.gov/taxation/individual/pay-online.html       $9,933. Enter the total on Line 2 of the Missouri Itemized 
or by calling (888) 929-0513. There will be a convenience       deductions, Page 14. 
fee to use this service.
                                                                 LINE 3 - RAILROAD RETIREMENT TAX
Credit Card: The Department accepts MasterCard, Discover,       Include the amount of railroad retirement tax withheld 
Visa, and American Express. To pay online, visit our website    from your wages, Tier I and Tier II, during 2023. The 
or call (888) 929-0513. The convenience fee is 2% of the total  amount cannot exceed $15,754. (Tier I maximum of 
amount due, plus $0.25 per card transaction, on all amounts     $9,933 and Tier II maximum of $5,821.)
and will be charged to your ac  count for processing credit 
card payments.                                                  If you have both social security and Tier I railroad 
                                                                retirement tax, the maximum deduction allowed is the 
Note: The convenience fees for credit card transactions         amount withheld as shown on the Form(s) W-2 minus, 
are paid to the third party vendor, not to the Missouri         either the amount entered on Federal Form 1040 or 
Department of Revenue. By accessing this payment system,        1040-SR, Schedule 3, Part 2, Line 11 or, if only one 
the user will be leaving Missouri’s website and connecting to   employer, the amount refunded by the employer.
the website of the third party vendor, which is a secure and 
confidential website.                                            LINE 4 - MEDICARE TAX
                                                                Include the total amount of Medicare tax for yourself and 
SIGN RETURN                                                     spouse (combined). If you are not subject to “additional 
You must sign Form MO-1040A. Both spouses must sign a           Medicare tax” on your federal return, enter the amount from 
                                                                your Form(s) W-2. If you are subject to “additional Medicare 
combined return. If you use a paid preparer, the preparer must 
                                                                tax” on your federal return, enter the amounts as calculated 
also sign the return. If you wish to authorize the Director of  below. You must attach a copy of Additional Medicare Tax 
Revenue to release information regarding your tax account to    (Federal Form 8959). 
your preparer or any member of your preparer’s firm, indicate 
by selecting the “yes” box below the signature line.             Wage income: Form(s) W-2, Box 6, plus Line 7 of  
                                                                   Federal Form 8959, minus Line 22 of Federal Form          
Each income tax return or claim for a refund prepared             8959; 
by a paid tax return preparer shall be signed by the paid 
                                                               8



- 9 -
 Railroad retirement compensation: Railroad retirement 
   Medicare tax withheld on Form(s) W-2, Box 14, plus Line 17 
   of Federal Form 8959, minus Line 23 of Federal Form 8959. 

 LINE 5 - SELF-EMPLOYMENT TAX
Include the amount from Federal Form 1040, Federal 
Form 1040-SR, or Federal Form 1040-NR: 
• Federal Schedule 2, Part 2, Line 4  
• Minus Federal Schedule 1, Part 2, Line 15 
• Plus Federal Form 8959, Line 13

 LINE 7 - STATE AND LOCAL INCOME TAXES
Include the amount of income taxes from Federal Form 
1040 or 1040-SR Schedule A, Line 5. The overall limit 
on state and local income taxes plus property taxes is 
$5,000 for married filing separately and $10,000 for all 
other taxpayers (single, married filing combined, head of 
household).  If the sum of these deductions exceeds this 
limit, use the worksheet for Net State Taxes to determine 
the state income tax portion of the state tax deduction.

 LINE 8 - EARNINGS TAXES
If you entered an amount on Line 7 and you live or work in 
the Kansas City or St. Louis area, you may have included 
earnings taxes. Include on Line 8 the amount of earnings 
taxes withheld shown on Form(s) W-2. See page 10, 
Diagram 1.

 LINE 10 - TOTAL MISSOURI ITEMIZED DEDUCTIONS
If your total Missouri itemized deductions are less than 
your standard deduction (see page 6, Line 5), you 
should take the standard deduction on the front of Form 
MO-1040A, Line 5, unless you were required to itemize 
your federal deductions.

                                                                                                              Federal Privacy Act Notice
                                                                                                        Section 143.961, RSMo, authorizes the Department to require the reporting of information 
                                                                                                        deemed necessary to enforce the income tax law of the state of Missouri. Section 143.961, 
                                                                                                        RSMo, is also made applicable to the property tax credit for procedural matters pursuant 
                                                                                                        to Section 135.015, RSMo. 42 U.S.C. Section 405(c)(2)(C) authorizes the states to require 
                                                                                                        taxpayers to provide social security numbers. The Department uses your social security number 
                                                                                                        to identify you and process your tax returns and other documents, to determine and collect 
                                                                                                        the correct amount of tax, to ensure you are complying with the tax laws, to offset tax refunds 
                                                                                                        against certain other tax liabilities or amounts due to a state agency, and where permitted 
                                                                                                        or required by law, to exchange tax information with the Internal Revenue Service, other 
                                                                                                        states, other state agencies, and the Multistate Tax Commission (see Chapters 32, 143, and 
                                                                                                        610, RSMo). It is mandatory that you provide your social security number on your tax return. 
          Personal Privacy Act Disclaimer                                                               Failure to provide your social security number may result in additional request(s) to you from 
 Pursuant to Section 105.1500, RSMo, the Department of Revenue is prohibited from requiring             the Department and may also result in the complete or partial denial of a refund or tax credit 
 any entity exempt from federal income tax under Section 501(c) of the Internal Revenue Code,           claimed on or with the return. (For further information about the Department’s authority to 
 or any individual, to provide the Department with any list, record, register, registry, roll, roster,  prescribe forms and to require furnishing of social security numbers, see Chapters 135 and 143, 
 or other compilation of data of any kind that directly or indirectly identifies a person as a          RSMo.)
 member, supporter, volunteer of, or donor of financial or nonfinancial support to, any entity 
 exempt from federal income tax under Section 501(c) of the Internal Revenue Code. Nothing in 
 this form should be read or understood as a requirement that you provide any such information. 
 Notwithstanding any publication, webpage, form, instruction, regulation, or statement shared 
 by the Department, you are not required to include such information on this form.

                                                                                                       9



- 10 -
                                                                                                  2023 Tax Chart
To identify your tax, use your Missouri taxable income from Form MO-1040A, Line 9 and the tax chart in Section A below. 
Calculate your Missouri tax using the online tax calculator at dor.mo.gov/taxation/individual/tax-types/income/ or by 
using the worksheet in Section B below. Round to the nearest whole dollar and enter on Form MO-1040A, Line 10.  

                                                                                                  Tax Rate Chart
                                                 If the Missouri taxable income is:                                                                                       The tax is: 

                                                $0 to $1,207  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .   $0
                                                Over $1,207 but not over $2,414   .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .    2.00% of excess over $1,207
                                                Over $2,414 but not over $3,621   .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .    $24 plus 2.50% of excess over $2,414 
                                                Over $3,621 but not over $4,828   .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .    $54 plus 3.00% of excess over $3,621
                                      Section A Over $4,828 but not over $6,035   .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .    $90 plus 3.50% of excess over $4,828
                                                Over $6,035 but not over $7,242   .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .    $132 plus 4.00% of excess over $6,035
                                                Over $7,242 but not over $8,449   .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .    $180 plus 4.50% of excess over $7,242
                                                Over $8,449  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .   $234 plus 4.95% of excess over $8,449

                                                                         Tax Calculation Worksheet
                                                                                                                      Yourself                                            Spouse      Example A       Example B
                                                 1.  Missouri taxable income (Form MO-1040A, 
                                                    Line 9) ...................................                 $   _____________     _____________                                   $ 3,090  $            12,000

                                                 2.  Enter the minimum taxable income for your tax 
                                                    bracket (see Section A above). If below $1,207 
                                                    enter $0 ..................................                 -  $   _____________  _____________                                -  $ 2,414   $             8,449

                                                 3.  Difference - Subtract Line 2 from Line 1 . . . . . . . . . =  $   _____________  _____________                              =  $            676  $     3,551
                                                 4.  Enter the percent for your tax bracket (see 
                                      Section    Section A above)...........................B                 _____________     _____________     X %                            % X    2.5%                4.95%
                                                 5.  Multiply Line 3 by the percent on Line 4 .........         =  $   _____________  _____________                                =  $ 16.90  $            175.77

                                                 6.  Enter the tax from your tax bracket - before 
                                                    applying the percent (see Section A above) . . . . . .      +  $   _____________  _____________                                +  $ 24  $               234

                                                 7.  Total Missouri Tax - Add Line 5 and 6. Enter here 
                                                    and on Form MO-1040A, Line 10 ..............                =  $   _____________  _____________                                =  $ 41  $               410
                                                                                                                                                                                        ($40.90         ($409.77
                                                                                                                                                                                      rounded to the  rounded to the 
                                                                                                                                                                                      nearest dollar) nearest dollar)

                                                 Missouri Taxes Withheld     Earnings Tax

                   Diagram 1: Form W-2

                                                                         2023

                                                                                                                    10



- 11 -
                          Form
                                     2023 Individual Income Tax Return  
  MO-1040A                           Single/Married (One Income)

Print in BLACK ink only and DO NOT STAPLE.
For Privacy Notice, see Instructions.

                          Federal Extension - Select this box if you have an approved federal 
                          extension. Attach a copy Federal Extension (Form 4868).                            Vendor Code                   Department Use Only

                           Department of Social Services Eligibility form attached.                             0 0 1

                              Single             Claimed as a            Married Filing            Married Filing                 Head of               Qualifying 
                                                 Dependent               Combined                  Separately                     Household             Widow(er)
             Filing Status
                                                        Age 65 or Older                      Blind                      100% Disabled       Non-Obligated Spouse
Select the appropriate 
boxes that apply.                                    Yourself Spouse                Yourself       Spouse       Yourself          Spouse    Yourself     Spouse

                                                                                        Deceased                                                         Deceased
                          Social Security Number                                        in 2023    Spouse’s Social Security Number                                in 2023

                                         -              -                                                               -           -
                          First Name                                     M.I.           Last Name                                                                   Suffix

             NameName
                          Spouse’s First Name                            M.I.           Spouse’s Last Name                                                          Suffix

                          In Care Of Name (Attorney, Executor, Personal Representative, etc.) Attach form if applicable.

                          Present Address (Include Apartment Number or Rural Route)

                          City, Town, or Post Office                                                                    State       ZIP Code
             Address                                                                                                                                    _

                          County of Residence

You may contribute to any one or all of the trust funds on Line 16. See instructions for more trust fund information.

                                                                                                                                                         Kansas 
                                                                                        Workers    LEAD                            General               City  
                                                                                                                                   Revenue               Regional 
                                                        Elderly Home     Missouri       Workers’   Childhood    Missouri Military                        Law            Soldiers  
                              Children’s      Veterans  Delivered Meals  National Guard Memorial   Lead Testing Family Relief     General  Organ Donor  Enforcement     Memorial   
Medal of Honor                Trust Fund     Trust Fund       Trust Fund Trust Fund     Fund       Fund         Fund              Revenue  Program Fund Memorial        Military Museum 
Fund                                                                                                                               Fund                 Foundation Fund in St. Louis Fund

                                                                         *23334010001*
                                                                                        23334010001
                                                                                                                                                          MO-1040A Page 1
                                                                                                 11



- 12 -
                   1.  Federal adjusted gross income from federal return (see page 6 of the instructions)..................                      1                . 00

      Income       2.  Any state income tax refund included in federal adjusted gross income  ....................                               2                . 00

                   3.  Total Missouri adjusted gross income...............................................                                       3                . 00

                 4a. Tax from federal return. Do not enter federal income tax withheld.                                      4a                  . 00

                 4b.  Federal tax percentage – Enter the percentage based on your Missouri
                 Adjusted Gross Income, Line 3. Use the chart below to find your
                 percentage. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4b                  %

                 Missouri Adjusted Gross Income Range, Line 3:      Federal Tax Percentage:
                 $25,000 or less ........................................................................35%
                 $25,001 to $50,000.................................................................. 25%
                 $50,001 to $100,000................................................................15%
                 $100,001 to $125,000............................................................... 5%
                 $125,001 or more .....................................................................0%

                 4c.  Federal income tax deduction – Multiply Line 4a by the percentage on Line 4b. Enter this 
      Deductions  amount not to exceed $5,000 for an individual or $10,000 for combined filers .  .  .  .  .  .  .  .  .  .  .  .                4c               . 00

                 5.  Missouri standard deduction or itemized deductions.
                        • Single or Married Filing Separate - $13,850
                        •  Head of Household - $20,800
                        •  Married Filing Combined or Qualifying Widow(er) - $27,700
                 If age 65 or older, blind, or claimed as a dependent, see federal return or page 6.  
                 If itemizing, see page 14 ........................................................                                              5                . 00

                   6.  Additional Exemption for Head of Household and Qualifying Widow(er) ....................                                  6                . 00

                   7.  Long-term care insurance deduction  ...............................................                                       7                . 00

                 8.  Total Deductions - Add Lines 4c through 7 ..........................................                                        8                . 00

                 9.  Missouri Taxable Income - Subtract Line 8 from Line 3.................................                                      9                . 00
            Tax
                10.  Tax - Use the tax chart on page 10 to figure the tax . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  10               . 00
                11.  Missouri tax withheld from Form(s) W-2 and 1099. 
                   Attach copies of Form(s) W-2 and 1099 .................................................                                       11               . 00

                12.  Missouri estimated tax payments made for 2023. 
                   Include overpayment from 2022 applied to 2023......................................                                           12               . 00

                13.  Total Payments - Add Lines 11 and 12 .............................................                                          13               . 00

                14.  If Line 13 is more than Line 10, enter the difference. This is your overpayment. 
                   If Line 13 is less than Line 10, skip to Line 19 ........................................                                     14               . 00
      Refund
                15.  Amount from Line 14 that you want applied to your 2024 estimated tax ....................                                   15               . 00

                16.  Enter the amount of your donation in the trust fund boxes below (see instructions for trust fund codes.)
                                                                                                            Elderly Home                         Missouri 
                      Children’s                 Veterans                                                   Delivered Meals                      National Guard 
                 16a. Trust Fund    . 00    16b. Trust Fund             . 00 16c.                           Trust Fund          . 00 16d.        Trust Fund     . 00

                                                 Childhood                                                  Missouri 
                      Workers’                   Lead                                                       Military Family                      General 
                 16e. Memorial Fund . 00    16f. Testing Fund           . 00 16g.                           Relief Fund         . 00 16h.        Revenue Fund   . 00
                 *23334020001*                                            12                                                                                     MO-1040A Page 2
                                 23334020001



- 13 -
                                                                           Kansas City                    Soldiers 
                                                                           Regional Law                   Memorial 
                                                                           Enforcement                    Military 
                                          Organ Donor                      Memorial                       Museum in  
                                     16i. Program Fund          .  00 16j. Foundation Fund        00 16k. St. Louis Fund     00  16l.       Medal of Honor  00

                                          Additional      Additional                         Additional   Additional 
                                          Fund            Fund                               Fund         Fund 
                                     16m. Code            Amount           . 00         16n. Code         Amount         . 00

                                       Total Donation - Add amounts from Boxes 16a through 16n and enter here  ................             16              . 00

               17.  Amount from Line 14 to be deposited into a Missouri 529 Education Plan (MOST)  
                                                                                                                                            17                00
              Refund (continued)       account. Enter amount from Line E of Form 5632.....................................                                  .

               18.                     REFUND - Subtract Lines 15, 16, and 17 from Line 14 and enter here.....................              18              . 00

                                                                      Reserved 

                                      19.   AMOUNT DUE - If Line 13 is less than Line 10, enter the difference here ................        19              . 00
                                  Due
       Amount 
                                     If you pay by check, you authorize the Department to process the check electronically. Any returned check may be presented again electronically. 

                                     Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best  
                                     of my knowledge and belief it is true, correct, and complete. By signing or entering my name in the “Signature” field(s) below, I am providing  
                                     the Department of Revenue with my signature as required under Section 143.561, RSMo. Declaration of preparer (other than taxpayer) is   
                                     based on all information of which he or she has knowledge. As provided in Chapter 143, RSMo., a penalty of up to $500 shall be  
                                     imposed  on  any  individual  who  files  a  frivolous  return.  I  also  declare  under  penalties  of  perjury  that  I  employ  no  illegal  or   
                                     unauthorized aliens as defined under federal law and that I am not eligible for any tax exemption, credit, or abatement  if I employ such  
                                     aliens.

                                     Signature                                                                               Date (MM/DD/YY)

                                     Spouse’s Signature (If filing combined, BOTH must sign)                                 Date (MM/DD/YY)

                                     E-mail Address                                                                          Daytime Telephone

              Signature              Preparer’s Signature                                                                    Date (MM/DD/YY)

                                     Preparer’s FEIN, SSN, or PTIN                                                           Preparer’s Telephone

                                     Preparer’s Address                                                                      State             ZIP Code

                                     I authorize the Director of Revenue or delegate to discuss my return and attachments with the preparer 
                                     or any member of the preparer’s firm ........................................................                    Yes    No

                                     Did you pay a tax return preparer to complete your return, but the preparer failed to sign the return or provide 
                                     an Internal Revenue Service preparer tax identification number?  If you marked yes, please insert the  
                                     preparer’s name, address, and phone number in the applicable sections of the signature block above.......        Yes    No

                                                                                             Department Use Only

                                     A                 FA             E10                    DE           F                                                .
                                                                                                                                                            MO-1040A Page 3
 *23334030001*                                                                                          13
                                                     23334030001



- 14 -
                                                                                                                                                                                     •  Complete this section only if you itemized deductions on your federal return (see the information on pages 6, 8 and 9). 
                                                                                                                                                                                     •  Attach a copy of your Federal Form 1040 or 1040-SR (pages 1 and 2) and Federal Schedule A.  
                                                                                                                                                                                     •  If you are subject to “additional Medicare tax”, attach a copy of Federal Form 8959.

                                                                                                                                                        1.  Total federal itemized deductions (from Federal Form 1040 or 1040-SR, Line 12)............                                       1                  . 00

                                                                                                                                                        2.  2023 Social security tax .........................................................                                               2                  . 00

                                                                                                                                                        3.  2023 Railroad retirement tax (Tier I and Tier II).......................................                                         3                  . 00

                                                                                                                                                        4.  2023 Medicare tax (see instructions on page 8 and 9) ...................................                                         4                  . 00

                                                                                                                                                        5.  2023 Self-employment tax (see instructions on page 9) ................................                                           5                  . 00

                                                                                                                                                        6.  Total - Add Lines 1 through 5.....................................................                                               6                  . 00
                                                                                                                                                         7.  State and local income taxes from Federal Schedule A, 
                                                                                                                                                      Missouri Itemized Deductions     Line 5a or Enter $0 if completing the worksheet below ..........  7                               . 00
                                                                                                                                                        8.  Earnings taxes included in Line 7 (see instructions on page 9)....                           8                               . 00

                                                                                                                                                        9.  Net state income taxes - Subtract Line 8 from Line 7 or enter Line 7 from worksheet below ....                                   9                  . 00

                                                                                                                                                       10.  Missouri Itemized Deductions - Subtract Line 9 from Line 6. Enter here and on Form MO-1040A,
                                                                                                                                                                                       Line 5. ...........................................................................                   10                 . 00

                                                                                                                                                                                                  Note: If Line 10 is less than your federal standard deduction, see information on page 6.

                                                                                                                                                                                    Complete this worksheet only if your total state and local taxes included in your federal itemized deductions
                                                                                                                                                                                    (Federal Schedule A, Line 5d) exceeds $10,000 (or $5,000 for married filing separate taxpayers).

                                                                                                                                                                                    1.  Enter the sum of your state and local taxes on Federal Form 1040 or 1040-SR, 
                                                                                                                                                                                     Schedule A, Line 5d. ..............................................................                   1                    . 00

                                                                                                                                                                                    2.  State and local income taxes from Federal Form 1040 or 1040-SR, Schedule A, Line 5a.    .......    2                    . 00

                                                                                                                                                                                    3.  Earnings taxes included on Federal Form 1040 or 1040-SR, Schedule A, Line 5a  ..........             3
                                                                                                                                                                                                                                                                                                                . 00
                                                                                                                                                                                    4.  Subtract Line 3 from Line 2. .....................................................                 4
                                                                                                                                                                                                                                                                                                                . 00
                                                                                                                                                                                    5.  Divide Line 4 by Line 1.........................................................                     5                    %

                                                                                                                                                                                    6.  Enter $10,000 ($5,000 if married filing separately).  ..................................             6                  . 00

                                                                                                                                                                                    7.  Multiply Line 6 by percentage on Line 5. Enter here and on Missouri Itemized Deductions,  
                                                                                                                                                                                     Line 9, above. ...............................................................                        7                    . 00

                                                                                                                                                                                                                    *23334040001*
                                                                           Worksheet for Net State Income tax, Line 9 of  Missouri Itemized Deductions
                                                                                                                                                                                                                                 23334040001
                                                                                                                                                                                                                                                                                                Form MO-1040A (Revised 12-2023)
Mail to:                                                                                                                                                                             Balance Due:                   Refund or No Amount Due:               Fax:  (573) 522-1762
                                                                                                                                                                                     Missouri Department of Revenue Missouri Department of Revenue         Email: incometaxprocessing@dor.mo.gov 
                                                                                                                                                                                     P.O. Box 329                   P.O. Box 500                           Submission of Individual Income Tax returns
                                                                                                                                                                                     Jefferson City, MO 65105-0329  Jefferson City, MO 65105-0500          Email:  income@dor.mo.gov
                                                                                                                                                                                     Phone:  (573) 751-5860         Phone:  (573) 751-3505                 Inquiry and correspondence 
                                                                                                                                                                                                                     
Ever served on active duty in the United States Armed Forces?                                                                                                                                                                                            Visit: dor.mo.gov/taxation/individual/tax-types/income/ 
If yes, visit dor.mo.gov/military/ to see the services and benefits we offer to all eligible                                                                                                                                                                                for additional information.
military individuals. A list of all state agency resources and benefits can be found at 
veteranbenefits.mo.gov/state-benefits/.                                                                                                                                                                                          14                                                              MO-1040A Page 4



- 15 -
                                                                                              Ever served on active duty in the United States Armed Forces? 
      Form                                                                                    If yes, visit dor.mo.gov/military/ to see the services and benefits we offer to all 
     MO-1040V        2023 Individual Income Tax Payment Voucher                               eligible military individuals. A list of all state agency resources and benefits can  
                                                                                              be found at veteranbenefits.mo.gov/state-benefits/.

What Is Form MO-1040V and Why Should I Use It?                                         How Do I Make My Payment?
Form MO-1040V, Individual Income Tax Payment Voucher, is the                           • Make your check or money order payable to the “Missouri 
voucher you send with your payment when you do not make the                            Department of Reve nue.” Do not send cash. Do not postdate your 
payment with your income tax return. It is similar to vouchers returned                check; it will be cashed upon receipt. The Department of Revenue 
with loan, utility, and credit card payments. Form MO-1040V ensures                    may collect on checks returned for insufficient or uncollected funds 
that your payment will be processed more efficiently and accurately.                   electronically. (U.S. funds only)
Form MO-1040V allows you to file your completed income tax return                      • Write your name, address, SSN, daytime telephone number, and 
and send your payment at a later date. Your income tax return and                      “2023 MO Income Tax” on your check or money order.
payment are due no later than April 15, 2024.                                          • Detach the payment voucher at the perforation, and mail with your 
When Should I Use Form MO-1040V?                                                       payment. Do not mail a copy of your previously filed return.
If you have an amount due on an electronically filed return, or do not                 • Please mail your Form MO-1040V and payment to:
submit payment in full when you file your income tax return, send                      Missouri Department of Revenue
Form MO-1040V with your payment. DO NOT use Form MO-1040V                              P.O. Box 371
for making extension payments. Please use Form MO-60 or visit our                      Jefferson City, MO 65105-0371
website to pay online.                                                                 Please print as shown below in black or dark blue ink. Do not use 
How Do I Fill In the Payment Voucher?                                                  red ink or pencil. 
Complete the name(s) and address block.                                                                      1  2  3  4                A  B  C   D
 Social Security Number - Enter your social security number (SSN). 
    If you are filing a combined return, enter your and your spouse’s 
    SSN(s) in the order they appear on the return; placing your                                             Federal Privacy Act Notice
    spouse’s SSN in the appropriate field below.                                       Section 143.961, RSMo, authorizes the Department to require the reporting of information 
  Name Control - Enter the first four letters of your last name.                      deemed necessary to enforce the income tax law of the state of Missouri. Section 143.961, 
                                                                                       RSMo, is also made applicable to the property tax credit for procedural matters pursuant 
    See examples. If you are filing a combined return, enter your                      to Section 135.015, RSMo. 42 U.S.C. Section 405(c)(2)(C) authorizes the states to require 
    and your spouse’s name control in the order they appear on the                     taxpayers to provide social security numbers. The Department uses your social security number 
                                                                                       to identify you and process your tax returns and other documents, to determine and collect 
    return, placing your spouse’s name control in the appropriate                      the correct amount of tax, to ensure you are complying with the tax laws, to offset tax refunds 
    field below.                                                                       against certain other tax liabilities or amounts due to a state agency, and where permitted 
                                                                                       or required by law, to exchange tax information with the Internal Revenue Service, other 
      Name                     Enter                                                   states, other state agencies, and the Multistate Tax Commission (see Chapters 32, 143, and 
      John Brown               BROW                                                    610, RSMo). It is mandatory that you provide your social security number on your tax return. 
      Juan De Jesus            DEJE                                                    Failure to provide your social security number may result in additional request(s) to you from 
                                                                                       the Department and may also result in the complete or partial denial of a refund or tax credit 
      Joan A. Lee              LEE      Please use capital                             claimed on or with the return. (For further information about the Department’s authority to 
      Jean McCarthy            MCCA     letters as shown.                              prescribe forms and to require furnishing of social security numbers, see Chapters 135 and 143, 
      John O’Neill             ONEI                                                    RSMo.)
      Pedro Torres-Lopez       TORR }
 Amount of Payment - Enter the amount of your payment in whole  
      dollars. 

                                                                                       Social Security
                 2023 Individual Income Tax                                            Number                         -          -
                 Payment Voucher (Form MO-1040V)
                                                                                       Name Control ..................................
Please print. Make check payable to Missouri Department of Revenue. Mail Form 
MO-1040V and payment to the Missouri Department of Revenue, P.O. Box 371,              Spouse’s Social 
Jefferson City, MO 65105-0371.                                                         Security Number                -          -
 Name 
                                                                                       Spouse’s Name Control . . . . . . . . . . . . . . . . . . . . . . . . . .
 Spouse’s Name                                                                         Amount of Payment
                                                                                       (U.S. funds only)............. $                                         .
 Street Address
                                                                                              *23347010001*
 City                                            State ZIP Code                                             23347010001

Full payment of taxes must be submitted by April 15, 2024 to avoid interest and               Department Use Only                                               .
additions to tax for failure to pay. If you pay by check, you authorize the Department 
of Revenue to process the check electronically. Any returned check may be presented           Department Use Only
again electronically.

                                                                              15



- 16 -
Visit our website at dor.mo.gov/taxation/individual/tax-types/income/ 
                                                       
In addition to electronic filing information found on our website, you can: 

•  Use our fill-in forms that automatically calculate   •  Pay your taxes online 
•  Download Missouri and federal tax forms              •  Find the status of your refund or balance due
•  Find answers to frequently asked questions           •  Find a copy of the Missouri Taxpayer Bill of Rights

                    Important Phone Numbers
General Inquiry Line ........................................................ (573) 751-3505
Automated Refund, Balance Due, and 1099G Inquiry  ......... (573) 526-8299
Electronic Filing Information ............................................ (573) 751-3505

Individuals with speech or hearing impairments may use TTY  
             (800) 735-2966 or fax (573) 522-1762.

                     Missouri Return Status System
                    dor.mo.gov/taxation/return-status/
Return Status available for 2018 through 2023 Tax Returns

                                                      16






PDF file checksum: 185105678

(Plugin #1/9.12/13.0)