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Scanband Version of Form 72-205-01-5
Special Tax Return
This form is not to be used by your taxpayer until the July 2001 tax period that is due by August 20, 2001. The use of the
attached form prior to August 2001, will result in such form being sent back to the taxpayer without processing. A penalty may
be assessed to you or the taxpayer.
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MS Mississippi
Special Tax Return SP
722050131000 Instructions: See reverse. Due 1st to 20th; Delinquent Form 72-205-01-3-1-000 (Rev. 7/01) DIRECT 030
after 20th.This form must be filed even if no fee is due.
Copies or reproductions of the official form are NOT Tax Calculation
acceptable.
AD Address Change ACCOUNT NUMBER TAX PERIOD Taxable Amount Rate of Tax Amount of Tax
Make changes below
AC TP 1. Rate 1 x 1/2%=
Close account
FN Final Return 2. Rate 2 x 1% =
FILING STATUS DUE ON OR BEFORE 3. Rate 3 x 1 1/2%=
AM Amended Return FS DD 4. Rate 4 x 2% =
Replace original return
5. Rate 5 x 2 1/2%=
AT Additional Tax Rate 6 x 3% =
Supplement original return 6.
7. Net Tax Due
8. Late Filing Penalty (See Instructions)
9. Credit Adjustments (See Instructions)
I declare, under the penalties of perjury, that this return (including any accompanying
schedules) has been examined by me and to the best of my knowledge and belief is a 10. Additional Assessments (See Instructions)
true, correct and complete return.
11. Total Due
Signature of Taxpayer or Agent Phone Date
Cut on Dotted Line Before Filing
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MS Mississippi
Special Tax Return SP
722050131000 Instructions: See reverse. Due 1st to 20th; Delinquent Form 72-205-01-3-1-000 (Rev. 7/01) DIRECT 030
after 20th.This form must be filed even if no fee is due.
Copies or reproductions of the official form are NOT Tax Calculation
acceptable.
6/8 Address Change ACCOUNT NUMBER TAX PERIOD Taxable Amount Rate of Tax Amount of Tax
Make changes below
20/9 to 32/9 35/9 to 42/9 1. Rate 1 56/9 to 64/9 x 1/2%= 73/9 to 79/9
6/10 Final Return 2. Rate 2 56/10 to 64/10 x 1% = 73/10 to 79/10
Close account
FILING STATUS DUE ON OR BEFORE 3. Rate 3 56/11 to 64/11 x 1 1/2%= 73/11 to 79/11
6/12 Amended Return 20/12 to 32/12 35/12 to 43/12 4. Rate 4 56/12 to 64/12 x 2% = 73/12 to 79/12
Replace original return
5. Rate 5 56/13 to 64/13 x 2 1/2%= 73/13 to 79/13
6/14 Additional Tax Rate 6 56/14 to 64/14 x 3% = 73/14 to 79/14
Supplement original return 6.
7. Net Tax Due 73/15 to 79/15
8. Late Filing Penalty (See Instructions) 73/16 to 79/16
9. Credit Adjustments (See Instructions) 73/17 to 79/17
I declare, under the penalties of perjury, that this return (including any accompanying 73/18 to 79/18
schedules) has been examined by me and to the best of my knowledge and belief is a 10. Additional Assessments (See Instructions)
true, correct and complete return. 73/19 to 79/19
11. Total Due
Signature of Taxpayer or Agent Phone Date
Cut on Dotted Line Before Filing
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MS Mississippi
Special Tax Return SP
722050131000 Instructions: See reverse. Due 1st to 20th; Delinquent Form 72-205-01-3-1-000 (Rev. 7/01) DIRECT 030
after 20th.This form must be filed even if no fee is due.
Copies or reproductions of the official form are NOT Tax Calculation
acceptable.
Address Change ACCOUNT NUMBER TAX PERIOD Taxable Amount Rate of Tax Amount of Tax
Y Make changes below
025-12345-7 07 09 01 1. Rate 1 0 x 1/2%= 0
Final Return
N Close account 2. Rate 2 0 x 1% = 0
FILING STATUS DUE ON OR BEFORE 3. Rate 3 0 x 1 1/2%= 0
Amended Return
N Replace original return Quarterly 10/20/01 4. Rate 4 0 x 2% = 0
5. Rate 5 0 x 2 1/2%= 0
Additional Tax
N Supplement original return John's Road House 6. Rate 6 99000000 x 3% = 2970000
123 Road House Rd. 7. Net Tax Due 2970000
Raymond, Ms 39154 8. Late Filing Penalty (See Instructions) 0
9. Credit Adjustments (See Instructions) 0
I declare, under the penalties of perjury, that this return (including any accompanying
schedules) has been examined by me and to the best of my knowledge and belief is a 10. Additional Assessments (See Instructions) 0
true, correct and complete return.
11. Total Due 2970000
Signature of Taxpayer or Agent Phone Date
Cut on Dotted Line Before Filing
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Key to Data Fields for the Mississippi Special Return 72-205-01-3
Key to the data fields for the sales tax coupon form version for 2001/2002, Form Number 72-205-01-3. All grid locations are presented as: x/y
the beginning location to x/y as the ending location on the 10/6 grid.
Page 1
The top left corner of the barcode is located at position 6/4 to 20/4.
The top right registration mark is located at the top right corner at grid 80/4.
The lower left registation mark is located at the lower left corner at grid 6/25.
"MS" to the left of the header must begin at grid 27/4 and end at grid 28/4 and is in a Courier 12pt.
The "SP" in the right corner begins at grid space 70/4 and ends at grid 73/4 and is Arial 18 pt.
If a draft version of this form is released in your software, the print function must be disabled. If a draft version is filed, it will be returned to
the taxpayer and a penalty may apply to you or your customer.
Provider forms are only accepted after approval. It is not acceptable for a taxpayer to print out a blank copy of the form and hand complete it.
A hand completed version of a provider form will be sent back to the taxpayer and a penalty may apply to you or your customer. All forms
must be original laser printed forms. Photocopies are NOT acceptable.
The following is the labeling and the description of the items to be included in this form. The beginning and ending data positions are included
in one of the templates for this form. The field length is included in this key for each data position. Grid positioning given is from the first grid
space and through the last grid space included in a data field. (Example 27/10 to 36/10 is 10 grid spaces). Use this information to position the
data on the returns. Do not use a grid overlay to determine the positions from a printed paper form. The field length specified assumes using a
Courier 12pt. font or OCR-A 12pt. font, which are the required fonts. All data fields should be right justified. All fields must be filled. If the
field is blank a "0" should be used for numeric field, an "N" should be used for an alpha field.
The money fields should not contain any commas, cents, decimals or other formatting information except for the negative signs (-) as a leading
indicator for any negative amount.
Front (Page 1) of the form:
Field Name Description
AC Account Number - The account number field should be 11 digits long and contain leading zeros. The last digit in the
account number is a check digit. This will be part of the account number funished to the taxpayer. Data position is
20/9 to 32/9.
TP Tax Period - Taxpayer may file monthly, quarterly, or annual. Example - July of 2001 should appear as 07 01. The
third quarter of 2001 sales tax year should appear as 07 09 01. Allowable periods are: Quarterly - July thru Sept.,
2001, Oct. thru Dec., 2001, Jan. thru Mar., 2002 and Apr. thru June, 2002. Annual Jan. thru Dec., 2001 and should
appear as 01 12 01. This field is 5 to 8 characters long. Data position is 35/9 tp 42/9.
AD Address Change - Y or N in the form. If this is Y, then the new address should be entered in the address field in the
body of the form. An N if there is no change. This field is 1 character long. Data position is 6/8.
FN Final Return - Y or N in the form. This should be Y if this is the last return and the account should be closed. An N if
there is no change. This field is 1 character long. Data position is 6/10.
AM Amended Return - Y or N in the body of the form. If Y, this return should replace the original return, not supplement
it. An N if there is no change. This field is 1 character long. Data position is 6/12.
AT Additional Tax - Y or N in the form. If Y, this is additional tax that should supplement the original return. An N if
there is no change.This field is 1 character long. Data position is 6/14.
FS Filing Status - This should be monthly, quarterly, or annual. This field is 13 characters long. Data position is 20/12
to 32/12.
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| DD Due Date - The due date should always be the 20th of the month following the period for which the tax is due. Example - January 2002 will be due on February 20, 2002. This field is 9 characters long. Data Position is 35/12 to 43/12. 1 Column 1 is the taxable amount. The field is numeric and is 8 characters long. Data position is 56/9 to 64/9. The rate is always 1/2%. Column 2 is the tax due on column 1. The second field is a numeric field and is 7 characters long. Data position is 73/9 to 79/9. 2 Column 1 is the taxable amount. The field is numeric and is 8 characters long. Data position is 56/10 to 64/10. The rate is always 1%. Column 2 is the tax due on column 1. The second field is a numeric field and is 7 characters long. Data position is 73/10 to 79/10. 3 Column 1 is the taxable amount. The field is numeric and is 8 characters long. Data position is 56/11 to 64/11. The rate is always 1 1/2%. Column 2 is the tax due on column 1. The second field is a numeric field and is 7 characters long. Data position is 73/11 to 79/11. 4 Column 1 is the taxable amount. The field is numeric and is 8 characters long. Data position is 56/12 to 64/12. The rate is always 2%. Column 2 is the tax due on column 1. The second field is a numeric field and is 7 characters long. Data position is 73/12 to 79/12. 5 Column 1 is the taxable amount. The field is numeric and is 8 characters long. Data position is 56/13 to 64/13. The rate is always 2 1/2%. Column 2 is the tax due on column 1. The second field is a numeric field and is 7 characters long. Data position is 73/13 to 79/13. 6 Column 1 is the taxable amount. The field is numeric and is 8 characters long. Data position is 56/14 to 64/14. The rate is always 3%. Column 2 is the tax due on column 1. The second field is a numeric field and is 7 characters long. Data position is 73/14 to 79/14. 7 This is a money field and is 7 characters long. Data position is 73/15 to 79/15. 8 This is a money field and is 7 characters long. Data position is 73/16 to 79/16. 9 This is a money field and is 7 characters long. Data position is 73/17 to 79/17. 10 This is a money field and is 7 characters long. Data position is 73/18 to 79/18. 11 This is a money field and is 7 characters long. Data position is 73/19 to 79/19. |
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Form 72-205-01-1-2-000 (Rev. 4/01)
Mississippi
Special Tax Return
Instructions
General Instructions
This return is for reporting Special Tax. DO NOT REPORT STATE SALES TAX ON THIS RETURN.
Filling in the return
All dollar amounts should be rounded to the nearest whole dollar (no pennies). Round down to the next lower dollar any figure
under $.50 and round up to the next higher dollar any figure $.50 and over.
Sending in the return
Include this return and your check or money order for the amount on Line 5 in the envelope provided with your Sales Tax Return
and mail to the Tax Commission, P.O. Box 960, Jackson, MS 39205.
Account Number
If your return does not have your account number preprinted, or if you are filing a return without a label, please enter your account
number in the boxes provided below the label or area for your name and address.
Filing Period
You must use a standard filing period. The use of any other period may cause a penalty notice to be issued.
Monthly must be 01, 02, 03, 04, 05, 06, 07, 08, 09, 10, 11 or 12.
Quarters must be 01 to 03 (Jan to Mar), 04 to 06 (Apr to June), 07 to 09 (July to Sept) or 10 to 12 (Oct to Dec).
Annual periods must be 01 to 12 (Jan. to Dec).
Line Items Instructions
Column 1
Enter the total taxable income beside the appropriate rate.
Column 2
The appropriate rate of tax for each line in Column 1 has been entered for you.
Column 3
Enter the result of multiplying taxable income (Column 1) by the tax rate (Column 2)
Line 1: Total Tax Due
Enter the total of all entries in Column 3.
Line 2: Credit Adjustments
Enter any authorized credit memos. Only credit memos received from the Tax Commission should be entered on this line.
Line 3: Additional Assessments
Enter any additional assessments. Only additional assessments received from the Tax Commission should be entered on this line.
Line 4: Net Tax Due
Enter the net total of Lines 1, 2 and 3.
Line 5: Penalty
Enter the applicable penalty if the return is filed late. The minimum penalty is 10%.
Line 6: Total Due
Enter the total of Lines 4 and 5.
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