Form 80-106-22-8-1-000 (Rev. 10/22)
                                                    Mississippi 
                                            Individual / Fiduciary Income Tax Voucher 

Instructions 

Who Must Make Estimated Tax Payments
Every individual taxpayer who does not have at least eighty percent (80%) of his/her annual tax liability prepaid through withholding must make
estimated tax payments if his/her annual tax liability exceeds two hundred dollars ($200).  For more information about the payment and calculation of
estimated income tax payments, please see the Individual Income Tax Return Instructions, Form 80-100.

Return Payments
This voucher may be used to make return payments for tax due on the Individual Income Tax Return (Form 80-105), Non-Resident Income Tax Return
(Form 80-205) and the Fiduciary Income Tax Return (Form 81-110).

Extension Payments
This voucher may be used to make extension payments for tax due on the Individual Income Tax Return (Form 80-105), Non-Resident Income Tax
Return (Form 80-205) and the Fiduciary Income Tax Return (Form 81-110).  Extension payments should be filed and paid on or before April 15th.

Payment Options
• To pay this amount online, go to www.dor.ms.gov, click on Taxpayer Access Point (TAP) and follow the instructions.

• To pay by check or money order, complete the payment coupon below:
- Make the check or money order payable to Department of Revenue
- Mail the payment coupon and check/money order with return to:  P.O. Box 23050, Jackson, MS  39225-3050
- Mail the payment coupon and check/money order without return to:  P.O. Box 23192, Jackson, MS  39225-3192
- Check the appropriate box on the voucher for the payment type you are remitting.
- Check the amended return box on the voucher if you are making a payment with an amended return.
- Write the identification number on the check or money order.
- Duplex forms or photocopies are NOT acceptable.

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                                                                                                             Print Form
Form 80-106-22-8-1-000 (Rev. 10/22)
                                                              Mississippi                            Tax Year Beginning 
                                            Individual / Fiduciary Income Tax                                           m m d d y  y  y  y 
     801062281000                                   Payment Voucher                                  Tax Year Ending  
                                                                                                                        m m d d        y  y  y  y 
Taxpayer SSN/ITIN                                                                          Trust FEIN
Spouse SSN/ITIN                                                     Name of Estate / Trust 
                                                                    (if fiduciary payment)
    Taxpayer First Name             Initial         Last Name                              Payment Type (Check One)     Account Type (Check One)
                                                                                           Quarterly Estimate Payment
  Spouse First Name                 Initial         Last Name 
                                                                                           Return Payment                   Individual Income
Address
                                                                                           Extension Payment                Fiduciary Income
City                                          State     Zip
                                                                                           Amended Return Payment

                                                                    Amount Paid                                                                    00
                                                                                                                                                  .
     Mail with return to: Department of Revenue, P.O. Box 23050, Jackson, MS 39225-3050
     Mail without return to: Department of Revenue, P.O. Box 23192, Jackson, MS 39225-3192