Form 81-110-22-8-1-000 (Rev. 10/22) Reset Form
Mississippi Print Form
Amended
Fiduciary Income Tax Return
811102281000 (For Estates and Trusts)
Tax Year Beginning 2022 Tax Year Ending
m m d d y y y y m m d d y y y y
Date entity created Date of decedent's death Entity FEIN
Decedent / Debtor SSN
m m d d y y y y m m d d y y y y
Check All That Apply Type of Entity
Name of Estate or Trust
Initial Return Decedent's Estate
Name and Title of Fiduciary Short Period Return Bankruptcy Estate-Ch. 7
Final Return Bankruptcy Estate-Ch. 11
Mailing Address Simple Trust
Date of confirmation Complex Trust
City State Zip County Code Grantor Type Trust
m m d d y y y y Qualified Disability Trust
Date of closure ESBT (S Portion Only)
Number of Mississippi K-1
Pooled Income Fund
schedules attached m m d d y y y y
MISSISSIPPI INCOME TAX
1 Mississippi taxable income (loss) (from page 2, line 26) 1 .00
2 Total income tax due (see instructions) 2 00
.
3 Credit from tax paid to another state (from Form 80-160, line 14; attach other state return) 3 .00
4 Credit for tax paid on an electing Pass-Through Entity Tax Return (from Form 80-161, line 3d) 4 00
.
5 Other credits (attach Form 80-401) 5 .00
6 Net income tax due (line 2 minus line 3, line 4 and line 5) 6 00
.
PAYMENTS
7 Mississippi income tax withheld (complete Form 80-107) 7 .00
8 Estimated tax payments, extension payments and/or amount paid on original return 8 00
.
9 Refund received and/or amount carried forward from original return (amended return only) 9 .00
10 Total payments (line 7 plus line 8 minus line 9) 10 .00
REFUND OR BALANCE DUE
11 Enter amount of overpayment (if line 10 is more than line 6, subtract line 6 from line 10) 11 00
.
12 Overpayment to be applied to next year estimate tax account 12 00
.
13 Overpayment refund (line 11 minus line 12) REFUND 13 00
.
14 Balance due (if line 6 is more than line 10, subtract line 10 from line 6) BALANCE DUE 14 00
.
15 Interest and penalty (see instructions) 15 00
.
16 Total due (line 14 plus line 15) AMOUNT YOU OWE 16 .00
This return may be discussed with the preparer Yes No
I declare, under penalties of perjury, that I have examined this return and accompanying schedules and statements, and to the best of my knowledge and belief,
this is a true, correct and complete return. Declaration of preparer (other than taxpayer) is based on all information of which preparer has any knowledge.
Signature of Fiduciary or Officer Representing Fiduciary Date Phone Number FEIN of Fiduciary
Paid Preparer Signature Date Paid Preparer Phone Number Paid Preparer PTIN
Paid Preparer Address City State Zip Code
Mail REFUND To: Department of Revenue, P.O. Box 23058, Jackson, MS 39225-3058
Mail All Other Returns To: Department of Revenue, P.O. Box 23050, Jackson, MS 39225-3050
Duplex and Photocopies are NOT Acceptable