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Form 83-391-23-3-1-000 (Rev. 01/24)
0606 0707 080 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 808 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80
0404 Mississippi 0404
0505 Insurance Company Income Tax Return 0505
0606 833912331000 2023 0606
0707 0707
0808 Tax Year Beginning 99999999 Tax Year Ending 99999999 0808
0909 0909
1010 FEIN 999999999 Mississippi Secretary of State ID 9999999999 1010
1111 1111
1212 Legal Name and DBA CHECK ALL THAT APPLY 1212
1313 X9X9X9X9X9X9X9X9X9X9X9X9X9X9X9X9X9X9X9X9X9 1313
1414 Address X Amended Return X Accident and Health 1414
1515 X9X9X9X9X9X9X9X9X9X9X9X9X9X9X9X9X9X9X9X9X9 1515
1616 X Final Return X Fire and Casualty 1616
1717 X9X9X9X9X9X9X9X9X9X9X9X9X9X9X9X9X9X9X9X9X9 1717
1818 City State Zip +4 Life Insurance 1818
X
1919 X9X9X9X9X9X9X9X9X9X9X9X9X9X9 XX 999999999 X Accrual Basis 1919
2020 2020
2121 County Code 99 NAICS Code 999999 X Receipts and 2121
2222 Disbursements Basis 2222
2323 COMPUTATION OF TAX (ROUND TO THE NEAREST DOLLAR) 2323
2424 2424
2525 X Combined income tax return (enter FEIN of reporting company) 999999999 2525
2626 2626
2727 1 Mississippi net taxable income (from page 2, line 17A or Form 83-310, page 1, line 5, column C) 1 99999999999 2727
2828 2828
2929 2 Income tax 2 9999999999 2929
3030 3030
3131 3 Retaliatory taxes paid to other states (Mississippi corporations only; from page 4, part V, line 1) 3 9999999999 3131
3232 3232
3333 4 Income tax credits (from Form 83-401, line 3 or Form 83-310, page 1, line 5, column B) 4 9999999999 3333
3434 3434
3535 5 Net income tax due (line 2 minus line 3 and line 4) 5 9999999999 3535
3636 3636
3737 PAYMENTS AND TAX DUE 3737
3838 3838
3939 6 Overpayment from prior year 6 9999999999 3939
4040 4040
4141 7 Estimated tax payments and payment with extension 7 9999999999 4141
4242 4242
4343 8 Total payments (line 6 plus line 7) 8 9999999999 4343
4444 4444
4545 9 Net total income tax due (line 5 minus line 8) 9 9999999999 4545
4646 4646
4747 10 Interest and penalty on underestimated income tax payments (from Form 83-305, line 19) 10 9999999999 4747
4848 4848
4949 11 Late payment interest 11 9999999999 4949
5050 5050
5151 12 Late payment penalty 12 9999999999 5151
5252 5252
5353 13 Late filing penalty (minimum $100) 13 9999999999 5353
5454 5454
5555 14 Total balance due (if line 5 is larger than line 8, add lines 9 through 13) 14 9999999999 5555
5656 5656
5757 15 Total overpayment (if line 8 is larger than line 5, subtract line 5 from line 8) 15 9999999999 5757
5858 5858
5959 16 Total overpayment credited to next year (from line 15) 16 9999999999 5959
6060 6060
6161 17 Total overpayment refunded (line 15 minus line 16) 17 9999999999 6161
6262 6262
6363 6363
0606 0707 080 09 10 11 12 13 14 15 16 17See instructions for electronic payment options or attach check or money order for balance due.18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 808 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80
