Form 80-161-22-3-1-000 (Rev. 09/22)
0606 0707 08009 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 0404
0505 Mississippi Page 1 0505
0606 801612231000 Tax Credit For Income Tax Paid 0606
0707 By Electing Pass-Through Entity 0707
0808 0808
0909 0909
1010 1010
1111 Name XXXXXXXXXXXXXXXXXXX SSN 999999999 1111
1212 1212
1313 Enter the name, FEIN, Mississippi taxable income and the amount of taxes paid on your behalf by electing pass-through entities. The Mississippi K-1s 1313
1414 you received from electing pass-through entities must be attached to the return. 1414
1515 1515
1616 COLUMN A COLUMN B COLUMN C COLUMN D 1616
1717 NAME OF ENTITY FEIN MISSISSIPPI TAXABLE INCOME AMOUNT OF TAX PAID 1717
1818 1818
1919 XXXXXXXXXXXXXXXXXXX 999999999 9999999999 9999999999 1919
2020 2020
2121 XXXXXXXXXXXXXXXXXXX 999999999 9999999999 9999999999 2121
2222 2222
2323 XXXXXXXXXXXXXXXXXXX 999999999 9999999999 9999999999 2323
2424 2424
2525 XXXXXXXXXXXXXXXXXXX 999999999 9999999999 9999999999 2525
2626 2626
2727 XXXXXXXXXXXXXXXXXXX 999999999 9999999999 9999999999 2727
2828 2828
2929 XXXXXXXXXXXXXXXXXXX 999999999 9999999999 9999999999 2929
3030 3030
3131 XXXXXXXXXXXXXXXXXXX 999999999 9999999999 9999999999 3131
3232 3232
3333 XXXXXXXXXXXXXXXXXXX 999999999 9999999999 9999999999 3333
3434 3434
3535 XXXXXXXXXXXXXXXXXXX 999999999 9999999999 9999999999 3535
3636 3636
3737 XXXXXXXXXXXXXXXXXXX 999999999 9999999999 9999999999 3737
3838 3838
3939 XXXXXXXXXXXXXXXXXXX 999999999 9999999999 9999999999 3939
4040 4040
4141 XXXXXXXXXXXXXXXXXXX 999999999 9999999999 9999999999 4141
4242 4242
4343 XXXXXXXXXXXXXXXXXXX 999999999 9999999999 9999999999 4343
4444 4444
4545 XXXXXXXXXXXXXXXXXXX 999999999 9999999999 9999999999 4545
4646 4646
4747 XXXXXXXXXXXXXXXXXXX 999999999 9999999999 9999999999 4747
4848 4848
4949 XXXXXXXXXXXXXXXXXXX 999999999 9999999999 9999999999 4949
5050 5050
5151 XXXXXXXXXXXXXXXXXXX 999999999 9999999999 9999999999 5151
5252 5252
5353 5353
5454 5454
55551 Total column C and column D from page 1 above 1C 9999999999 1D 9999999999 5555
5656 5656
57572 Totals from page 2 (total of column C and column D from additional 5757
5858 page(s) Form 80-161) 2C 2D 5858
9999999999 9999999999
5959 5959
3 Total Mississippi taxable income and amount of taxes paid on
6060 pass-through entity returns (enter here and on Form 80-105, page 1, 3C 9999999999 3D 9999999999 6060
6161 line 19; or Form 80-205, page 1, line 21; or on Form 81-110, page 1, line 4) 6161
6262 6262
6363 6363
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