Fillable Printable Annual Summary And Transmittal Of Missouri Forms Mo-99 Misc.
Fillable Printable Annual Summary And Transmittal Of Missouri Forms Mo-99 Misc.
Annual Summary And Transmittal Of Missouri Forms Mo-99 Misc.
Name Identifying Number
Address City State ZIP Code
Under penalties of perjury, I declare that the information I have provided is true, complete, and correct. I have direct control, supervision or
responsibility for ling this return. In the case of documents without recipients’ identifying numbers I have complied with the requirements of the
law by requesting such numbers from the recipients, but did not receive them.
Signature Title Date (MM/DD/YYYY)
__ __ / __ __ / __ __ __ __
Payer’s Information
Form
MO-96
Enter the total number of Federal 1099-MISC forms if substituted for the Missouri Form MO-99 Misc. ___________________
Mail to:Taxation Division Phone: (573) 751-3505
P.O. Box 3330 Fax: (573) 751-2195
Jefferson City, MO 65105-3330 E-mail:[email protected]
Form MO-96 (Revised 03-2017)
Missouri Department of Revenue
Annual Summary and Transmittal of Missouri Forms MO-99 Misc.
All documents are: r Original r Corrected r With Taxpayer Identifying No. r Without Taxpayer Identifying No.
Tax Year
20_____
Visit //dor.mo.gov/personal/individual/
for additional information.
