Fillable Printable Form Mo-1040A - Missouri Department Of Revenue
Fillable Printable Form Mo-1040A - Missouri Department Of Revenue
Form Mo-1040A - Missouri Department Of Revenue
Organ Donor
Program
Fund
X
4. Mark your filing status box below and enter the appropriate exemption amount on Line 4.
4 00
5.
Tax from federal return (Do not Enter this amount on Line 5 or $5,000, whichever is less.
enter federal income tax withheld.) — If married filing combined, enter this amount on Line 5
or $10,000, whichever is less.
5 + 00
6. Missouri standard deduction or itemized deductions.
Single or Married Filing Separate— $6,300; Head of
Household — $9,300; Married Filing a Combined Return or Qualifying Widow(er) — $12,600
. If you are age 65 or
older, blind, or claimed as a dependent, see your federal return or page 7. If you are itemizing, see back of form. 6 + 00
7.
Number of dependents you claimed on your Federal Form 1040 OR 1040A, Line 6c.
Check box if claiming a stillborn child; see instructions on Page 7...........................................................
x $1,200 =
7 + 00
8. Long-term care insurance deduction ...................................................................................................................... 8 + 00
9. Total Deductions — Add Lines 4 through 8. ...........................................................................................................
9 = 00
12. Missouri tax withheld from your Forms W-2 and Forms 1099. Attach copies of Forms W-2 and Forms 1099. .... 12 00
13. Any Missouri estimated tax payments made for 2016 (include overpayment from 2015 applied to 2016) ............ 13 00
14. Total Payments — Add Lines 12 and 13. ...............................................................................................................
14 00
15. If Line 14 (Total Payments) is more than Line 11 (Total Tax), enter the difference (amount of overpayment)
here. (If Line 14 is less than Line 11, skip to Line 20.) ........................................................................................... 15 00
16. Amount from Line 15 that you want applied to your 2017 estimated tax ............................................................. 16 00
10. Missouri Taxable Income — Subtract Line 9 from Line 3. ...................................................................................... 10 00
11. Tax — Use the tax chart on the back of this form to figure the tax. .......................................................................
11 00
1. Federal adjusted gross income from your 2016 federal return. (See page 6 of the instructions.). ................................. 1 00
2. Any state income tax refund included in your 2016 federal adjusted gross income. ............................................ 2 – 00
3. Total Missouri adjusted gross income — Subtract Line 2 from Line 1. .................................................................
3 = 00
INCOMEDEDUCTIONS
TAX
REFUND
AMOUNT DUE
I authorize the Director of Revenue or delegate to discuss my return and
attachments with the preparer or any member of the preparer’s firm.
YES NO
SIGNATURE
A. Single — $2,100 (See Box B before checking.)
B. Claimed as a dependent on another person’s federal
tax return — $0.00
C. Married filing joint federal & combined Missouri — $4,200
Check which spouse had income: Yourself Spouse
PREPARER’S PHONEE-MAIL ADDRESS
SIGNATURE DATE PREPARER’S SIGNATURE FEIN, SSN, OR PTIN
SPOUSE’S SIGNATURE (If filing combined, BOTH must sign) DAYTIME TELEPHONE PREPARER’S ADDRESS AND ZIP CODE DATE
For Privacy Notice, see instructions.
IN CARE OF NAME (ATTORNEY, EXECUTOR, PERSONAL REP., ETC.)
PRESENT ADDRESS (INCLUDE APARTMENT NO. OR RURAL ROUTE) COUNTY OF RESIDENCE
CITY, TOWN, OR POST OFFICE STATE ZIP CODE
AGE 65 OR OLDER BLIND 100% DISABLED NON-OBLIGATED SPOUSE
YOURSELF YOURSELF YOURSELF YOURSELF
SPOUSE SPOUSE SPOUSE SPOUSE
PLEASE CHECK THE APPROPRIATE BOXES THAT APPLY TO YOURSELF OR YOUR SPOUSE.
MISSOURI DEPARTMENT OF REVENUE 2016 FORM MO-1040A
INDIVIDUAL INCOME TAX RETURN
SINGLE/MARRIED
(
ONE INCOME
)
SOCIAL SECURITY NUMBER SPOUSE’S SOCIAL SECURITY NUMBER
NAME (LAST) (FIRST) M.I. JR, SR
SPOUSE’S (LAST) (FIRST) M.I. JR, SR
VENDOR CODE
006
D. Married filing separate — $2,100
E. Married filing separate (spouse
NOT filing) — $4,200
F. Head of household — $3,500
G. Qualifying widow(er) with
dependent child — $3,500
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief it is true, correct, and complete. Declaration of
preparer (other than taxpayer) is based on all information of which he or she has any knowledge. As provided in Chapter 143, RSMo, a penalty of up to $500 shall be imposed on any individual who files a frivolous
return. I also declare under penalties of perjury that I employ no illegal or unauthorized aliens as defined under federal law and that I am not eligible for any tax exemption, credit or abatement if I employ such aliens.
19. REFUND -
Subtract Lines 16, 17, and 18 from Line 15 and enter here. This is your refund.
Sign below and mail to
:
Department of Revenue, P.O. Box 3222, Jefferson City, MO 65105-3222. ...................................................... 19 00
20. AMOUNT DUE - If Line 14 is less than Line 11, enter the difference here. You have an amount due. Sign below and
mail to: Department of Revenue, P.O. Box 3370, Jefferson City, MO 65105-3370. See instructions for Line 20. ...... 20 00
If you pay by check, you authorize the Department of Revenue to process the check electronically. Any check returned unpaid may be presented again electronically.
If you would like your refund deposited directly to your checking or savings account, complete boxes a, b, and c below.
a. Routing Number b. Account Number c. Checking Savings
DECEASED
IN 2016
17.
Enter the amount of your
donation in the trust fund
boxes to the right. Se e
instructions for fund codes...17.
00 00 00 00 00 00 00 00 00 00 00
Workers
Additional
Fund Code
(See Instr.)
______|______
Children’s
Trust
Fund
Veterans
Trust
Fund
Missouri
National Guard
Trust Fund
Workers’
Memorial
Fund
Elderly Home
Delivered Meals
Trust Fund
Childhood Lead
Testing
Fund
General
Revenue
LEAD
Missouri Military
Family Relief
Fund
General
Revenue
Fund
Additional
Fund Code
(See Instr.)
______|______
(__ __ __) __ __ __ - __ __ __ __
(__ __ __) __ __ __ - __ __ __ __
__ __/__ __/__ __ __ __
__ __/__ __/__ __ __ __
MO-1040A 2-D (Revised 12-2016)
18.
Amount from Line 15 to be deposited into a Missouri 529 College Savings Plan (MOST) account. Enter amount from Line E of Form 5632.
18 00
00
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INSTRUCTIONS:
- Enter numbers without decimals (integers)
- Don't forget to attach all required forms
- You can tab from one field to another or use the mouse to click in
the field you want.
- Use the print button at the top of page to print form
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- Click on the gray boxes to view the instructions for that line.
- If a field does not allow a negative number and a negative number
is entered, a zero will be displayed.
006
SELECT COUNTY
Line 1
Line 2
0
Line 4
0
Line 5
Itemized Worksheet
0
Line 6
0
Line 7
Line 8
0
0
0
Line 11
Line 12
Line 13
0
0
Line 16
Line 17
MOST
0
0
Line 19
0
M1
Click here to finish
FORM MO-1040A
MO-1040A 2-D (Revised 12-2016)
Complete this worksheet only if your federal adjusted gross income from federal Form 1040, Line 37 is more than $311,300 if married filing combined or qualifying widow(er),
$285,350 if head of household, $259,400 if single or claimed as a dependent, or $155,650 if married filing separate. If your federal adjusted gross income is less than or
equal to these amounts, do not complete this worksheet. Attach a copy of your Federal Itemized Deduction Worksheet (Page A-13 of Federal Schedule A instructions).
1. Enter amount from Federal Itemized Deduction Worksheet, Line 3
(See page A-13 of Federal Schedule A instructions.) If $0 or less, enter “0”. ................................... 1 00
2. Enter amount from Federal Itemized Deduction Worksheet, Line 9 (See Federal Schedule A instructions.) ........... 2 00
3. State and local income taxes from Federal Form 1040, Schedule A, Line 5 .................................... 3 00
4. Earnings taxes included on Federal Form 1040, Schedule A, Line 5 .......................................... 4 00
5. Subtract Line 4 from Line 3. .........................................................................
5 00
6. Divide Line 5 by Line 1. ............................................................................ 6 %
7. Multiply Line 2 by Line 6. ...........................................................................
7 00
8. Subtract Line 7 from Line 5. Enter here and on Missouri Itemized Deductions, Line 9, above. ......................
8 00
Missouri Itemized Deductions
• Complete this section only if you itemized deductions on your federal return. (See the information on page 7.)
• Attach a copy of your Federal Form 1040 (pages 1 and 2) and Federal Schedule A.
• If you are subject to “additional Medicare tax”, attach a copy of Federal Form 8959.
1. Total federal itemized deductions from Federal Form 1040, Line 40 ......................................... 1 00
2. 2016 Social security tax ............................................................................ 2 00
3. 2016 Railroad retirement tax — (Tier I and Tier II) ....................................................... 3 00
4. 2016 Medicare tax.
See instructions on page 9.
......................................................... 4 00
5. 2016 Self-employment tax. See instructions on Page 9. .................................................. 5 00
6. Total - Add Lines 1 through 5 ....................................................................... 6 00
7. State and local income taxes. From Federal Schedule A, Line 5 or see the worksheet below. 7 00
8. Earnings taxes included in Line 7. See instructions on Page 9. ........................ 8 00
9. Net state income taxes. Subtract Line 8 from Line 7 or enter Line 8 from worksheet below. ....................... 9 00
10. MISSOURI ITEMIZED DEDUCTIONS - Subtract Line 9 from Line 6. Enter here and on front of form, Line 6 ......... 10 00
Note: If Line 10 is less than your federal standard deduction, see information on pages 6 & 7.
Worksheet For Net State Income Taxes, Line 9 of Missouri Itemized Deductions
2016 TAX CHART
If Missouri taxable income from Form MO-1040A, Line 10, is less than $9,000, use the chart to figure tax;
if more than $9,000, use worksheet below or use the online tax calculator at http://dor.mo.gov/personal/individual/.
Missouri taxable income (Line 10) ..............................
Subtract $9,000 .....................................................
Difference ..............................................................
Multiply by 6%........................................................
Tax on income over $9,000
Add $315 (tax on first $9,000) ...............................
TOTAL MISSOURI TAX ........................................
FIGURING TAX
OVER $9,000
$ _______________
– $ 9,000
= $ _______________
x 6%
= $ _______________
+ $ 315
= $ _______________
Example
$ 12,000
– $ 9,000
= $ 3,000
x 6%
= $ 180
+ $ 315
= $ 495
If the Missouri taxable income is: The tax is:
$0 to $99 .............................$0
At least $100 but not over $1,000
..........1½% of the Missouri taxable income
Over $1,000 but not over $2,000
...........$15 plus 2% of excess over $1,000
Over $2,000 but not over $3,000
...........$35 plus 2½% of excess over $2,000
Over $3,000 but not over $4,000
...........$60 plus 3% of excess over $3,000
Over $4,000 but not over $5,000
...........$90 plus 3½% of excess over $4,000
Over $5,000 but not over $6,000
...........$125 plus 4% of excess over $5,000
Over $6,000 but not over $7,000
...........$165 plus 4½% of excess over $6,000
Over $7,000 but not over $8,000
...........$210 plus 5% of excess over $7,000
Over $8,000 but not over $9,000
...........$260 plus 5½% of excess over $8,000
Over $9,000
...........................$315 plus 6% of excess over $9,000
Example: If Line 10 is $3,090, the tax
would be computed as follows: $60 +
$2.70 (3% of $90) = $62.70. The whole
dollar amount to enter on Line 11 would
be $63.
FIGURING TAX
ON $9,000 OR LESS
If more than $9,000,
tax is $315 PLUS 6% of
excess over $9,000.
Round to nearest whole
dollar and enter on
Form MO-1040A, Line 11.
Line 1
Line 2
Line 3
Line 4
Line 5
0
Line 7
Line 8
0
0
Line 10
Carry amount to 1040A Line 6
0
0
0
Reset Worksheet
Use data from worksheet
Form
5632
Missouri Department of Revenue
2016 MOST - Missouri’s 529 College Savings Plan
Direct Deposit Form - Individual Income Tax
Requirements
• Provideyournameandsocialsecuritynumber.Ifyouaremarriedandlingacombinedreturn,also
provide your spouse’s name and social security number.
• Enterbelowthe11-digitMOST529accountnumberandtheamountyouwantcontributedtoeach
account. (You may contribute to a maximum of four accounts.)
• AddtheamountsfromLinesAthroughDandenterthe“TotalDeposit”belowandonyourMissouri
IndividualIncomeTaxReturn.
Instructions
IfyouwanttodeposityourrefundasacontributiontooneormoreMissouriMOST529CollegeSavings
Plan accounts:
•YoumusthaveanopenMissouriMOST529CollegeSavingsPlanaccountthatisadministeredby
theMissouriHigherEducationSavingsProgram.Seethecontactinformationbelow.
•Yourtotaldepositmustbeatleast$25.
• If your overpayment is adjusted and the amount you requested to deposit exceeds your available
refund,theDepartmentwillcancelyourdepositandissuearefundtoyou.
•Ifyourrefundisoffsettopayanotherdebt,theDepartmentwillcancelyourdeposit.
LastName FirstName SocialSecurityNumber
Spouse’sLastName Spouse’sFirstName Spouse’sSocialSecurityNumber
Taxpayer
A) Account Number A) Amount
B) Account Number B) Amount
C)AccountNumber C)Amount
D) Account Number D) Amount
E) TotalDeposit
529 Account
MOST-Missouri’s529CollegeSavingsPlan
https://www.missourimost.org E-mail: [email protected]
Telephone:(888)414-6678
Contact Information
Form5632(Revised12-2016)
IfyouwishtodepositalloraportionofyourrefundintoaMissouriMOST529CollegeSavings
Plan,youmustincludethisformwithyourMissouriIndividualIncomeTaxReturn.
TaxationDivision
___ ___ ___ - ___ ___ - ___ ___ ___ ___
___ ___ ___ - ___ ___ - ___ ___ ___ ___
___ ___ ___ ___ ___ ___ ___ ___ ___ - ___ ___
___ ___ ___ ___ ___ ___ ___ ___ ___ - ___ ___
___ ___ ___ ___ ___ ___ ___ ___ ___ - ___ ___
___ ___ ___ ___ ___ ___ ___ ___ ___ - ___ ___
EntertheTotalDepositamountonFormMO-1040,Line48;
FormMO-1040A,Line18;orFormMO-1040P,Line25.
.00
.00
.00
.00
.00
$0
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