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Form 89-140-12-8-1-000 Rev. 11/12 MS MISSISSIPPI ANNUAL INFORMATION RETURN 891401281000 - Tax Year Name MS Account ID Address - FEIN Form Type choose one City State Zip W2 W2-C 1099-R Number of Forms MS Taxable Wages MS Tax Withheld Signature Phone Extension Date Signed Submitting Company If different than above Date Mailed Contact Person Please Print Other 1099 MS Tax Remitted General Instructions Employers that issue 25 or more W-2s 1099s or other information returns are required to electronically submit those in the required formats to the Department of Revenue DOR through Taxpayer Access Point TAP. W-2 s must be submitted in Social Security Administration SSA format and must contain the RS record for state data* See SSA Publication EFW2 for record format and specifications. 1099s W-2Gs and all other information returns must be submitted in Internal Revenue Service IRS format. See IRS Publication 1220 for specifications and procedures. You may be subject to penalties if you issue more than 25 returns and do not file as required* All employers regardless of the number of returns are encouraged to utilize the system to electronically enter and submit return information securely to DOR* To access TAP and submit returns electronically visit our website at www. dor. ms. gov* Filing Due Dates If the date falls on a weekend or state holiday the filing due date is the next business working day. Form Types Due Date W-2s 1099-Rs Statements Due to Employees January 31st Paper Less than 25 February 28th All Information Returns Media Electronic March 31st Return Instructions Do not send a tax payment with this form* Credit will not be applied to your account if payment is submitted with this form* Additional payments can be filed through TAP or with a paper Form 89-105 Withholding Tax Return* A separate Form 89-140 must be submitted for each type of return. Mail the form and copies of Information Returns to Department of Revenue Withholding Tax Division P. W-2 s must be submitted in Social Security Administration SSA format and must contain the RS record for state data* See SSA Publication EFW2 for record format and specifications. 1099s W-2Gs and all other information returns must be submitted in Internal Revenue Service IRS format. 1099s W-2Gs and all other information returns must be submitted in Internal Revenue Service IRS format. See IRS Publication 1220 for specifications and procedures. You may be subject to penalties if you issue more than 25 returns and do not file as required* All employers regardless of the number of returns are encouraged to utilize the system to electronically enter and submit return information securely to DOR* To access TAP and submit returns electronically visit our website at www. See IRS Publication 1220 for specifications and procedures. You may be subject to penalties if you issue more than 25 returns and do not file as required* All employers regardless of the number of returns are encouraged to utilize the system to electronically enter and submit return information securely to DOR* To access TAP and submit returns electronically visit our website at www. dor. ms. gov* Filing Due Dates If the date falls on a weekend or state holiday the filing due date is the next business working day.

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