Form 80-491 "Mississippi Individual Income Tax Statement of Additional Dependents" - Mississippi

What Is Form 80-491?

This is a legal form that was released by the Mississippi Department of Revenue - a government authority operating within Mississippi. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on June 1, 2019;
  • The latest edition provided by the Mississippi Department of Revenue;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form 80-491 by clicking the link below or browse more documents and templates provided by the Mississippi Department of Revenue.

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Download Form 80-491 "Mississippi Individual Income Tax Statement of Additional Dependents" - Mississippi

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Reset Form
Form 80-491-19-8-1-000 (Rev. 06/19)
Print Form
Mississippi
Individual Income Tax Statement of
804911981000
Additional Dependents
2019
Taxpayer First Name
Initial
Last Name
SSN
Initial Last Name
Spouse First Name
Spouse SSN
Mailing Address (Number and Street, Including Rural Route)
City
State
Zip
County Code
A dependent is a relative or other person who qualifies for federal income tax purposes as a dependent of the taxpayer. Enter the dependent's name
(Column A), the dependent's relationship to taxpayer (Column B), and the dependent's social security number (Column C).
(B) DEPENDENT
(A) DEPENDENT'S NAME
(C) DEPENDENT'S SSN
Enter "C" for child, "P" for parent and "R" for relative
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Duplex and Photocopies NOT Acceptable
Reset Form
Form 80-491-19-8-1-000 (Rev. 06/19)
Print Form
Mississippi
Individual Income Tax Statement of
804911981000
Additional Dependents
2019
Taxpayer First Name
Initial
Last Name
SSN
Initial Last Name
Spouse First Name
Spouse SSN
Mailing Address (Number and Street, Including Rural Route)
City
State
Zip
County Code
A dependent is a relative or other person who qualifies for federal income tax purposes as a dependent of the taxpayer. Enter the dependent's name
(Column A), the dependent's relationship to taxpayer (Column B), and the dependent's social security number (Column C).
(B) DEPENDENT
(A) DEPENDENT'S NAME
(C) DEPENDENT'S SSN
Enter "C" for child, "P" for parent and "R" for relative
1
2
3
4
5
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7
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10
11
12
13
14
15
Duplex and Photocopies NOT Acceptable