The Mississippi Individual Income Tax Statement of Additional Dependents is used when a taxpayer needs to report additional dependents for Mississippi individual income tax purposes. A dependent is generally a child, parent, relative, or another qualifying person who meets the federal income tax rules for being claimed as a dependent. This statement gives Mississippi a clear list of each additional dependent’s name, relationship to the taxpayer, and Social Security number. The form is especially useful when the main individual income tax return does not provide enough space for all dependents. It connects the dependent information to the taxpayer by asking for the taxpayer’s name, spouse’s name if applicable, Social Security numbers, mailing address, city, state, ZIP Code, and county code. In simple terms, this statement helps identify who the taxpayer is claiming as additional dependents and supports the dependent information reported with the Mississippi individual income tax return.
How To File The Mississippi Individual Income Tax Statement Of Additional Dependents
Complete this statement only when you need to report additional dependents for a Mississippi individual income tax return. Enter the taxpayer and spouse information at the top, then list each dependent in the table. Use the correct relationship code for each dependent. Enter C for child, P for parent, and R for relative. Make sure every Social Security number is accurate because dependent information must match tax records. Attach this statement to the Mississippi individual income tax return when filing. Use the original form format when required, because duplex copies and photocopies are not acceptable.
How To Complete The Mississippi Individual Income Tax Statement Of Additional Dependents
Header Information
Form Year: Use this statement for the correct tax year. This version is for 2025.
Taxpayer First Name: Enter the taxpayer’s first name.
Taxpayer Initial: Enter the taxpayer’s middle initial, if applicable.
Taxpayer Last Name: Enter the taxpayer’s last name.
SSN: Enter the taxpayer’s Social Security number.
Spouse First Name: If filing with a spouse, enter the spouse’s first name.
Spouse Initial: Enter the spouse’s middle initial, if applicable.
Spouse Last Name: Enter the spouse’s last name.
Spouse SSN: If filing with a spouse, enter the spouse’s Social Security number.
Mailing Address: Enter the full mailing address, including number and street. Include a rural route if that applies.
City: Enter the city for the mailing address.
State: Enter the state for the mailing address.
Zip: Enter the ZIP Code.
County Code: Enter the correct Mississippi county code.
Dependent Information Instructions
Use the dependent table to list each additional dependent. Each row has three required parts: the dependent’s name, the relationship code, and the dependent’s Social Security number.
Column A, Dependent’s Name: Enter the full name of the dependent being claimed.
Column B, Dependent: Enter the relationship code. Use C for child, P for parent, and R for relative.
Column C, Dependent’s SSN: Enter the dependent’s Social Security number.
Line By Line Instructions For Additional Dependents
Line 1: Enter the first additional dependent’s full name in Column A, the correct relationship code in Column B, and the dependent’s Social Security number in Column C.
Line 2: Enter the second additional dependent’s full name, relationship code, and Social Security number.
Line 3: Enter the third additional dependent’s full name, relationship code, and Social Security number.
Line 4: Enter the fourth additional dependent’s full name, relationship code, and Social Security number.
Line 5: Enter the fifth additional dependent’s full name, relationship code, and Social Security number.
Line 6: Enter the sixth additional dependent’s full name, relationship code, and Social Security number.
Line 7: Enter the seventh additional dependent’s full name, relationship code, and Social Security number.
Line 8: Enter the eighth additional dependent’s full name, relationship code, and Social Security number.
Line 9: Enter the ninth additional dependent’s full name, relationship code, and Social Security number.
Line 10: Enter the tenth additional dependent’s full name, relationship code, and Social Security number.
Line 11: Enter the eleventh additional dependent’s full name, relationship code, and Social Security number.
Line 12: Enter the twelfth additional dependent’s full name, relationship code, and Social Security number.
Line 13: Enter the thirteenth additional dependent’s full name, relationship code, and Social Security number.
Line 14: Enter the fourteenth additional dependent’s full name, relationship code, and Social Security number.
Line 15: Enter the fifteenth additional dependent’s full name, relationship code, and Social Security number.
Relationship Code Guide
C For Child: Use C when the dependent is the taxpayer’s qualifying child.
P For Parent: Use P when the dependent is the taxpayer’s qualifying parent.
R For Relative: Use R when the dependent is another qualifying relative.
Important Filing Notes
Dependent Qualification: Only list people who qualify as dependents for federal income tax purposes.
Name Accuracy: Enter each dependent’s name exactly as it appears on Social Security records.
SSN Accuracy: Check each dependent’s Social Security number carefully before filing.
No Duplicate Dependents: Do not list the same dependent more than once.
Duplex And Photocopies Not Acceptable: Do not use duplex printing or photocopies if the form requires an original single-sided version.
Final Review Before Filing
Before filing, review the taxpayer name, spouse name, Social Security numbers, mailing address, ZIP Code, county code, and every dependent entry. Make sure each dependent has a full name, the correct relationship code, and a valid Social Security number. Attach the completed statement to the Mississippi individual income tax return when additional dependent information is needed.