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Mississippi Free Printable 89-350-12.xlsx for 2024 Mississippi Withholding Exemption Certificate

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Withholding Exemption Certificate
89-350-12.xlsx

Print Form Reset Form Form 89-350-22-8-1-000 (Rev. 10/22) MISSISSIPPI EMPLOYEE'S WITHHOLDING EXEMPTION CERTIFICATE Employee's Name SSN Employee's Residence Number and Street EMPLOYEE: File this form with your employer. Otherwise, you must withhold Mississippi income tax from the full amount of your wages. CLAIM YOUR WITHHOLDING PERSONAL EXEMPTION Personal Exemption Allowed Marital Status 1. Single 2. Marital Status (Check One) EMPLOYER: 4. Dependents Number Claimed 5. Age and blindness $ ► Enter $6,000 as exemption . . . . (a) Spouse NOT employed: Enter $12,000 (b) Spouse IS employed: Enter that part of $12,000 claimed by you in multiples of $500. See instructions 2(b) below. ► $ Enter $9,500 as exemption. To qualify as head of family, you must be single and have a dependent living in the home with you. See instructions 2(c) and 2(d)below . . . . . . . . . . . .► $ 3. Head of Family Keep this certificate with your records. If the employee is believed to have claimed excess exemption, the Department of Revenue should be advised. State City or Town ► Zip Code Amount Claimed $ You may claim $1,500 for each dependent*, other than for taxpayer and spouse, who receives chief support from you and who qualifies as a dependent for Federal income tax purposes. * A head of family may claim $1,500 for each dependent excluding the one which qualifies you as head of family. Multiply number of dependents claimed by you by $1,500. Enter amount claimed . . . ► • Age 65 or older Husband Wife Single • Blind Husband Wife Single Multiply the number of blocks checked by $1,500. Enter the amount claimed . . . . . ► * Note: No exemption allowed for age or $ $ blindness for dependents. 6. TOTAL AMOUNT OF EXEMPTION CLAIMED - Lines 1 through 5... ► 7. Additional dollar amount of withholding per pay period if agreed to by your employer . . . . . . . . . . . . . . . Military Spouses Residency Relief Act Exemption from Mississippi Withholding ► $ $ 8. If you meet the conditions set forth under the Service Member Civil Relief, as amended by the Military Spouses Residency Relief Act, and have no Mississippi tax liability, write "Exempt" on Line 8. You must attach a copy of the Federal Form DD-2058 and a copy of your Military Spouse ID Card to this form so your employer can validate the exemption claim.. ► I declare under the penalties imposed for filing false reports that the amount of exemption claimed on this certificate does not exceed the amount to which I am entitled or I am entitled to claim exempt status. Employee's Signature: Date: INSTRUCTIONS 1. The personal exemptions allowed: (a) Single Individuals (b) Married Individuals (Jointly) (c) Head of family $6,000 $12,000 $9,500 (d) Dependents (e) Age 65 and Over (f) Blindness $1,500 $1,500 $1,500 2. Claiming personal exemptions: (a) Single Individuals enter $6,000 on Line 1. (b) Married individuals are allowed a joint exemption of $12,000. If the spouse is not employed, enter $12,000 on Line 2(a). If the spouse is employed, the exemption of $12,000 may be divided between taxpayer and spouse in any manner they choose - in multiples of $500. For example, the taxpayer may claim $6,500 and the spouse claims $5,500; or the taxpayer may claim $8,000 and the spouse claims $4,000. The total claimed by the taxpayer and spouse may not exceed $12,000. Enter amount claimed by you on Line 2(b). (c) Head of Family A head of family is a single individual who maintains a home which is the principal place of abode for himself and at least one other dependent. Single individuals qualifying as a head of family enter $9,500 on Line 3. If the taxpayer has more than one dependent, additional exemptions are applicable. See item (d). (d) An additional exemption of $1,500 may generally be claimed for each dependent of the taxpayer. A dependent is any relative who receives chief support from the taxpayer and who qualifies as a dep p endent for Federal income tax p urp poses. Head of family individuals may claim an additional exemption for each dependent excluding the one which is required for head of family status. For example, a head of family taxpayer has 2 dependent children and his dependent mother living with him. The taxpayer may claim 2 additional exemptions. Married or single individuals may claim an additional exemption for each dependent, but should not include themselves or their spouse. Married taxpayers may divide the number of their dependents between them in any manner they choose; for example, a married couple has 3 children who qualify as dependents. The taxpayer may claim 2 dependents and the spouse 1; or the taxpayer may claim 3 dependents and the spouse none. Enter the amount of dependent exemption on Line 4. (e) An additional exemption of $1,500 may be claimed by either taxpayer or spouse or both if either or both have reached the age of 65 before the close of the taxable year. No additional exemption is authorized for dependents by reason of age. Check applicable blocks on Line 5. (f) An additional exemption of $1,500 may be claimed by either taxpayer or spouse or both if either or both are blind. No additional exemption is authorized for dependents by reason of blindness. Check applicable blocks on Line 5. Multiply number of blocks checked on Line 5 by $1,500 and enter amount of exemption claimed. 3. Total Exemption Claimed: Add the amount of exemptions claimed in each category and enter the total on Line 6. This amount will be used as a basis for withholding income tax under the appropriate withholding tables. 4. A NEW EXEMPTION CERTIFICATE MUST BE FILED WITH YOUR EMPLOYER WITHIN 30 DAYS AFTER ANY CHANGE IN YOUR EXEMPTION STATUS. 5. PENALTIES ARE IMPOSED FOR WILLFULLY SUPPLYING FALSE INFORMATION. 6. IF THE EMPLOYEE FAILS TO FILE AN EXEMPTION CERTIFICATE WITH HIS EMPLOYER, INCOME TAX MUST BE WITHHELD BY THE EMPLOYER ON TOTAL WAGES WITHOUT THE BENIFIT OF EXEMPTION. To comply with the Military Spouse Residency Relief Act (PL111-97) signed on November 11, 2009.
Extracted from PDF file 2023-mississippi-form-89-350.pdf, last modified June 2017

More about the Mississippi Form 89-350​​ Other TY 2023

This form should be completed by employee; retained by employer.

We last updated the Withholding Exemption Certificate in January 2024, so this is the latest version of Form 89-350​​, fully updated for tax year 2023. You can download or print current or past-year PDFs of Form 89-350​​ directly from TaxFormFinder. You can print other Mississippi tax forms here.


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Other Mississippi Other Forms:

TaxFormFinder has an additional 36 Mississippi income tax forms that you may need, plus all federal income tax forms.

Form Code Form Name
Form 89-140​​​ Annual W-2 and 1099 Information Return (Fill In Version)
Form 89-350​​ Withholding Exemption Certificate
Form 89-386 Affidavit for Withholding Income Tax on Sale of Real Estate by Non-Resident
Form 89-505 Withholding Tax Cash Bond
Form 89-506 Withholding Tax Surety Bond

Download all MS tax forms View all 37 Mississippi Income Tax Forms


Form Sources:

Mississippi usually releases forms for the current tax year between January and April. We last updated Mississippi Form 89-350​​ from the Department of Revenue in January 2024.

Show Sources >

Historical Past-Year Versions of Mississippi Form 89-350​​

We have a total of three past-year versions of Form 89-350​​ in the TaxFormFinder archives, including for the previous tax year. Download past year versions of this tax form as PDFs here:



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