Mississippi Department of Revenue Form Instructions
2025 Form 84-380 Non-Residence Income Tax Agreement
Official textdor.ms.gov
Form 84-380-25-8-1-000 (Rev 10/25)
Text version of this table
Business Name Name of Taxpayer Address Address City State Zip +4 City State Zip +4
- This form may be reproduced.
- Do not file this agreement with the S Corporation Tax Return.
- Retain this agreement in your permanent tax files.
# AGREEMENT
Tax Year Beginning Tax Year Ending
FEIN SSN mm dd yyyy mm dd yyyy
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Source: view the official PDF
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