Form 89 at a glance
What it is: Form 89-350-25-8-1-000 (Rev. 10/25) is the Mississippi Employee's Withholding Exemption Certificate to claim your withholding personal exemption.
Where and when to file: File this form with your employer. File a new exemption certificate with your employer within 30 days after any change in your exemption status.
Who signs: Sign on the Employee's Signature line and enter the Date.
A filled-in Form 89 example: a single employee claims her exemptions
How to fill out Form 89, box by box
Employee's name and residence
Enter the Employee's Name and SSN, then the Employee's Residence: Number and Street, City or Town, State and Zip Code.
Marital Status
Under Marital Status, check one.
Single Individuals enter $6,000 on Line 1 (checked October 22, 2026).
If the spouse is not employed, enter $12,000 on Line 2(a) (checked October 22, 2026).
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 (checked October 22, 2026).
The total claimed by the taxpayer and spouse may not exceed $12,000 (checked October 22, 2026).
Enter amount claimed by you on Line 2(b).
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 (checked October 22, 2026). If the taxpayer has more than one dependent, additional exemptions are applicable. See item (d).
Dependents
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 (checked October 22, 2026).
A head of family may claim $1,500 for each dependent excluding the one which qualifies you as head of family (checked October 22, 2026). Multiply number of dependents claimed by you by $1,500 (checked October 22, 2026).
Dependents 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.
Age and blindness
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 (checked October 22, 2026). No additional exemption is authorized for dependents by reason of age. An additional exemption of $1,500 may be claimed by either taxpayer or spouse or both if either or both are blind (checked October 22, 2026). 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 (checked October 22, 2026).
Total Amount of 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.
Additional dollar amount of withholding per pay period
Line 7 is the additional dollar amount of withholding per pay period if agreed to by your employer.
Military Spouses Residency Relief Act exemption
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.
Declaration, signature and date
By signing you 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 you are entitled or you are entitled to claim exempt status.
Sign on the Employee's Signature line and enter the Date.
More rules for Form 89
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.
Common questions about Form 89
Is there a deadline?
File a new exemption certificate with your employer within 30 days after any change in your exemption status.
Where do I file it?
File this form with your employer.
Is there a penalty?
Penalties are imposed for willfully supplying false information.
Sources
[1] Form 89 (Rev. 10/25), Mississippi Employee's Withholding Exemption Certificate, Mississippi Department of Revenue (the Official source link on this page).