Form Ar1000nr - Arkansas Individual Income Tax Return 2015
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1
22015 AR1000NR
NR1
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ITNR151
ARKANSAS INDIVIDUAL
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CHECK BOX IF
INCOME TAX RETURN
AMENDED RETURN
Nonresident and Part Year Resident
Dept. Use Only
-DQ 'HF RU ¿VFDO \HDU HQGLQJ ____________ , 20 ____
35,0$5< ),567 1$0(
MI
/$67 1$0(
<285 62&,$/ 6(&85,7< 180%(5
63286( ),567 1$0(
MI
/$67 1$0(
Important
63286(¶6 62&,$/ 6(&85,7< 180%(5
0$,/,1* $''5(66
(Number and Street, P.O. Box or Rural Route)
&,7< 67$7( $1' =,3 &2'(
Important: You MUST
enter your SSN(s) above
1215(6,'(17
3$57 <($5 5(6,'(17
ATTACH A COPY OF YOUR COMPLETE FEDERAL RETURN
(List State of residence)
(Dates Lived in AR)
1.
SINGLE (Or widowed before 2015 or divorced at end of 2015)
0$55,(' ),/,1* 6(3$5$7(/< 21 7+( 6$0( 5(7851
0$55,(' ),/,1* -2,17 (Even if only one had income)
0$55,(' ),/,1* 6(3$5$7(/< 21 ',))(5(17 5(78516
Enter spouse’s name here and SSN above _______________
3.
HEAD OF HOUSEHOLD (See Instructions)
If the qualifying person was your child but not your dependent,
48$/,)<,1* :,'2: (5 ZLWK GHSHQGHQW FKLOG
enter child’s name here: ______________________________
Year spouse died: (See Instructions)_____________________
&KHFN WKLV ER[ LI \RX KDYH ÀOHG D VWDWH H[WHQVLRQ
HAVE YOU FILED AN EXTENSION?
or an automatic federal extension
DEAF
+($' 2) +286(+2/'48$/,)<,1* :,'2: (5
7A.
<2856(/)
RU 29(5
65 SPECIAL
BLIND
(Filing Status 3 Only)
(Filing Status 6 Only)
SPOUSE
RU 29(5
65 SPECIAL
BLIND
DEAF
0XOWLSO\ QXPEHU RI ER[HV FKHFNHG .................................................................................................................................................7A
00
X $26 =
(Do not list yourself or spouse)
Dependents
First Name
Last Name
Dependent’s Social Security Number
Dependent’s relationship to you
1.
2.
3.
7B. Multiply number of dependents from above ...............................................................................................7B
X $26 =
00
7C. First name of individual(s) with developmental disability: (See Instructions)
00
Multiply number of individuals with developmental disabilities from 7C ........................................................ 7C
X $500 =
00
7D. TOTAL PERSONAL TAX CREDITS: (Add Lines 7A, 7B, and 7C. Enter total here and on Line 32).........................7D
(C)
Arkansas
(A)
Your/Joint
(B) Spouse’s Income
ROUND ALL AMOUNTS TO WHOLE DOLLARS
Income Only
Income
Status 4 Only
00
00
00
8.
Wages, salaries, tips, etc:
(Attach W-2s)
..................................................................8
9A.
U. S. Military compensation:
00
9A
(Your/joint gross amt.)
9B.
U. S. Military compensation:
00
9B
(Spouse’s gross amt.)
00
00
00
10.
Interest income:
(If over $1,500, attach AR4)
.........................................................10
00
00
00
11.
Dividend income:
(If over $1,500, attach AR4)
.......................................................11
00
00
00
12.
Alimony and separate maintenance received: .......................................................12
00
00
00
13.
Business or professional income:
(Attach federal Schedule C or C-EZ)
................13
00
00
00
14.
Capital gains/(losses) from stocks, bonds, etc:
(See Instr. Attach Schedule D)
.............14
00
00
00
15.
Other gains or (losses):
(Attach federal Form 4797 and/or 4684 if applicable)
......15
00
00
00
16.
1RQ4XDOL¿HG ,5$ GLVWULEXWLRQV DQG WD[DEOH DQQXLWLHV
(Attach All
1099Rs)...........16
00
$ <RXU-RLQW (PSOR\HU SHQVLRQ SODQ V 4XDOL¿HG
,5$ V (See Instructions, Attach All 1099Rs)
Less
00
00
00
Gross Distribution
Taxable Amount
00
17A
00
$6,000
% 6SRXVH (PSOR\HU SHQVLRQ SODQ V 4XDOL¿HG ,5$ V
(Filing Status 4 only)
00
00
00
Less
Gross Distribution
Taxable Amount
17B
00
00
$6,000
00
00
00
18.
5HQWV UR\DOWLHV SDUWQHUVKLSV HVWDWHV WUXVWV HWF
(Attach federal Schedule
E)...... 18
00
00
00
19.
Farm income:
(Attach federal Schedule F)
............................................................. 19
00
00
00
Other income/depreciation differences:
(Attach Form AR-OI)
................................ 20
20.
00
00
00
21.
TOTAL INCOME: (Add Lines 8 through 20) ....................................................... 21
00
00
00
22. TOTAL ADJUSTMENTS:
(Attach Form AR1000ADJ)
...................................... 22
00
00
00
23. ADJUSTED GROSS INCOME: (Subtract Line 22 from Line 21) ..................... 23
3DJH 15 5
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