Form Ar-Oi - Arkansas Individual Income Tax Other Income/loss And Depreciation Differences - 2014

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AR-OI
2014
ARKANSAS INDIVIDUAL INCOME TAX
OTHER INCOME/LOSS AND DEPRECIATION DIFFERENCES
Name
Social Security Number
Full Year Resident Filers - Complete columns (A) and (B) if using filing status 4 (married filing
separately on the same return). All other filing statuses must complete column (A) only.
Part Year Resident Filers - Complete columns (A) and (B), if using filing status 4 (married filing
separately on the same return). All other filing statuses must complete column (A) only.
Enter only
the amount of income/loss attributable to Arkansas in column (C).
Full Year Nonresident Filers - Complete columns (A) and (B), if using filing status 4 (married filing
separately on the same return). All other filing statuses must complete column (A) only.
If an amount
is entered in column (C), attach explanation.
(B)
(C)
(A)
Arkansas Only
Primary/Joint
Spouse
(Status 4)
1. HSA and/or MSA taxable distributions: .......................................1
00
00
00
2. Long-term care insurance contracts: ..........................................2
00
00
00
3. Gambling winnings: ....................................................................3
00
00
00
4. Lottery / contest winnings: ..........................................................4
00
00
00
00
00
00
5. Federal / state depreciation differences: ....................................5
00
00
00
6. Net Operating Loss: ....................................................................6
7. Foreign earned income exclusion:
(attach federal Form 2555 or 2555-EZ) ......................................7
00
00
00
00
00
00
8. Scholarships / fellowships / stipends: .........................................8
9. Loss on excess deferral distribution: ..........................................9
00
00
00
10. Other:
Description:
10a
________________________________________________
00
00
00
Description:
10b
_______________________________________
00
00
00
Description:
10c
_______________________________________
00
00
00
11. TOTAL: (add lines 1-10 and enter total of each column on
line 20 of Form AR1000F / AR1000NR) ...................................11
00
00
00
AR-OI (R 8/12/14)

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