Form Ar1000 - Arkansas Individual Income Tax Return Full Year Resident

(A)

Your/Total

(B) Spouse Income

Income

Status 4 Only

35.

ADJUSTED GROSS INCOME: (From Line 34, Columns A and B, Page AR1) ....................... 35

36.

Select tax table: (Check the appropriate box)

LOW INCOME Table 1

REGULAR Table 2

If you qualify for the Low Income Tax Table, enter zero (0) on Line 36A. If not, then:

}

Itemized Deductions (See itemized deduction schedule, Line 28)

Enter

the larger

Standard Deduction (See Standard Deduction Instr., Line 36) ......... 36

of your:

37.

NET TAXABLE INCOME: (Subtract Line 36 from Line 35) ...................................................... 37

38.

Tax: (Enter tax from tax table) .............................................................................................. 38

39.

Combined tax: (Add amounts from Lines 38A and 38B and enter here) ................................................................................ 39

40.

Income Tax Surcharge: (Multiply Line 39 by 3% (.03);

TEXARKANA RESIDENTS SEE

INSTRUCTIONS) ............................ 40

41.

Enter tax from Lump Sum Distribution Averaging Schedule:

(Attach AR1000TD)

................................................................... 41

42.

IRA and qualified plan withdrawal and overpayment penalties:

(Attach Federal Form 5329, if required)

.................................. 42

TOTAL TAX: (Add Lines 39 through 42) ........................................................................................................................... 43

43.

44.

Personal Tax credit: (Enter total from Line 7D, page AR1) ....................................................... 44

45.

State Political Contributions credit:

(Attach schedule)

............................................................. 45

46.

Other State Tax credit:

[Attach a copy of other state tax return(s)]

........................................... 46

47.

Child care credit:

(Attach Federal Form 2441 or 1040A, Sch. 2, 20% of Federal credit allowed)

Credit for adoption expenses:

(Attach Form 8839)

................................................................. 48

49.

Phenylketonuria Disorder credit:

(See Instructions. Attach AR1113)

........................................ 49

50.

Business and Incentive Tax credit:

(Attach schedule and certificate)

....................................... 50

TOTAL CREDITS: (Add Lines 44 through 50) .................................................................................................................. 51

51.

NET TAX: (Subtract Line 51 from Line 43. If Line 51 is greater than Line 43, enter 0) .......................................................... 52

52.

53.

Arkansas Income Tax withheld:

(Attach State copies of W-2 Forms)

....................................... 53

54.

Estimated tax paid or credit brought forward from last year: .................................................... 54

55.

Payments made with extension: (See Instructions) ................................................................ 55

56.

Early childhood program: Certification Number: __________________________________

(Attach Fed. Form 2441 or 1040A, Sch. 2 & Cert. Form AR1000EC, 20% of Fed. credit allowed)

TOTAL PAYMENTS: (Add Lines 53 through 56) .............................................................................................................. 57

57.

AMOUNT OF OVERPAYMENT/REFUND: (If Line 57 is greater than Line 52, enter difference) ..................................... 58

58.

59.

Amount to be applied to 2005 estimated tax: ......................................................................... 59

60.

Amount of Checkoff Contributions:

(Attach Schedule

AR1000-CO). ........................................ 60

AMOUNT TO BE REFUNDED TO YOU: (Subtract Lines 59 and 60 from Line 58) ..................................... REFUND 61

☺

61.

AMOUNT DUE: (If Line 57 is less than Line 52, enter difference; If over $1,000, See Instructions) ..................... TAX DUE 62

62.

62A.

Attach Form AR2210:

Enter Exception in box 62A

Penalty 62B

62C. Please attach your check or money order, made out to “Dept. of Finance and Administration”, for the tax and

penalty (if applicable) due. Be sure to write your Social Security Number on your check: ............................. TOTAL DUE 62C

63.

Amount of income not subject to Arkansas tax from AR4, Part III: (Memorandum only)

May the Arkansas Revenue

Yes

Agency discuss this return with

the preparer shown below?

PLEASE SIGN HERE:

Under penalties of perjury, I declare that I have examined this return and accompanying schedules and

statements, and to the best of my knowledge and belief, they are true, correct and complete. Declaration of preparer (other than

taxpayer) is based on all information of which preparer has any knowledge.

Your Signature

Occupation

Date

Home Telephone:

Spouse’s Signature

Occupation

Date

Work Telephone:

For Department Use Only

Paid Preparer’s Signature

ID Number/Social Security Number

City/State/Zip

Preparer’s Name

Address

Telephone Number

Mail REFUND returns to:

DFA State Income Tax, P. O. Box 1000, Little Rock, AR 72203-1000.

Mailing Information

Mail TAX DUE returns to:

DFA State Income Tax, P. O. Box 2144, Little Rock, AR 72203-2144.

Mail NO TAX DUE returns to: DFA State Income Tax, P. O. Box 8026, Little Rock, AR 72203-8026.

Please Note: DUE DATE IS APRIL 15, 2005

Page AR2 (R 08/04)

Form Ar1000 - Arkansas Individual Income Tax Return Full Year Resident - 2004 Page 2

Related Articles

Related forms

Related Categories