Form Ar1000a - Arkansas Individual Income Tax Amended Return Full Year Resident - 2001
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1
2STATE OF ARKANSAS
AR1000A
2001
Amended Individual Income Tax Return
FULL YEAR RESIDENTS AMENDING TAX YEAR 2001
OR FISCAL YEAR ENDING _____________________________________ 20 ____
File Date
Amount Paid
Your Social Security Number
FOR OFFICE
USE ONLY
First Name(s) and Initial(s) (List both if applicable)
Last Name
Spouse’s Social Security Number
Present Address (Number and Street, Apartment Number or Rural Route)
Preparer’s Identification Number
City, Town or Post Office , State and Zip Code
Telephone Numbers
Home:
Work:
CHECK ONLY ONE BOX:
1.
SINGLE (Or widowed before 2001 or divorced at end of 2001)
4.
MARRIED FILING SEPARATELY ON THE SAME RETURN
2.
MARRIED FILING JOINT (Even if only one had income)
5.
MARRIED FILING SEPARATELY ON DIFFERENT RETURNS
3.
HEAD OF HOUSEHOLD (See Instructions)
Enter spouse’s name here and SSN above _________________
If the qualifying person is your child but not your dependent,
6.
QUALIFYING WIDOW(ER) with dependent child.
enter this child’s name here: ____________________________
Year spouse died: (See Instructions) _______________________
7A.
YOURSELF
65 or OVER
65 SPECIAL
BLIND
DEAF
HEAD OF HOUSEHOLD/
QUALIFYING WIDOW(ER)
SPOUSE
65 or OVER
65 SPECIAL
BLIND
DEAF
00
X $20 =
7B. First name(s) of dependents:
Multiply number of boxes checked from Line 7A ...
(Do not list yourself or spouse)
00
X $20 =
____________________________________________
Multiply number of dependents from Line 7B ........
7C. First name of developmentally disabled individual(s):
(See Instr.)
Multiply number of developmentally disabled
00
____________________________________________
X $500 =
individuals from Line 7C .......................................
7D.TOTAL PERSONAL CREDITS: (Add Lines 7A, 7B and 7C. Enter total here and on Line 18) ..................................................... 7D
00
Has your tax return been adjusted by the IRS? If yes, attach reports.
Yes
No
PART 1: ORIGINAL
PART 2: AMENDED
INCOME
A. YOURS
B. SPOUSE’S
A. YOURS
B. SPOUSE’S
00
00
00
00
8. Total Income: .................................................... 8
8
00
00
00
00
9. Adjustments to Income: ..................................... 9
9
00
00
00
00
10. Adjusted Gross Income: .................................. 10
10
00
00
00
00
11. Itemized/Standard Deductions: ........................ 11
11
00
00
00
00
12. Net Taxable Income: ........................................ 12
12
TAX COMPUTATION
A. YOURS
B. SPOUSE’S
00
00
13. Select tax table: (Enter tax from table). ................................................................................................ 13
LOW INCOME
REGULAR
Table 1
Table 2
00
14. Tax: (Enter total from Lines 13A and 13B). ................................................................................................................................. 14
00
15. Enter tax from ten (10) year averaging schedule: (Attach AR1000TD) ......................................................................................... 15
00
16. IRA and qualified plan withdrawal and overpayment penalties: (Attach Fed. Form 5329 if required) .............................................. 16
00
17. Total Tax: (Add Lines 14 through 16. Enter here) ........................................................................................................................ 17
TAX CREDITS
00
18. Personal Tax Credit(s): (Enter total from Line 7D) .................................................................................... 18
00
19. Working Taxpayer Credit: (See Instructions. Attach AR1328) ................................................................... 19
00
20. State Political Contributions Credit: (Attach Schedule) ............................................................................. 20
00
21. Other State Tax Credit(s): {Attach copy of other State return(s)} ............................................................... 21
00
22. Child Care Credit(s): (Attach Federal Form 2441 or 1040A, Sch. 2, 20% of Federal credit allowed) .............. 22
00
23. Credit for Adoption Expenses: (Attach Federal Form 8839, 20% of Federal credit allowed) .......................... 23
00
24. Phenylketonuria Disorder Credit: (See Instructions, Attach AR1113) .......................................................... 24
00
25. Business and Incentive Tax Credits: (Attach Schedule and Certificate) ...................................................... 25
00
26. TOTAL CREDITS: (Add Lines 18 through 25) .............................................................................................................................. 26
00
27. NET TAX: (Subtract Line 26 from Line 17. Enter here) .................................................................................................................. 27
Effective Date: January 1, 2001
AR1000A (R 10/01)
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