Form Ar1000s - Arkansas Individual Income Tax Return - 2005

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S
2005 AR1000S
ARKANSAS INDIVIDUAL INCOME TAX RETURN
Full Year Resident/Short Form
Dept. Use Only
Jan 1 - Dec 31, 2005 or fiscal year ending ________ , 20 __
FIRST NAME(S) AND INITIAL(S)
LAST NAME(S)
YOUR SOCIAL SECURITY NUMBER
(List both spouses if applicable)
(See Instructions)
MAILING ADDRESS
SPOUSE’S SOCIAL SECURITY NUMBER
(Number and Street, P.O. Box or Rural Route)
You MUST enter
IMPORTANT
CITY, STATE AND ZIP CODE
your SSN(s) above
HOME TELEPHONE:
WORK TELEPHONE:
1.
SINGLE (Or widowed before 2005 or divorced at end of 2005)
4.
MARRIED FILING SEPARATELY ON THE SAME RETURN
IF FILING STATUS 5, USE AR1000/AR1000NR - LONG FORM
2.
MARRIED FILING JOINT (Even if only one had income)
5.
3.
HEAD OF HOUSEHOLD (See Instructions)
6.
QUALIFYING WIDOW(ER) with dependent child.
If the qualifying person is your child but not your dependent,
Year spouse died:(See Instructions) _____________________
enter child’s name here: ______________________________
HAVE YOU FILED A FEDERAL EXTENSION?
Check this box if you have filed an
IF SO, CHECK THE APPROPRIATE BOX
automatic Federal Extension Form 4868
7A.
YOURSELF
65 or OVER
65 SPECIAL
BLIND
DEAF
HEAD OF HOUSEHOLD/
QUALIFYING WIDOW(ER)
SPOUSE
65 or OVER
65 SPECIAL
BLIND
DEAF
X $21 =
00
Multiply number of boxes checked from Line 7A
7B. First name(s) of dependent(s): (Do not list yourself or spouse)
X $21 =
00
________________________________________________ Multiply number of dependent(s) from Line 7B
7C.TOTAL PERSONAL CREDITS: (Add Lines 7A and 7B. Enter total here and on Line 16) .................................................. 7C
00
(A)
Your/Total
(B)
Spouse’s Income
ROUND ALL FIGURES TO WHOLE DOLLARS
Income
Status 4 Only
00
00
8.
Wages, salaries, tips, etc.: .................................................................................................... 8
8
00
00
9.
Interest income/dividend income:
9
9
(If interest or dividends are over $1,500, attach page ARS2) ..............
00
00
10.
Miscellaneous income:
(List type and amount. See
Instructions). ........................................... 10
10
TOTAL INCOME: (Add Lines 8 through 10) ...................................................................... 11
00
00
11.
11
LOW INCOME Table 1
REGULAR Table 2
12.
Select Tax Table:
Standard Deduction: (See Instructions)
00
00
NOTE: If you qualify for the Low Income Table, enter zero (0) on Line 12. .............................. 12
12
00
00
13.
Taxable Income: (Subtract Line 12 from Line 11) ................................................................... 13
13
00
00
14.
Enter tax from table: ............................................................................................................ 14
14
TOTAL TAX: (Add Lines 14A and 14B) ............................................................................................................................ 15
00
15.
00
16.
Personal Tax Credits. (Enter total from Line 7C) .................................................................... 16
00
17.
Child Care Credit:
(Attach Federal schedule, 20% of Federal credit
allowed.). ........................ 17
00
18.
TOTAL CREDITS: (Add Lines 16 and 17) ........................................................................................................................... 18
NET TAX: (Subtract Line 18 from Line 15. If Line 18 is greater than Line 15, enter 0) ......................................................... 19
00
19.
00
20.
Arkansas Income Tax withheld:
[Attach State copies of W-2
Form(s)]. ................................... 20
21.
Early Childhood Program: Certification Number: ______________________________
(Attach Fed. Form 2441 or 1040A, Sch. 2 & Cert. Form AR1000EC, 20% of Fed. credit
00
allowed). ..
21
TOTAL PAYMENTS: (Add Lines 20 and 21) ................................................................................................................... 22
00
22.
00
23.
AMOUNT OF OVERPAYMENT/REFUND: (If Line 22 is greater than Line 19, enter difference) ............................................ 23
00
24.
Amount of Check-off Contributions:
(Attach Schedule
AR1000-CO). ...................................... 24
00
25.
AMOUNT TO BE REFUNDED TO YOU: (Subtract Line 24 from Line 23) ............................................................. REFUND 25
00
26.
Amount Due: (If Line 22 is less than Line 19, enter the difference; If over $1,000 see instructions) ........................ TAX DUE 26
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
May the Arkansas Revenue
Agency discuss this return with
the preparer of the return?
Spouse’s Signature
Occupation
Date
Yes
No
For Department Use Only
Paid Preparer’s Signature
ID Number/Social Security Number
A
B
Preparer’s Name
City/State/Zip
C
Address
Telephone Number
D
Mail REFUND returns to:
DFA State Income Tax, P. O. Box 1000, Little Rock, AR 72203-1000.
Mailing Information
E
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.
F
Please Note: DUE DATE IS APRIL 17, 2006
Page AR1000S (R 09/05)
CLICK HERE TO CLEAR FORM

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