Form Ar1000nr - Arkansas Individual Income Tax Return

NR2

Primary SSN _______- _____- ________

(A)

Your/Joint

(B) Spouse’s Income

Income

Status 4 Only

ADJUSTED GROSS INCOME: (From Line 23, Columns A and B) ..............................24

24.

25. Select tax table: (Check the appropriate box)

LOW INCOME Table

REGULAR Table

If you qualify for the Low Income Tax Table, enter zero (0) on Line 25A. If not, then:

}

Itemized Deductions (See Instructions, Line 25 and

Enter

attach AR3)

the larger

If your spouse itemizes on a separate return, check here

Standard Deduction (See Instructions, Line 25) .........................25

of your:

NET TAXABLE INCOME: (Subtract Line 25 from Line 24) ..........................................26

26.

TAX: (Enter tax from tax table) ..........................................................................................27

27.

28. Combined tax: (Add amounts from Line 27, Columns A and B) ......................................................................................28

29.

Enter tax from Lump Sum Distribution Averaging Schedule: (Attach AR1000TD)

.......................................................... 29

30. Additional tax on IRA and qualified plan withdrawal and overpayment:

(Attach federal Form 5329, if required)

............ 30

TOTAL TAX: (Add Lines 28 through 30) ......................................................................................................................31

31.

32. Personal Tax Credit(s): (Enter total from Line 7D) .............................................................32

33.

Child Care Credit:

(20% of federal credit allowed; Attach federal Form 2441)

..........................33

34.

Other Credits:

(Attach AR1000TC)

.....................................................................................34

TOTAL CREDITS: (Add Lines 32 through 34) .............................................................................................................35

35.

NET TAX: (Subtract Line 35 from Line 31. If Line 35 is greater than Line 31, enter 0) ................................................ 36

36.

36A. Enter the amount from Line 23, Column C: ............................................................... 36A

36B. Enter the total amount from Line 23, Columns A and B: ......................................... 36B

36C. Divide Line 36A by 36B: (See Instructions) ...................................................................................................................

36C

36D. APPORTIONED TAX LIABILITY: (Multiply Line 36 by Line 36C) .........................................................................

36D

37.

Arkansas income tax withheld: [Attach state copies of W-2 and/or 1099R Form(s)]

.........37

38. Estimated tax paid or credit brought forward from 2015:....................................................

39. Payment made with extension: (See Instructions) .............................................................39

40.

AMENDED RETURNS ONLY

- Previous payments: (See instructions) .............................40

41. Early childhood program: Certification Number:

(20% of federal credit; Attach federal Form 2441 and Form AR1000EC)

................................

TOTAL PAYMENTS: (Add Lines 37 through 41) .........................................................................................................42

42.

43.

AMENDED RETURNS ONLY

- Previous refund: (See instructions) .............................................................................. 43

44. Adjusted Total Payments: (Subtract Line 43 from Line 42)..............................................................................................44

AMOUNT OF OVERPAYMENT/REFUND: (If Line 44 is greater than Line 36D, enter difference) ......................... 45

45.

46. Amount to be applied to 2017 estimated tax: .....................................................................46

47.

Amount of Check-off Contributions:

(Attach Schedule AR1000-CO)

.................................47



AMOUNT TO BE REFUNDED TO YOU: (Subtract Lines 46 and 47 from Line 45) ............................. REFUND 48

48.

DIRECT DEPOSIT? If your deposit will be ultimately placed in a foreign account check the box.

Routing Number

Account Number

Checking or

Savings

AMOUNT DUE: (If Line 44 is less than Line 36D, enter difference; If over $1,000, continue to 50A) .......TAX DUE 49

49.



50A.

UEP:

Attach Form AR2210 or AR2210A. If required, enter exception in box 50A

Penalty 50B

50C.

Add Lines 49 and 50B. Attach Form AR1000V with check or money order payable in U.S. Dollars to “Dept. of Finance

.............. TOTAL DUE 50C

and Administration”. Include your SSN on payment. To pay by credit card, see instructions

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

FOR MAILING ADDRESSES SEE PAGE 2 OF INSTRUCTIONS

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.

SIGN HERE

Date

E-mail:

Telephone:

Your Signature

Spouse’s Signature

Date

E-mail:

Telephone:

ID Number/Social Security Number

Paid Preparer’s Signature

May the Arkansas Revenue