Form Ar1000adj - Individual Income Tax Schedule Of Adjustments

AR1000ADJ INSTRUCTIONS

LINE 4. This line is used to report your allowable

LINE 8.

Employees and self-employed

contribution to an Archer Medical Savings account

persons can deduct certain moving expenses

(MSA). An MSA is a trust or custodial account that

incurred in 2015.

LINE 1. To claim the Texarkana exemption, you

is created or organized exclusively for the purpose

must file a return and report all Arkansas income

of paying the qualified medical expenses of the tax-

You can take this deduction if you moved for

you received during the year. Attach AR-TX Form.

payer (account holder) and the taxpayer’s spouse

your job or business and added at least fifty

(AR-TX Form is supplied by your employer.)

and/or dependents. To be eligible, a taxpayer

50 miles to the distance from your old home to

must have had insurance coverage under a high

your workplace. If you had no former workplace,

The AR-TX Form is not required for non wage

deductible health plan (HDHP) only. A HDHP will

your new workplace must be at least 50 miles

income such as interest, dividends, Schedule C

have the following deductions and limitations: (1)

from your old home. (Attach a completed copy

(sole proprietor), Schedule F (farm), Schedule

for self-only coverage, the minimum deductible is

of federal Form 3903.)

E (rents, royalties, partnerships, etc.) or retire-

$2,200, maximum deductible is $3,300 and the

ment. Additional information may be required for

maximum out of pocket expense is $4,450, and

If you were reimbursed for any moving expenses

verification if an adjustment for these types of

(2) for family coverage, the minimum deductible

and the amount was included on your W-2, re-

income is allowed.

is $4,450, maximum deductible is $6,650 and the

port this amount as income on Form AR1000F/

maximum out of pocket expense is $8,150. The

AR1000NR, Line 8.

NOTE: Taxpayers who claim this exemption

contribution limitation for any month is the amount

must file using their street address in Texarkana,

LINE 9. If you were self-employed and had a

equal to 1/12 of 65% of the annual deductible for an

Arkansas or Texarkana, Texas. If you use a Post

individual with self-only coverage and 1/12 of 75%

net profit for 2015, you may be able to deduct

Office Box, this exemption will not be allowed.

of the annual deductible for family coverage. New

part of the amount paid for health insurance for

Archer MSAs may not be established after 2007

yourself, your spouse, and/or dependents. Com-

If you lived within the city limits of Texarkana,

but contributions can be made to existing accounts.

plete the worksheet on page 21 of the booklet

Arkansas, you are allowed a full exemption

to determine your deduction.

from Arkansas income tax. Part year Texarkana

LINE 5. This line is used to report your allowable

residents claim the exemption only on income

LINE 10. If you were self-employed and con-

contribution to a Health Savings Account (HSA). To

earned while a resident of Texarkana, Arkansas.

be eligible, a taxpayer must have had insurance

tributed to a “Keogh”, H.R. 10 retirement plan,

coverage under a HDHP only. A HDHP will have the

or a SIMPLE plan, enter the total contributions.

If you lived in the city limits of Texarkana, Texas,

following deductions and limitations: (1) for self-only

The amount of the deduction depends upon the

you may deduct the income you earned in the city

coverage, the minimum deductible is $1,300 and

type of plan.

limits of Texarkana, Arkansas. All other Arkansas

the maximum out of pocket expense is $6,450, and

income is taxable to you.

LINE 11. Enter the total penalties paid for early

(2) for family coverage, the minimum deductible is

$2,600 and the maximum out of pocket expense is

withdrawal of certificates of deposit.

LINE 2. If you made contributions to a tuition

$12,900. You can make pre-tax contributions of up to

savings account established under the Arkansas

LINE 12. If you paid alimony or separate

$3,350 each year ($6,650 for families) to cover health

Tax Deferred Tuition Savings Program enter

care costs. Individuals who reached age 55 by the

maintenance as the result of a court order, enter

the amount here. Contributions to plans es-

end of the tax year can increase their annual contri-

the total amount. Enter the name and Social

tablished in states other than Arkansas are not

bution by $1,000 for 2015. Maximum contributions

Security Number of the person you paid.

deductible. The deductible contribution cannot

allowed to an HSA are reduced by any contributions

exceed $5,000 per taxpayer per tax year. Quali-

LINE 13. If you have an individual with disabili-

made to an Archer MSA. Attach federal Form 8889.

fied withdrawals from a tuition savings account

ties who qualifies for the deduction you can take

established under the Arkansas Tax Deferred

LINE 6. You may take an adjustment for inter-

an adjustment from income of $500 for each indi-

Tuition Savings Program or a tax-deferred tuition

est paid on student loans if all of the following

vidual with disabilities. Attach Form AR1000DC.

savings program established by another state will

apply:

be exempt from Arkansas income tax with respect

LINE 14. If you paid unreimbursed expenses

to the designated beneficiary’s income.

1.You paid interest in 2015 on a qualified stu-

for yourself or one of your dependents related to

dent loan.

the donation of an organ (part of a liver, pancreas,

LINE 3. This line is used to report your allow-

2.Your filing status is any status other than married

kidney, intestine, lung or bone marrow) you may

able contribution to an Individual Retirement Ac-

filing separately on different returns (Status 5).

take a tax deduction up to $10,000. The deduction

count (IRA). If you contributed to your own IRA,

3.Your AGI is less than: $80,000 if filing Status 1,

must be claimed for the year in which the trans-

certain limitations may apply to the amount you

3, or 6; $160,000 if filing Status 2 or 4. Status 4

plantation occurs. Allowable expenses include

may use as an adjustment to income. If neither

filers, note that this is a combined income amount.

travel, lodging, medical expenses and lost wages

you nor your spouse was covered by an employer

4.You are not claimed as a dependent on another

related to the organ donation. An individual may

provided retirement plan, the entire contribution is

taxpayer’s 2015 tax return.

claim the deduction only once in his or her lifetime.

deductible up to $5,500 each for all filing statuses.

The deduction does not apply to organs harvested

If either you or your spouse was covered by such

Figure your allowable deduction using the work-

from a deceased donor. Attach Form AR1000-OD.

a plan, the amount of the deduction depends

sheet on page 20 of the booklet. Do not enter

on the amount of your Adjusted Gross Income

LINE 15. If you have military reserve expenses,

more than $2,500 on AR1000ADJ.

(AGI) before the IRA deduction, as shown in the

enter the total amount.

table on

page 20 of the booklet.

Use this table

LINE 7. You may take an adjustment for con-

along with your Arkansas AGI to determine your

LINE 16. If you have reforestation deductions,

tributions made to a long-term intergenerational

allowable deduction. Catch up Contributions -

trust. This is a trust established for an individual

enter the total amount.

Individuals who turned 50 before the close of the

under age 18 to provide funds for the minor’s

tax year may increase the maximum permitted

LINE 17. Total Adjustments. Add Lines 1

retirement. The trustee must be a resident of

annual contribution by up to $1,000.

Arkansas and cannot distribute any of the trust

through 16 and enter on this line and on Forms

funds to the beneficiary until the beneficiary

AR1000F or AR1000NR, Line 22.

reaches age 55. Contributions are limited to

$4,000 per year.

AR1000ADJ (R 10/21/15)

Form Ar1000adj - Individual Income Tax Schedule Of Adjustments - 2015 Page 2

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