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SPOUSE INCOME

YOUR 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)

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.

Enter tax from Lump Sum Distribution Averaging Schedule:

(Attach AR1000TD)

........................................................................ 40

41.

IRA and qualified plan withdrawal and overpayment penalties:

(Attach Federal Form 5329, if required)

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

TOTAL TAX: (Add Lines 39 through 41) .............................................................................................................................. 42

42.

43.

Personal Tax credit: (Enter total from Line 7D, page AR1) ........................................................... 43

44.

Working Taxpayer credit:

(See Instructions. Attach AR1328)

................................................... 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)

48.

Credit for adoption expenses:

(Attach Federal Form 8839, 20% of Federal credit allowed)

........ 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 43 through 50) ................................................................................................................... 51

51.

NET TAX: (Subtract Line 51 from Line 42. If Line 51 is greater than Line 42, enter 0) ........................................................... 52

52.

53.

Arkansas Income Tax withheld:

(Attach State copies of W-2s)

................................................. 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 2002 estimated tax: .............................................................................. 59

60.

Amount to be contributed to the AR Disaster Relief Fund: ....... 60

61.

Amount to be contributed to the U. S. Olympic Fund: .................. 61

62.

Amount to be contributed to AR Schools for the Blind and Deaf: .. 62

AMOUNT TO BE REFUNDED TO YOU: (Subtract Lines 59, 60, 61 and 62 from Line 58) .............................. REFUND 63

63.

AMOUNT DUE: (If Line 57 is less than Line 52, enter difference; If over $1,000, See Instructions) ............................ TAX DUE 64

64.

64A.

Attach Form AR2210:

Enter Exception in box .. 64A

Penalty 64B

64C. 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 64C

65.

Source of income not subject to Arkansas tax: (Memorandum only)

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 shown below?

Spouse’s Signature

Occupation

Date

Yes

FOR DEPARTMENT USE ONLY

Paid Preparer’s Signature

ID Number/Social Security Number

Preparer’s Name

City/State/Zip

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.

Page AR2 (R 10/01)

Form Ar1000 - Arkansas Individual Income Tax Return Full Year Resident - Ar Department Of Finance And Administration - 2001 Page 2

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