Form Ar1000f - Arkansas Individual Income Tax Return - 2012
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1
22012 AR1000F
AR1
ITAR121
ARKANSAS INDIVIDUAL
CHECK BOX IF
INCOME TAX RETURN
AMENDED RETURN
Full Year Resident
Dept. Use Only
Jan. 1 - Dec. 31, 2012 or fiscal year ending ____________ , 20 ____
PRIMARY NAME
MI
LAST NAME
PRIMARY SOCIAL SECURITY NUMBER
SPOUSE NAME
MI
LAST NAME
Important
SPOUSE’S SOCIAL SECURITY NUMBER
MAILING ADDRESS
(Number and Street, P.O. Box or Rural Route)
CITY, STATE AND ZIP CODE
Important: You MUST
enter your SSN(s) above
1.
SINGLE (Or widowed before 2012 or divorced at end of 2012)
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 was your child, but not your dependent,
6.
QUALIFYING WIDOW(ER) with dependent child
enter child’s name here:
Year spouse died: (See Instructions)
Check this box if you have filed a state extension
HAVE YOU FILED AN EXTENSION?
or an automatic federal extension
HEAD OF HOUSEHOLD/QUALIFYING WIDOW(ER)
7A.
YOURSELF
65 SPECIAL
BLIND
DEAF
65 or OVER
(Filing Status 3 Only)
(Filing Status 6 Only)
SPOUSE
65 or OVER
65 SPECIAL
BLIND
DEAF
00
X $23 =
Multiply number of boxes checked from 7A............
(Do not list yourself or spouse)
7B. Dependents
First Name
Last Name
Dependent’s relationship to you
Dependent’s Social Security Number
1.
2.
3.
4.
5.
X $23 =
00
Multiply number of dependents from 7B............
7C. First name of individual(s) with developmental disability: (See Instructions)
00
X $500 =
Multiply number of individuals with developmental disabilities from 7C...........
7D. TOTAL PERSONAL TAX CREDITS: (Add Lines 7A, 7B, and 7C. Enter total here and on Line 32).........................7D
00
(A) Your/Joint
(B) Spouse’s Income
ROUND ALL AMOUNTS TO WHOLE DOLLARS
Income
Status 4 Only
00
00
8.
8
Wages, salaries, tips, etc:
(Attach W-2s)
.....................................................................................
00
00
Less
9A
9A.
U.S. Military compensation: (Your/joint gross amount)
00
$9,000
00
Less
9B.
U.S. Military compensation: (Spouse’s gross amount)
9B
00
$9,000
00
00
10.
Interest income:
(If over $1,500, attach AR4)
..............................................................................
10
00
00
11.
Dividend income:
(If over $1,500, attach AR4)
............................................................................
11
00
00
12.
Alimony and separate maintenance received:.............................................................................
12
00
00
13.
Business or professional income:
(Attach federal Schedule C or C-EZ)
.....................................
13
00
00
Capital gains/(losses) from stocks, bonds, etc:
(See Instr. Attach federal Schedule D)
..............
14.
14
00
00
15.
Other gains or (losses):
(Attach federal Form 4797 and/or 4684 if applicable)
...........................
15
00
00
16.
Non-Qualified IRA distributions and taxable annuities:
(Attach All 1099Rs)
................................
16
17A.
Your/Joint Employer pension plan(s)/Qualified IRA(s):
(See Instructions - Attach All 1099Rs)
Less
00
00
00
Gross Distribution
Taxable Amount
17A
$6,000
17B.
Spouse’s Employer pension plan(s)/Qualified IRA(s): (Filing Status 4 Only)
Less
00
00
00
Gross Distribution
Taxable Amount
17B
$6,000
00
00
18.
18
Rents, royalties, partnerships, estates, trusts, etc:
(Attach federal Schedule E)
.........................
00
00
19.
19
Farm income:
(Attach federal Schedule F)
..................................................................................
00
00
20.
Other income/depreciation differences: (List type and amount. See Instructions) .....................
20
00
00
21.
TOTAL INCOME: (Add Lines 8 through 20) ............................................................................
21
Page AR1 (R 10/4/12)
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