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Form Ar4 - Arkansas Individual Income Tax Return Interest And Dividend Income Schedule - 1999

ARKANSAS INDIVIDUAL INCOME TAX RETURN

AR4

1999

Interest and Dividend Income Schedule

Name:

Social Security Number:

Part I

INTEREST INCOME

Part II

DIVIDEND INCOME

Interest on bank deposits, notes, mortgages, interest from

Dividends, incuding capital gains distributions and other dis-

individuals, corporation bonds, savings and loan deposits

tributions on stock, are fully taxable. There is no dividend

and credit union deposits are taxable. Interest on obligations

exclusion applicable to Arkansas.

of other states and subdivisions are fully taxable.

List the names of the dividend source below and designate

List the names of the interest source below and designate

the ownership by writing Y (Yours), S (Spouse) or J (Joint).

1.YSJ

NAME OF PAYER

AMOUNT

1.YSJ

NAME OF PAYER

AMOUNT

2. Add the amounts on Line 1.

3. Excludable interest income, if any.

3. Nontaxable distributions.

4. Subtract Line 3 from Line 2. Enter the result here and on

Line 11, AR1/NR1.

Line 12, AR1/NR1.

Part III

INTEREST AND DIVIDEND INCOME NOT SUBJECT TO ARKANSAS TAX

(See Instructions)

TOTAL INTEREST INCOME NOT SUBJECT TO ARKANSAS TAX: (Enter here and on page AR2/NR2, Line 64). .........................................

Page AR4 (R 8/99)

Form Ar4 - Arkansas Individual Income Tax Return Interest And Dividend Income Schedule - 1999