Form Ar1000 - Arkansas Individual Income Tax Return Full Year Resident

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 2001 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

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

62.

AMOUNT DUE: (If Line 57 is less than Line 52, enter difference; If over $1,000.00, See Instructions) .................. TAX DUE 63

63.

63A.

Attach Form AR2210:

.................... Exception 63A

Penalty 63B

63C. Please attach your check for payment in full and include your Social Security Number

and the amount for tax due and/or penalty: .................................................................................................. TOTAL DUE 63C

64.

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?