Form Ar1000anr - Amended Return Nonresident And Part Year Resident

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AR1000ANR
TAX YEAR:
or fiscal year ending_________ 20_______
ITAN101
(ONLY FOR TAX YEARS 2009 AND PRIOR)
ARKANSAS INDIVIDUAL INCOME TAX
AMENDED RETURN
NONRESIDENT AND PART YEAR RESIDENT
Your Social Security Number
File Date
Amount Paid
FOR OFFICE
USE ONLY
First Name(s) and Initial(s) (List both if applicable)
Last Name
Spouse’s Social Security Number
Present Address (Number and Street, Apartment Number or Rural Route)
Preparer’s Identification Number
City, State, and Zip Code
Telephone Numbers
Home:
Work:
Nonresident - List state of residence
Part-Year Resident - Dates you were a resident of Arkansas
From:
To:
CHECK ONLY ONE BOX:
1.
SINGLE (Or widowed/divorced at end of tax year being amended)
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 is your child but not your dependent,
6.
QUALIFYING WIDOW(ER) with dependent child.
enter this child’s name here: ___________________________
Year spouse died: (See Instructions)_____________________
7A.
YOURSELF
65 or OVER
65 SPECIAL
BLIND
DEAF
HEAD OF HOUSEHOLD/
QUALIFYING WIDOW(ER)
SPOUSE
65 or OVER
65 SPECIAL
BLIND
DEAF
X $__ =
00
7B. First name(s) of dependents: (Do not list yourself or spouse)
.....
Multiply number of boxes checked from Line 7A
X $__ =
00
____________________________________________
..........
Multiply number of dependents from Line 7B
7C. First name of developmentally disabled individual(s): (See Instr.)
Multiply number of developmentally disabled
X $500 =
00
........................................
____________________________________________
individuals from Line 7C
00
7D. TOTAL PERSONAL CREDITS: (Add Lines 7A, 7B and 7C. Enter total here and on Line 18) .................................................7D
PART 1:
ORIGINAL
PART 2:
AMENDED
A.
B.
Spouse’s
C.
Arkansas
A.
B.
Spouse’s
C.
Arkansas
Your/Joint
Your/Joint
INCOME
Income
Income Only
Income
Income Only
Income
Income
00
00
00
00
00
00
8. Total Income: ...............................8
8
00
00
00
00
00
00
9. Adjustments to Income: ...............9
9
00
00
00
00
00
00
10. Adjusted Gross Income: ............10
10
00
00
00
00
11. Itemized/Standard Deductions: .11
11
00
00
00
00
12. Net Taxable Income: ..................12
12
TAX COMPUTATION
00
00
13. Select tax table: (Enter tax from applicable tax table). ............................................................ 13
LOW INCOME
REGULAR
00
14. Combined Tax: (Enter total from Lines 13A and 13B). ........................................................................................................14
00
15. Enter tax from ten (10) year averaging schedule: (Attach AR1000TD) ...............................................................................15
00
16. IRA and qualified plan withdrawal and overpayment penalties: (Attach federal Form 5329 if required) .............................16
00
17. Total Tax: (Add Lines 14 through 16. Enter here) ................................................................................................................17
TAX CREDITS
00
18. Personal Tax Credit(s): (Enter total from Line 7D) .................................................................. 18
00
19. State Political Contributions Credit: (Attach AR1800) ............................................................. 19
00
20. Other State Tax Credit(s): {Attach copy of other State return(s)} ............................................ 20
00
21. Child Care Credit(s): (20% of federal credit allowed, Attach federal Form 2441) ............................ 21
00
22. Credit for Adoption Expenses: (Attach federal Form 8839) ..................................................... 22
00
23. Phenylketonuria Disorder Credit: (Attach AR1113) ................................................................. 23
00
24. Business and Incentive Tax Credits: [Attach Schedule and certificate(s)] ............................... 24
00
25. TOTAL CREDITS: (Add Lines 18 through 24) .....................................................................................................................25
00
26. NET TAX: (Subtract Line 25 from Line 17. Enter here) .......................................................................................................26
AR1000ANR (R 10/21/2010)

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