Form Ar1000f - Arkansas Individual Income Tax Return - 2015
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-DQ 'HF RU ¿VFDO \HDU HQGLQJ ____________ , 20 ____
PRIMARY FIRST NAME
MI
LAST NAME
PRIMARY SOCIAL SECURITY NUMBER
SPOUSE FIRST NAME
MI
LAST NAME
Important
SPOUSE’S SOCIAL SECURITY NUMBER
MAILING ADDRESS
(Number and Street, P.O. Box or Rural Route)
Important: You MUST
CITY, STATE AND ZIP CODE
enter your SSN(s) above
1.
SINGLE (Or widowed before 2015 or divorced at end of 2015)
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)
&KHFN WKLV ER[ LI \RX KDYH ÀOHG D VWDWH H[WHQVLRQ
HAVE YOU FILED AN EXTENSION?
RU DQ DXWRPDWLF IHGHUDO H[WHQVLRQ
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
Multiply number of boxes checked ................................................................................................................................................ 7A
00
X $26 =
(Do not list yourself or spouse)
Dependents
First Name
Last Name
Dependent’s relationship to you
Dependent’s Social Security Number
1.
2.
3.
00
7B. Multiply number of dependents from above ...............................................................................................7B
X $26 =
7C. First name of individual(s) with developmental disability: (See Instructions)
X $500 =
Multiply number of individuals with developmental disabilities from 7C ........................................................ 7C
00
7D. 727$/ 3(5621$/ 7$; &5(',76 (Add Lines 7A, 7B, and 7C. Enter total here and on Line 32).........................7D
00
(A) Your/Joint
% 6SRXVH·V ,QFRPH
5281' $// $028176 72 :+2/( '2//$56
Income
6WDWXV 2QO\
00
00
8.
8
Wages, salaries, tips, etc:
(Attach W-2s)
.....................................................................................
U.S. Military compensation: (Your/joint gross amount)
9A.
9A
00
U.S. Military compensation: (Spouse’s gross amount)
9B.
9B
00
00
00
10.
Interest income:
(If over $1,500, attach AR4)
..............................................................................
10
00
00
11.
Dividend income:
(If over $1,500, attach AR4)
............................................................................
11
00
00
12.
Alimony and separate maintenance received:.............................................................................
12
00
00
13.
Business or professional income:
(Attach federal Schedule C or C-EZ)
.....................................
13
00
00
14.
Capital gains/(losses) from stocks, bonds, etc:
(See Instr. Attach Schedule D)
..........................
14
00
00
15.
Other gains or (losses):
(Attach federal Form 4797 and/or 4684 if applicable)
...........................
15
00
00
16.
1RQ4XDOL¿HG ,5$ GLVWULEXWLRQV DQG WD[DEOH DQQXLWLHV
(Attach All 1099Rs)
................................
16
17A.
<RXU-RLQW (PSOR\HU SHQVLRQ SODQ V 4XDOL¿HG ,5$ V
(See Instructions - Attach All 1099Rs)
Less
Gross Distribution
7D[DEOH $PRXQW
00
00
00
$6,000
17A
17B.
6SRXVH¶V (PSOR\HU SHQVLRQ SODQ V 4XDOL¿HG ,5$ V (Filing Status 4 Only)
Less
00
Gross Distribution
7D[DEOH $PRXQW
00
00
$6,000
17B
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:
(Attach Form AR-OI)
.....................................................
20
00
TOTAL INCOME: (Add Lines 8 through 20) ............................................................................
00
21.
21
00
00
TOTAL ADJUSTMENTS:
22.
(Attach Form
AR1000ADJ)................................................ ...........
22
$'-867(' *5266 ,1&20( (Subtract Line 22 from Line 21)................................ ...........
00
00
23.
23
Page AR1 (R 5/19/15)
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