Form Arw-4ms - Annual Withholding Tax Exemption Certificate For Military Spouse

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ARW-4MS

STATE OF ARKANSAS

Annual Withholding Tax Exemption

Certificate For Military Spouse

Form ARW-4MS is used for employees claiming exemption from Arkansas’ Income Tax Withholding require-

ments. The Military Spouses Residency Relief Act of 2009 amends the Servicemembers Civil Relief Act of

2003 to allow military servicemembers spouse’s income to be taxed in the state of domicile.

In order to qualify the conditions below must be met and Sections I, II and IV completed. Each claim for

exemption will last for one year and this form needs to be filed by December 1 of each year to continue the

withholding exemption yearly. To opt out of the withholding exemption, complete Sections I, III and IV below.

TAX YEAR

CLICK HERE TO CLEAR FORM

SECTION I

Employee’s Name

Employee’s SSN

Military Sevicemember Spouse’s Name

Spouse’s SSN

Current Street Address, City, and Zip Code

Military Servicemember’s Domicile

SECTION II

To qualify for the exemption you must meet the conditions below and complete this section in full.

I am not a military servicemember ...........................................................................................

YES

I am married to a military servicemember ................................................................................

YES

I live with my spouse ................................................................................................................

YES

My spouse’s current military orders assign him/her to a location in Arkansas? .......................

YES

My domicile is a state other than Arkansas? ...........................................................................

YES

State of domicile _____________________________

SECTION III

I want to opt out of the exemption for military spouse’s and withhold Arkansas taxes ...................

YES

SECTION IV

Employee’s Signature

Date

Phone Number

Under penalties of perjury, I certify that I am not subject to Arkansas withholding tax because I meet the conditions set forth under the Servicemembers

Civil Relief Act, as amended by the Military Spouses Residency Relief Act (P.L. 111-97)

Give this certificate to your employer and keep a copy for your records.