Form Ar-Ms - Tax Exemption Certificate For Military Spouse

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AR-MS
STATE OF ARKANSAS
Tax Exemption Certificate
For Military Spouse
Military spouses may use Form AR-MS to claim exemption from Arkansas income tax. The Military Spouses
Residency Relief Act of 2009 amends the Servicemembers Civil Relief Act of 2003 to allow servicemembers’
spouses’ income to be taxed in the state of domicile.
If a military spouse’s employer withheld Arkansas tax from income and the conditions in the sections below
are met, income earned in Arkansas is not taxable to Arkansas. Attach this completed certificate and an LES
to Form AR1000NR. Write “Military Spouse” at the top of the return and list amount of Arkansas tax withheld
on second page of Form AR1000NR. (Do not list income on Form AR1000NR.)
SECTION I
Employee’s Name
Employee’s SSN
Military Servicemember’s Name
Military Sevicemember’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. Complete this section in full.
I am not a military servicemember ...........................................................................................
TRUE
FALSE
I am married to a military servicemember ................................................................................
TRUE
FALSE
I live with my spouse ................................................................................................................
TRUE
FALSE
My spouse’s current military orders assign him/her to a location in Arkansas .........................
TRUE
FALSE
My domicile is a state other than Arkansas .............................................................................
TRUE
FALSE
State of domicile _____________________________
SECTION III
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)
AR-MS (R 10/4/12)
Attach this certificate to your AR1000NR tax return

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