Form Ar1002v - Fiduciary Tax Return Payment Voucher - 2012
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1STATE OF ARKANSAS
FIDUCIARY TAX PAYMENT VOUCHER INSTRUCTIONS
IMPORTANT: This voucher must be fully completed and included with any payment made when
filing an original or amended tax return. Failure to complete a payment voucher could cause a delay
in receiving credit for your payment. You must also use this payment voucher for filing prior year tax
forms.
Paper Returns
If mailing a paper tax return with payment, complete Form AR1002V and include a check or money
order. Mail the AR1002V, payment, and your tax return (Form AR1002 or AR1002NR) to the PO Box
listed below. If this payment is for an amended return, mark “YES” on Form AR10002V in the appro-
priate space.
Arkansas State Income Tax
P.O. Box 2144
Little Rock, AR 72203-2144
All tax return payments should be mailed on or before the due date of the tax return.
Note: Write your Social Security Number on your check or money order, and make payable in U.S.
Dollars to the Department of Finance and Administration.
For assistance, call (501) 682-1100
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You must cut along the dotted line or the processing of your payment will be delayed.
AR1002V
FIDUCIARY TAX RETURN PAYMENT VOUCHER
(R 1/13/11)
Federal Identification Number
Fiscal Year End
Tax Year
2012
Due Date
Amount Paid
04/15/2013
Name
Include Cents
(ex. 1,234,567.89)
Is Payment for an Amended Return?
Address
Yes
No
City, State, Zip
Click Here to Print Document
Telephone #
Click Here to Clear Form Info
FITEIN0000000000012312012RTNPYM00000000000000000000000
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