Form Ar1000a - Amended Return Full Year Resident Page 2

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ITA122

27. NET TAX: (From Line 26) ......................................................................................................................................................... 27

PAYMENTS

28. Arkansas Income Tax withheld: ........................................................................................................... 28

29. Estimated tax paid or credit brought forward from preceding tax year: .............................................. 29

30. Early childhood program: Certification No. __________________ : (20% of federal credit allowed;

Attach federal Form 2441 and Certification Form AR1000EC) ................................................... 30

31. Amount Paid with Return: ................................................................................................................... 31

32. Amount Paid after Return was filed: ................................................................................................... 32

33. TOTAL PAID: (Add Lines 28 through 32. Enter here) ......................................................................... 33

34. Enter prior Overpayment/Refund/Estimate carried forward: ............................................................... 34

35. TOTAL PAYMENTS: (Subtract Line 34 from Line 33. Enter here) ...................................................... 35

REFUND OR TAX DUE

36. AMOUNT TO BE REFUNDED TO YOU: (If Line 35 is greater than Line 27, enter the difference here) ................REFUND 36

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37. AMOUNT DUE: (If Line 27 is greater than Line 35, enter the difference here) ......................................................TAX DUE 37

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Complete and attach Form AR1000V to your check or money order payable in U.S. Dollars to “Dept. of Finance and

Administration” for the tax due.

Include your SSN on the check or money order. To pay by credit card, see instructions.

PLEASE SIGN HERE

Under penalties of perjury, I declare that I have examined this return and accompanying schedules and statements, and to the best of my knowledge and

belief, they are true, correct and complete. Declaration of preparer (other than taxpayer) is based on all information of which preparer has any knowledge.

Your Signature

Occupation

Date

Spouse’s Signature

Occupation

Date

Paid Preparer’s Signature

ID Number/SSN

Date

May the Arkansas Revenue

Firm Name (Or yours, if self employed)

Telephone