Arkansas Individual Income Tax Return Form

A resident of Arkansas must use this form when filing for her/his annual individual income tax.Download

Extracted Text for Proper Search

INCOME
Attach W-2(s)/1099(s) here / Attach check on top of  W-2(s)/1099(s)
1. SINGLE 	(Or widowed before 2012 or divorced at end of 2012)	
2. MARRIED FILING JOINT	 (Even if only one had income)	
3. HEAD OF HOUSEHOLD 	(See Instructions) 	
 	If the qualifying person was your child, but not your dependent,	 enter child’s name here:	
4. MARRIED FILING SEPARATELY ON THE SAME RETURN
5. MARRIED FILING SEPARATELY ON DIFFERENT RETURNS
 Enter spouse’s name here and SSN above
6. QUALIFYING WIDOW(ER) with dependent child Year spouse died: 	(See Instructions)	
HAVE YOU FILED AN EXTENSION?	Check this box if  you have filed a state extension  or an automatic federal extension	
FILING STATUSCheck Only One Box	
Page AR1 (R 10/4/12)
USE LABEL ORPRINT OR TYPE	
2012 AR1000F
ARKANSAS INDIVIDUAL
INCOME TAX RETURN
Full Year Resident
Jan. 1 - Dec. 31, 2012 or fiscal year ending	 ____________	, 20	 ____	
Dept. Use Only	
AR1	
P R I M A R Y   N A M E                                                           
MAILING ADDRESS 	(Number and Street, P.O. Box or Rural Route)	
CITY, STATE AND ZIP CODE	
LAST NAME	PRIMARY SOCIAL SECURITY NUMBER
SPOUSE’S SOCIAL SECURITY NUMBER	Important	
Important: You MUST 
enter your SSN(s) above	
PERSONAL TAX CREDITS
7A.	
SPOUSE
YOURSELF	DEAF	
BLIND	65 SPECIAL	
BLIND	65 or OVER
65 or OVER	
65 SPECIAL	
DEAF	
HEAD OF HOUSEHOLD/QUALIFYING WIDOW(ER)	
Multiply number of boxes checked from 7A............	X $23 =
X $23 =
X $500 =	
Multiply number of dependents from 7B............	
Multiply number of individuals with developmental disabilities from 7C..\
.........	
7D. 	TOTAL PERSONAL TAX CREDITS: 	(Add Lines 7A, 7B, and 7C.  Enter total here and on Line 32)	.........................7D	
7C. First name of individual(s) with developmental disability: (See Instructions)	
Wages, salaries, tips, etc: 	(Attach W-2s)	 ........................................................................\
.............	
U.S. Military compensation: 	(Your/joint 	gross amount	)	
8
9A
9B
10
11
12
13
14
16
15	
17A.	
17B
19
20
21	
U.S. Military compensation: 	(Spouse’s 	gross amount	)	
Less$9,000	
00
00	
00
00
00
00
00
00
00
00
00
00
00	
8.	
17A	
17B.
9A.
9B.
10.
11.
12.
13.
14.
15.
16.
18.
19.
20.	
Interest income: 	(If over $1,500, attach AR4)	  ........................................................................\
......	
Dividend income: 	(If over $1,500, attach AR4)	 ........................................................................\
....	
Alimony and separate maintenance received:	........................................................................\
.....	
Business or professional income: 	(Attach federal Schedule C or C-EZ)	  .....................................	
Capital gains/(losses) from stocks, bonds, etc: 	(See Instr. Attach federal Schedule D)	 ..............	
Other gains or	 (losses)	: (Attach federal Form 4797 and/or 4684 if applicable)	  ...........................	
Non-Qualified IRA distributions and taxable annuities: 	(Attach All 1099Rs)	 ................................	
Gross Distribution
Your/Joint Employer pension plan(s)/Qualified IRA(s): 	(See Instructions - Attach All 1099Rs)	
Rents, royalties, partnerships, estates, trusts, etc: 	(Attach federal Schedule E)	  .........................	
TOTAL INCOME: 	(Add Lines 8 through 20)	  ........................................................................\
....	
Other income/depreciation differences: 	(List type and amount.  See Instructions)	 .....................	
Farm income: 	(Attach federal Schedule F)	 ........................................................................\
..........	
Spouse’s Employer pension plan(s)/Qualified IRA(s): 	(Filing Status 4 Only)	
Gross Distribution	Less$6,000
Less$6,000	Taxable Amount
Taxable Amount	
00
00	
00
00	
ROUND ALL AMOUNTS TO WHOLE DOLLARS	
00
00
00
00
00
00
00
00
00
00
00	
(A) Your/JointIncome	(B) Spouse’s Income	Status 4 Only	
Less$9,000	
00	
00	
00	
21.	
18	
(Filing Status 3 Only)	
00	
00	
CHECK BOX IF 	
AMENDED RETURN	
(Do not list yourself or spouse)	7B. 	Dependents	
 First Name                                    Last Name	 Dependent’s Social Security Number	 Dependent’s relationship to you	
00
00
00
00	
(Filing Status 6 Only)	
SPOUSE NAME                                                 	LAST NAME	
00
00	
1.
5.
4.
3.
2.	
M I                                                           
M I

TOTAL CREDITS:	 (Add Lines 32 through 34)	 ........................................................................\
....................................	
PLEASE SIGN HERE	
SIGN HERE	
For Department Use Only	
00
00	
00
00	
00
00
00	
00
00	
00
00	
PLEASE SIGN HERE:	 Under penalties of  perjur y, 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
Spouse’s Signature
Paid Preparer’s Signature
Preparer’s Name
Address	
Date
Date	
Occupation
Occupation
ID Number/Social Security Number
City/State/Zip
Telephone Number	
A	
Page AR2 (R 10/4/12)	
}	
TAX COMPUTATION 
PAID PREPARER
PAYMENTS
REFUND OR TAX DUE	
 (A)  Your/Joint    Income	 (B) Spouse’s Income   	Status 4 Only	 	
Home Telephone:
Work Telephone:	
00
00
00	
TOTAL INCOME:	 (From Line 21, Columns A and B)	 ....................................................	
24.	24	
Select tax table: 	(Check the appropriate box)	25.	
LOW INCOME	 Table	REGULAR	 Table	
If you qualify for the Low Income Tax Table, enter zero (0) on Line 25A.  If not, then:	
25
26
27	TAX:	 (Enter tax from tax table)	  ........................................................................\
................	
NET TAXABLE INCOME:	 (Subtract Line 25 from Line 24)	  ........................................	
Enterthe 	larger	of your:	
Itemized Deductions	 (See Instructions, Line 25)	
Standard Deduction	 (See Instructions, Line 25)	  .......................	
OR	
Combined tax: 	(Add amounts from Lines 27A and 27B)	 ........................................................................\
........................	
Enter tax from Lump Sum Distribution Averaging Schedule: 	(Attach AR1000TD)	  .........................................................	
IRA and qualified plan withdrawal and overpayment penalties: 	(Attach federal Form 5329, if required)	 .......................	
TOTAL TAX:	 (Add Lines 28 through 30)	 ........................................................................\
..............................................	
26.
27.
28.
29.
30.
31.	
29
28
30
31	
38.
37.
36.
35.
42.
41.
39.
51.	
NET TAX: 	(Subtract Line 35 from Line 31. If Line 35 is greater than Line 31, ent\
er 0)	  ...............................................	
Arkansas income tax withheld: 	[Attach state copies of W-2 and/or 1099R Form(s)]	 .........	
Estimated tax paid or credit brought forward from 2011:	  ...................................................	
Payment made with extension: 	(See Instructions)	  ............................................................	
(20% of federal credit; Attach federal Form 2441 	and	 Form AR1000EC)	  ..............................	
TOTAL PAYMENTS:	 (Add Lines 37 through 41)	........................................................................\
................................	
Early childhood program: Certification Number: _______________________________
Amount of income not subject to Arkansas tax from AR4, Part III: 	(Memorandum only)	
38
39
41
37	
36
35	
AMENDED RETURNS ONLY	 - Previous refund (see instructions).................................\
...............................................	 	
40.	AMENDED RETURNS ONLY	 - Previous payments (see instructions): ........................... 	
43.	
Adjusted Total Payments	 
 (Subtract Line 43 from Line 42)......................................\
........................................................	44.	
40	
44
42
43	
00	
00
00
00
00
00	
00
00
00
00	
	
00
00	
00	
00	
47.
46.
49.
48.
45.
50C.
50A.	
AMOUNT OF OVERPAYMENT/REFUND:	 (If Line 44 is greater than Line 36, enter difference)	 ...........................	
Amount to be applied to 2013 estimated tax:	  ....................................................................	
Amount of Check-off Contributions: 	(Attach Schedule AR1000-CO)	.................................	
AMOUNT TO BE REFUNDED TO YOU:	 (Subtract Lines 46 and 47 from Line 45)	 ..................................	
AMOUNT DUE:	 (If Line 44 is less than Line 36, enter difference; If over $1,000, See Instructions)	  .........	
UEP:	 Attach Form AR2210 or AR2210A.  If required, enter exception in box 	50A	
Add Lines 49 and 50B.  Attach Form AR1000V to check or money order payable in U.S. Dollars to “Dept. of \
Finance 
and Administration”.  	Include your SSN on payment. To pay by credit card, see instructions	 .................	
REFUND
TAX DUE	
50C
45	
46
47	
48
49	
TOTAL DUE	
50B	Penalty	
00	
Personal Tax Credit(s): 	(Enter total from Line 7D)	 ..............................................................	
Child Care Credit: 	(20% of federal credit allowed; Attach federal Form 2441)	  ............................	
Other Credits: 	(Attach AR1000TC)	  ........................................................................\
.......................	
00
00
00	
 32.
 33.
 34.
TAX CREDITS	
32
34
33	
AR2	
ADJUSTMENTS	
23
22	22.
23.	
ADJUSTED GROSS INCOME:	 (Subtract Line 23 from Line 22)	................................	
TOTAL ADJUSTMENTS: 	(Attach Form AR1000ADJ)	................................................	00
00	00
00	
May the Arkansas Revenue Agency discussthis return with the preparer shown below?	
No	Yes	FOR MAILING ADDRESSES SEE PAGE 2 OF INSTRUCTIONS