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Tax Exemption Certificate For Military Spouse

To claim exemption from the State of Arkansas’ income tax, you are required to fill and sub the State of Arkansas Tax Exemption Certificate For Military Spouse form.

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STATE OF ARKANSAS	
Tax Exemption Certificate	
For Militar y Spouse	
AR-MS	
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 Servicemem	bers 	Civil Relief Act, as amended by the Military Spouses Residency Relief Act (P.L. 111-97)	
Attach this certificate to your AR1000NR tax return	
AR-MS (R 10/4/12)
Next: Taxpayer Refund Information Previous: Testimonial Affidavit
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