MEDICAL AND DENTAL EXPENSES: [Do not include expense(s) paid by others]. (See Instructions)

1. Medical and dental expenses:..........................................................................................................1

2. Enter amount from Form AR1000F/AR1000NR, Line 24(A) and 24(B):.....2

3. Multiply Line 2 by 7.5% (.075):..........................................................................................................3

4. TOTAL MEDICAL EXPENSES: (Subtract Line 3 from Line 1; if Line 3 is more than Line 1, enter 0)....................................4 TAXES: (See Instructions)

5. Real estate tax:.................................................................................................................................5

6. Personal property tax or other taxes: (List type and amount)_ ____________________________

_____________________________________________________________________________ 6

7. TOTAL TAXES: (Add Lines 5 and 6)......................................................................................................................................7 INTEREST EXPENSES: (See Instructions)

8. Home mortgage interest paid to financial institutions:......................................................................8

9. Home mortgage interest paid to an individual:

Name:___________________________________________________

Address:_ ________________________________________________ .................................. 9 10. Deductible points:...........................................................................................................................10 11. Investment interest: (Attach federal Form 4952)............................................................................. 11 12. TOTAL INTEREST EXPENSE: (Add Lines 8 through 11)................................................................................................... 12 CONTRIBUTIONS: (See Instructions) 13. Cash contributions:.........................................................................................................................13 14. Art and literary contributions:..........................................................................................................14 15. Other:..............................................................................................................................................15 16. Carryover contributions: (List type and amount)_ _____________________________________ 16 17. TOTAL CONTRIBUTIONS: (Add Lines 13 through 16)...................................................................................................... 17 CASUALTY AND THEFT LOSSES: (See Instructions) 18. TOTAL CASUALTY AND THEFT LOSSES: (Attach federal Form 4684)______________________________________ 18 POST-SECONDARY EDUCATION TUITION DEDUCTION(S): (See Instructions) 19. TOTAL POST-SECONDARY EDUCATION TUITION DEDUCTION(S): [Attach AR1075(s)] ............................................. 19 MISCELLANEOUS DEDUCTIONS SUBJECT TO 2% AGI LIMIT: (See Instructions) 20. Unreimbursed employee business expenses: (Attach federal Form 2106).................................... 20 21. Other expenses: (List type and amount)_ ___________________________________________

____________________________________________________________________________ 21 22. Add the amounts on Lines 20 and 21. Enter the total:....................................................................22 23. Enter amount from Form AR1000F/AR1000NR, Line 24(A) and 24(B):...23 24. Multiply Line 23 above by 2% (.02):................................................................................................24 25. TOTAL MISCELLANEOUS DEDUCTIONS: (Subtract Line 24 from Line 22; If Line 24 is more than Line 22, enter 0)......... 25 OTHER MISCELLANEOUS DEDUCTIONS: (See Instructions) 26. TOTAL MISCELLANEOUS DEDUCTIONS NOT SUBJECT TO THE 2% AGI LIMITATION: (List type and amount)......... 26 TOTAL ITEMIZED DEDUCTIONS: 27. Add amounts on Lines 4, 7, 12, 17, 18,19, 25, and 26 and enter the total here:......................................................................27 Note: Complete lines 28 through 32 ONLY if you and

your spouse are using Filing Status 4 or 5.

28. Enter the adjusted gross income from Form AR1000F/AR1000NR, Line 24, Columns (A) and (B) here:...28A 28B 29. Total Arkansas adjusted gross income: (Add columns 28A and 28B from above)....................................................................29 30. Divide the amount on Line 28A above by the amount on Line 29. Enter the percentage here:................................................30 31. Multiply Line 27 by the percentage on Line 30. Enter here and on Form AR1000F/AR1000NR, Line 25, Col. (A):.... (YOU) 31 32. Subtract Line 31 from Line 27, Form AR3. Enter here and on Form AR1000F/AR1000NR, Line 25, Column (B).

If you and your spouse are using Filing Status 5, enter this amount on Line 25, Col. (A) of your spouse’s return:...... (SPOUSE) 32 ARKANSAS INDIVIDUAL INCOME TAX ITEMIZED DEDUCTION SCHEDULE AR3 2012 Name Social Security Number Page AR3 (R 11/7/12) 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 % 00 00 00 00 00 YOUR Adjusted Gross Income SPOUSE’S Adjusted Gross Income 00 00 00 00 CLICK HERE TO CLEAR FORM Click Here to Print Document