Arkansas 2015

Individual Income Tax

Forms and Instructions

Full Year Resident Part Year Resident Nonresident

Using e-file will allow you to: @ Join over 1,000,000 who e-filed last year. @ Receive confirmation proving you filed.

@ Receive a refund in less than 10 days.

Other E-Services available for all filers:

@ Direct Deposit

@ Avoid time consuming phone calls with online refund inquiry

@ Pay tax by credit card

@ Arkansas Taxpayer Access Point (ATAP)

SATE

Governor Asa Hutchinson

Free File Alliance:

As a member of the “Free File Alliance”, the State of Arkansas offers certain taxpayers the opportunity to electronically file their return with no fee. If you meet the specified criteria (in- cluding income, military service, or eligibility for federal Earned Income Tax Credit) you may be eligible for this program.

Go to www.arkansas.gov/efile for details.

Direct Deposit Now Available on Paper Returns

See page 17 for details on how you can get your refund faster than ever with Direct Deposit.

For your questions/comments: Manager, Individual Income Tax

P. O. Box 3628

Little Rock, AR 72203-3628

TAX HELP AND FORMS

Internet

You can access the Department of Finance and Administration’s website at www.arkansas.gov/dfa.

@ Check the status of your refund

@ Get current and prior year forms and instructions

e@ Access latest income tax info and archived news

@ Get e-file information

You can e-mail questions to:

individual.income@dfa.arkansas.gov

Ym ww, J 44 Phone Individual Income Tax Hotline... eects (601) 682-1100

or (800) 882-9275

Representatives are available to assist callers at the numbers above during normal business hours (Monday through Friday from 8:00 a.m. to 4:30 p.m.) with:

e@ Notices Received @ Amended Returns @ Payment Information

@ Taxpayer Assistance e@ Forms e@ Audit and Examination

For hearing impaired access, call (800) 285-1121 using a Text Telephone Device (for Spanish, call (866) 656-1842).

Other useful phone numbers: Business Incentive Credits ............. Withholding Tax... Collections........... Revenue Legal Counsel Corporate Income Tax Sales and Use Tax.. - (501) 682-7104 Problem Resolution and... .... (501) 682-7751 Tax Information Office (Offers In Compromise)

(501) 682-7106 .... (501) 682-7290 . (501) 682-5000 _ (501) 682-7030 ( ( (

- (501) 682-4775

Internal Revenue Service............... (800) 829-1040 Social Security Administration ........ (800) 772-1213

To obtain a booklet or forms you may:

1. Access our website at: www.arkansas.gov/incometax

2. Visit your county revenue office 3. Visit your local library or

4. Call the Individual Income Tax Hotline

Page 2

ATAP

Arkansas Taxpayer Access Point (ATAP) allows taxpayers or their representatives to log on to a secure site and manage their ac- count online.

You can access ATAP at www.atap.arkansas.gov to:

@ Make name and address changes

e@ View account letters

@ Make payments

@ Check refund status

(Registration is not required to make payments or to check refund status.)

GP mai

Choose the appropriate address below to mail your return:

TAX DUE RETURN: Arkansas State Income Tax P.O. Box 2144 Little Rock, AR 72203-2144

REFUND RETURN: Arkansas State Income Tax P.O. Box 1000 Little Rock, AR 72203-1000

NO TAX DUE/REFUND RETURN: Arkansas State Income Tax P.O. Box 8026 Little Rock, AR 72203-8026

Be sure to apply sufficient postage or your return will not be delivered by the U.S. Postal Service.

Walk-In

Representatives are available to assist walk-in taxpayers with income tax questions, but are not available to pre- pare your return.

No appointment is necessary, but plan to arrive before 4:00 p.m. to allow sufficient time for assistance.

The Individual Income Tax Office is located in Room 2300, Ledbetter Building, at 1816 W. 7th Street in Little Rock.

Office hours are Monday through Friday from 8:00 a.m. to 4:30 p.m.

CONTENTS

Tax Help and Forms

Electronic Filing

For Taxpayers’ Information

Special Information for 2014 and 2015

Military Personnel

Individual Income Tax Account Change Form

Request for Copies of Arkansas Tax Returns and W-2s (AR4506) Definitions

Instructions

Form Inserts:

AR1000F AR1000NR ARDD

AR3

AR4 AR1000ADJ AR1000D AR1075 AR1000TC AR1000-CO Consumer Use Voter Registration

Instructions (continued)

Instructions for Form AR3, Itemized Deduction Schedule Student Loan Interest Worksheet

IRA Phase Out Chart

Self-Employed Health Insurance Deduction Worksheet Mileage and Depletion Allowances

Depreciation Information

How to Fill Out Your Check

Preservation of Tax Records

If the IRS Audits You

Information Exchange Programs with the IRS

Identity Theft

Taxpayer Bill of Rights

Low Income Tax Tables

Regular Tax Table

Index to Instructions

Before Mailing Your Return Checklist

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ELECTRONIC FILING

www.arkansas.goviefile

E-file is hassle-free—both your federal and Arkansas income tax returns can be filed electronically in one transmission.

E-file is smart—computer programs catch 98% of tax return errors.

E-file is worry-free—receive acknowledgement within 2 to 3 business days if your return has been received and accepted.

E-file gets your money to you fast-refunds are issued within 10 days after you receive state acknowledgement.

Arkansas participates in the Federal/State Electronic Filing Program for Individual Income Tax. The program is available to most full year residents and certain qualifying nonresidents and part year residents.

Since Arkansas is a member of the “Free File Alliance,” depending on the level of income, taxpayers may qualify to file returns for free.

(Go to www.arkansas.govilefile for details.)

Over 150,000 taxpayers took advantage of online filing last year. The same advantages are obtained by online filing as by electronic filing, but it does not require a preparer. For a nominal fee your federal and state returns can be prepared and filed electronically.

OTHER E-SERVICES

These services are available for all filers (paper and electronic).

Direct Deposit (See page 17 for more oF FICIAL aT NTS Corp information)

Arkansas Taxpayer Access Point (ATAP) evemcant (See page 2 for more information) EXPRESS Cards

Pay by credit card "VISA. = (Vendor charges nominal fee) 1 |+-——rowus www.officialpayments.com

or call (800) 272-9829

Page 4

FOR TAXPAYERS’ INFORMATION

Individual and corporation income taxes are the largest source of state general revenue.

$6,337 MILLION GENERAL REVENUE TAX Where It Comes From:

Other $25.2 0.4%

Sales/Use $2,273.0 35.9%

Income Taxes $3,568.2 56.3%

Misc/Alcohol/

Tobacco $368.2 5.8% Insurance Taxes $102.4 1.6%

$6,337 MILLION GENERAL REVENUE TAX Where It Is Spent:

. Refunds to Central Services Taxpayers $202.8 $479.3 Health & Human 3.2% 76% Services \ ‘ $1,412.1 22.3% \— General

Government

$225.1 3.6% Criminal a 4

Justice/Military $491.1 7.7%

Aid to Cities and Counties $50.8 0.8%

Public Education $3,475.8 54.8%

Page 5

Y SPECIAL INFORMATION FOR TAX YEAR 2015 4

Capital Gains Exemption (Act 1173 of 2015)

For tax year 2015, the exemption has been increased: For gains realized from January 1, 2015 to January 31, 2015, 50% of net capital gains are exempt from tax. For gains realized from February 1, 2015 to December 31, 2015, 45% of net capital gains are exempt from tax.

For tax year 2014 and forward, 100% of net capital gains in excess of $10,000,000 are exempt from tax.

Tax Brackets Reduced (Act 22 of 2015) For tax year 2015, tax brackets have been reduced by one tenth of one percent (.1%) for taxpayers with net income less than $21,100.

New Setoff Added (Act 531 of 2015) Authorizes a setoff against an Arkansas income tax refund for a debt owed to the Arkansas Highway and Transportation De- partment. Effective July 22, 2015.

New Check-Off Added And One Eliminated (Act 399 of 2015) Beginning with tax year 2015, taxpayers are allowed to contribute all or part of their refund to the Arkansas Game and Fish Foun- dation. See Form AR1000-CO for instructions. The check-off for the U.S. Olympic Committee Program has been eliminated.

Standard Deduction Increased (Act 1488 of 2013) Beginning with tax year 2015, the standard deduction has been increased from $2,000 to $2,200 for each taxpayer. For married couples filing a joint return (Filing Status 2), the standard deduction will be $4,400.

Y SPECIAL INFORMATION FOR TAX YEAR 2014 4

Federal Tax Provisions May Affect Your 2014 Arkansas Tax Return

The State of Arkansas retroactively adopted IRC § § 163 and 408, part of the Tax Increase Prevention Act of 2014. For tax year 2014 only, deductions of mortgage insurance premiums (PMI) and tax free distributions from an IRA for charitable purposes are allowed. Taxpayers who have already filed 2014 returns but qualify to claim either or both of these tax provisions may amend their returns using Form AR1000F (full year resident) or AR1000NR (part year resident or nonresident).

PMI should be reported on Line 27 of the itemized deduction schedule, Form AR3. Tax free distributions from an IRA for charitable purposes should be reported on Line 51 of Form AR1000F or AR1000NR. Income tax forms are available at www. arkansas.gov/incometax or by calling the Individual Income Tax Section at (501) 682-1100 or (800) 882-9275.

Income Tax Technical Corrections Act (Act 580 of 2015) IRC § § 167 and 168(a)-(j) as in effect on January 1, 2015 regarding depreciation and expensing of property for tax years beginning on or after January 1, 2014.

IRC § 170 regarding the deduction of charitable contributions, applies retroactively to tax year 2014 only.

IRC § 179 as in effect on January 1, 2009 regarding depreciation dollar limits and phase out thresholds for tax years beginning on or after January 1, 2014. See page 21 for additional information. Page 6

a= MILITARY PERSONNEL

Military Pay Exemption (Act 1408 of 2013)

Creates a 100% exemption from income tax for service pay or allowance received by an active duty member of the armed forces for tax years beginning on or after January 1, 2014. Active duty includes all members of the armed forces, including the National Guard and Reserve Units.

Military Spouses Residency Relief Act

Exempts a military spouse’s income from Arkansas tax if the servicemember’s Home of Record is not Arkansas and the spouse’s domicile is the same as the service member’s Home of Record. Effective January 1, 2009. Write the words “military spouse” at top of tax return and attach a completed Form AR-MS (available at www.arkansas.gov/incometax) and a copy of service member's LES to verify Home of Record. (For future tax purposes, the nonmilitary spouse must submit a new payroll withholding form, ARW-4MS to his/her employer each year to exempt future withholding.)

The Military Family Tax Relief Act of 2003 (Act 372 of 2009)

This act adopts IRC 121, 134, and 162 as in effect on January 1, 2009. Provisions of this act include exclusion of gain on sale of principal residence, deduction of overnight travel expenses for National Guard and Reserve members, and exclusion from income of “qualified military benefits”.

The Servicemembers Civil Relief Act

Deferral of Tax - Upon notice to the Internal Revenue Service or the tax authority of a state or a political subdivision of a state, the collection of income tax on the income of a servicemember falling due before or during military service shall be deferred for a period not more than 180 days after termination of or release from military service, if a service member’s ability to pay such income tax is materially affected by military service.

Accrual of Interest or Penalty - No interest or penalty shall accrue for the period of deferment by reason of nonpayment on any amount of tax deferred under this section.

Statute of Limitations - The running of a statute of limitations against the collection of tax deferred under this section, by seizure or otherwise, shall be suspended for the period of military service of the servicemember and for an additional period of 270 days thereafter.

Residence or Domicile -Aservicemember shall neither lose nor acquire a residence or domicile for purposes of taxation with respect to the person, personal property, or income of the servicemember by reason of being absent or present in any tax jurisdiction of the United States solely in compliance with military orders.

Military Service Compensation - Compensation of a servicemember for military service shall not be deemed to be income for services performed or from sources within a tax jurisdiction of the United States if the servicemember is not a resident or domiciliary of the jurisdiction in which the servicemember is serving in com- pliance with military orders.

RETIRED MILITARY PERSONNEL

Extension of Time for Veterans (Retirees) to File for Refund (Act 238 of 2009)

This act extends the statute of limitations for a veteran to file a claim for refund of an overpayment that results from ret- roactive determination by the Secretary of Veterans Affairs that part or all of the uniformed service retirement payments to the taxpayer are payments made for a service-connected disability and are not included in gross income. Effective January 1, 2001.

Page 7

REVENUE DIVISION Individual Income Tax

STATE OF ARKANSAS 1816 W 7th Street, Room 2300 Individual Income Tax Account Lite Rock, Arkemeae 72209-3608 Change Form Phone: (501) 682-1100

Fax: (501) 682-7691 http://www.arkansas.gov/dfa

Please type or print when filling out this form

SECTION I - COMPLETE THIS PART TO CHANGE YOUR INDIVIDUAL NAME AND/OR ADDRESS

Check all that apply: oO Name Change (Jadaress Change O Lost or Stolen Check O Remail Check 1A Your Name (first name, initial, and last name) 1B Your Social Security Number 2A Spouse’s Name (first name, initial, and last name) 2B Spouse’s SSN

3A Your Prior Name (if any)

3B Spouse's Prior Name (if any)

4A Old Mailing Address, City, State, and Zip Code

4B New Mailing Address, City, State, and Zip Code

SECTION II - COMPLETE THIS PART TO CHANGE BUSINESS ADDRESS OR LOCATION

Check all that apply: oO Partnership O Fiduciary

5A Business, Estate, or Trust Name 5B Federal Identification Number

6A Old Mailing Address, City, State, and Zip Code

6B New Mailing Address, City, State, and Zip Code

7 New Business Location (if different from mailing address)

SECTION III - SIGNATURE

If Part | Completed

Your Signature Date Phone Number

If Joint Return, Spouse’s Signature Date Phone Number

If Part Il Completed

Signature of Owner, Officer, or Representative Date Title Phone Number

Address Change (R 10/25/12)

MAIL COMPLETED FORM TO: FAX COMPLETED FORM TO: ARKANSAS STATE INCOME TAX OR 501-682-7691 PO BOX 3628

LITTLE ROCK, AR 72203

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CUT ALONG DOTTED LINE

AR4506

STATE OF ARKANSAS REQUEST FOR COPIES OF ARKANSAS TAX RETURNS AND W-2S

Mail To: Or Bring To: State of Arkansas Joel Y. Ledbetter Building Individual Income Tax 1816 W 7th Street, Room 2300 P.O. Box 3628 Little Rock, AR 72201 Little Rock, AR 72203-3628 (501) 682-1100 or (800) 882-9275 Primary Name On Return SSN, FEIN, or ID Number Secondary Name On Return (If Applicable) SSN or ID Number PRINT | Current Mailing Address (City, State, & Zip) Daytime Phone Number OR TYPE Return(s) Requested (List Tax Year(s)) W-2(s) Requested (List Tax Year(s))

NOTE - You may be able to get your tax information from other sources. If you had your tax return completed by a paid preparer, he/she should be able to provide a copy of the return. Your employer should be able to provide a copy of your W-2.

INSTRUCTIONS

1. Print or type your name, mailing information, SSN, FEIN (if applicable), Account ID, spouse’s information (if applicable), return(s) and/or W-2(s) you are requesting.

2. Copies are $2.00 per year. Attach a check or money order. DO NOT SEND CASH IN THE MAIL. (If you make your request in person, you may pay with cash. Bring exact change.)

3. Mail this form with your payment to the mailing address or deliver to the physical address at the top of this form. In order to process your request, signatures are required below. For entities other than individuals, you must attach an authorization document.

Signature of taxpayer(s). | declare that | am either the taxpayer whose name is shown above, or a person authorized to obtain the tax information requested. If the request applies to a joint return, either husband or wife must sign. If signed by a corporate officer, partner, guardian, tax matters partner, executor, receiver, administrator, trustee, or party other than the taxpayer, | certify that | have the authority to execute Form AR4506 on behalf of the taxpayer.

Primary Signature Date Secondary Signature (If Applicable) Date

Title (if primary name is a partnership or trust)

AR4506 (R 10/11/13) Page 9

CUT ALONG DOTTED LINE

DEFINITIONS

|

GROSS INCOME

Gross income is any and all income (before deductions) other than income specifically described as exempt from tax on pages 11 and 12 “Exempt From Income Tax”.

Exception: The $6,000 exemption on retirement income and the exemption on military income as described on page 12 are included in gross income.

DOMICILE This is the place you intend to have as your permanent home and the place you intend to return to whenever you are away. You can have only one domicile. Your domicile does not change until you move to a new location which you intend to make your permanent home. If you move to a new location but intend to stay there only for a limited time (no matter how long), your domicile does not change. This also applies if you are working in a foreign country.

FULL YEAR RESIDENT You are a full year resident if you lived in Arkansas all of calendar year 2015, or if you have maintained a domicile or Home of Record in Arkansas during the tax year.

NONRESIDENT

You are a nonresident if you did not make your domicile in Arkansas.

PART YEAR RESIDENT

You are a part year resident if you established a domicile in Arkansas or moved out of the state during calendar year 2015.

MILITARY PERSONNEL

If Arkansas is your Home of Record (HOR) and you are stationed outside the State of Arkansas, you are still required to file an AR1000F reporting all of your income, including U.S. Military Compensation. However, military compensation is exempt from Arkansas tax begin- ning in tax year 2014. (If you are stationed in Arkansas and your Home of Record is another state, Arkansas does not tax your U.S. Military Compensation.)

U.S. Military compensation includes wages received by members of the Army, Navy, Air Force, Marine Corps, Coast Guard, National Guard, and Reserve Units.

DEPENDENTS

You may claim as a dependent any person who received over half of his or her support from you, earned less than $4,000 in gross income, and was your:

Child Stepchild Mother Father Grandparent Brother Sister Grandchild Stepbrother Stepsister Stepmother Stepfather Mother-In-Law — Father-In-Law Brother-In-Law — Sister-In-Law Son-In-Law Daughter-In-Law

Or, an individual (other than your spouse) who, for the tax year of the taxpayer, had the same principal place of abode as the taxpayer and was a member of the taxpayer’s household. Or, if related by blood: Uncle, Aunt, Nephew, Niece. The term “dependent” includes a foster child if the child had as his principal place of abode the home of the taxpayer and was a member of the taxpayer’s household for the taxpayer’s entire tax year.

The term “dependent” does not apply to anyone who is a citizen or subject of a foreign country UNLESS that person is a resident of Mexico or Canada.

If your child/stepchild was under age 19 at the end of the year, the $4,000 gross income limitation does not apply. Your child/ stepchild may have earned any amount of income and still be your dependent if the other dependency requirements in this section were met.

If your child/stepchild was a student under age 24 at the end of the calendar year, the $4,000 gross income limitation does not apply. The other requirements in this section must be met.

To qualify as a student, your child/stepchild must have been a full-time student for five (5) months during the calendar year at a qualified school, as defined by the Internal Revenue Service.

If your dependent died during the tax year, you may claim the full amount of tax credit for the dependent on your tax return regard- less of when the death occurred during the year.

Arkansas has adopted Internal Revenue Code §151(c)(6) regarding the tax treatment of kidnapped children.

Page 10

THESE INSTRU

ONS ARE FOR GUIDANCE ON

INSTRUCTIONS

WHO MUST FILE A TAX RETURN

FULL YEAR RESIDENTS (Use Form AR1000F)

Married

Married Filin

Widowed in 2013 or 2014, and not remarried in 2015

If your and your file if GROSS MARITAL STATUS FILING STATUS INCOME* is: is: is atleast Single (Including divorced Single $11,644 and legally separated) Head of Household with 1 or no dependents $16,554 Head of Household with 2 or more dependents $19,734

Married Filing Joint with 1 or no dependents

Married Filing Joint with 2 or more dependents

Qualifying Widow(er) with 1 or no dependents

Qualifying Widow(er) with 2 or more dependents $19,734

$16,554

*Gross income is all income (before deductions) other than income specifi- cally described as exempt on pages 11 and 12 “Exempt From Income Tax.”

Exception: The $6,000 exemption on retirement income and the exemption on mili- tary income as described on page 12 are included in gross income.

If your gross income was less than the amount shown in the last column for your filing status, you are not required to file a return. However, you must file a return to claim any refund due.

NONRESIDENTS (Use Form AR1000NR)

Nonresidents who received any taxable income from Arkansas sources must file a return (regardless of marital status, filing status, or amount).

PART YEAR RESIDENTS (Use Form AR1000NR)

Part year residents who received any taxable income while an Arkansas resident must file a return (regardless of marital status, filing status, or amount).

WHEN TO FILE

You can file your calendar year original tax return any time after December 31, 2015, but NO LATER THAN April 15, 2016, (unless an extension has been granted).

If you file a fiscal year tax return, your return is due NO LATER THAN three and one-half (3 *2) months following the close of the income year.

NOTE: The date of the postmark stamped by the U.S. Postal Ser- vice is the date you filed your return.

If the due date of your return falls on a Saturday, Sunday, or legal holiday, the return will be con- sidered timely filed if it is postmarked on the next business day.

Statute of Limitations - Refunds. An amended return or claim for refund of an overpayment must be filed by the taxpayer within three (3) years from the time the return was filed or two (2) years from the time the tax was paid, whichever is later.

IF YOU NEED MORE TIME

If you request an extension of time to file your federal income tax return (by filing federal Form 4868 with the IRS) you are entitled to receive the same extension on your Arkansas income tax return. The federal automatic extension extends the deadline to file until October 15".

The Department no longer requires that a copy of federal Form 4868 be attached to your state tax return. When your Arkansas return is complete and ready to file, simply check the box on the face of the return indicating you filed a federal extension.

If you do not file a federal extension, you can file an Arkansas extension using Form AR1055 before the filing due date of April 15". Inability to pay is not a valid reason to request an Arkansas extension. Send your request to:

Individual Income Tax Section ATTN: Extension

P.O. Box 3628

Little Rock, AR 72203-3628

AND DO NOT STATE THE COMPLETE LAW

NOTE: The maximum extension that will be granted to an individual on an AR1055 is one hundred and eighty (180) days,

extending the due date until October 15".

When you file your return, check the box indicating you filed a state extension. If the box on the front of your return is not checked, you will not receive credit for your federal or state extension.

An extension extends the amount of time to file your return, but does not extend the amount of time to pay. Any tax due must be paid by April 15, 2016 to avoid failure to pay penalty and interest.

Payments made on extension should be made on Form AR1000ES, Voucher 5.

See Page 17 for information on penalties and interest.

EXEMPT FROM INCOME TAX NOTE: List exempt income on AR4, Part III and include the total on AR1000F/AR1000NR, Line 51. (You do not need to list exclusion amounts from numbers 10-12.)

1. Money you received from a life insur- ance policy because of the death of the person who was insured is exempt from tax.

NOTE: You must include as taxable income any

interest payments made to you from the

insurer (the insurance company that is- sued the policy).

2. Money you received from life insur- ance, an endowment, or a private an- nuity contract for which you paid the premiums is allowed cost recovery pursuant to Internal Revenue Code §72.

3. Amounts you received as child sup- port payments are exempt from tax.

4. Gifts, inheritances, bequests, or de- vises are exempt from tax.

5. Scholarships, fellowships, and grants are taxed pursuant to Internal Rev- enue Code §117. (Stipends are taxed in their entirety.) For additional informa- tion on scholarships, fellowships, and grants see instructions for Line 20 on Page 15.

6. Interest you received from direct United States obligations, its posses- sions, the State of Arkansas, or any political subdivision of the State of Arkansas is exempt from tax. Obliga- tions include bonds and other evidence of debt issued pursuant to a government unit's borrowing power. (Interest received on tax refunds is not exempt income, because it did

Page 11

not result from a debt issued by the United States, the State of Arkansas, or any political subdivision of the State of Arkansas.) Interest from government securities paid to individuals through a mutual fund is exempt from tax.

7. Social Security benefits, VA benefits, Workers’ Compensation, Unemploy- ment Compensation, Railroad Retire- ment benefits and related supple- mental benefits are exempt from tax.

8. The rental value of a home or the housing allowance paid to a duly ordained or licensed minister of a recognized church is exempt to the extent that it was used to rent or provide a home. The rental value of a home furnished to a minister includes utilities furnished to the minister as part of compensa- tion. The housing allowance paid to a minister includes an allowance for utilities paid to the minister as part of compensation to the extent it was used to furnish utilities in the home.

9. Disability income MAY BE exempt from tax pursuant to Internal Revenue Code §104.

10. Beginning with tax year 2014, U.S. Military Compensation is exempt from tax. To claim the exemption, you must file a return and report all of the income you received during the year.

11. If you received income from an em- ployer sponsored retirement plan, including disability retirement, that is not exempt under IRC §104, the first $6,000 is exempt from tax. For tax years 2003 and later, if you contrib- uted after-tax dollars to your plan, you are allowed to recover your cost (investment) in your retirement plan in accordance with Internal Revenue Code §72. Then the first $6,000 of the balance is exempt from tax. (If you received income from military retirement, you may adjust your figures if the payment included Survivor’s Benefit Payments. The amount of adjustment must be listed on the income statement, and supporting documen- tation must be submitted with the return.)

12. If you received a traditional IRA dis- tribution after reaching age fifty-nine and one-half (59 1/2), the first $6,000 is exempt from tax. Your traditional IRA distribution may be adjusted for nondeduct- ible IRA contributions, if any, by completing Federal Form 8606 and attaching it to your Arkansas return. Premature distributions made on account of the participant's death or disability also qualify for the exemption. All other premature distributions or early withdrawals including, but not limited to, those taken for medical expenses, higher education expenses or a first- time home purchase do not qualify for the exemption.

A surviving spouse qualifies for the exemption;

however he/she is limited to a single $6,000 ex- emption.

Page 12

NOTE: Total exemptions from all plans described under 11 and 12 cannot exceed $6,000 per taxpayer, not

including recovery of cost.

Gambling winnings from Arkansas elec- tronic games of skill are not included as income and the 3% withholding is excluded from Line 37. To determine if your gambling winnings are taxable, see instructions for Line 20, Page 15.

FILING AN AMENDED RETURN

If filing an amended return, check the box at the top right corner of Form AR1000F/AR1000NR/ AR1000S. Complete the return, replacing the incorrect entries from your original return with the amended entries. Attach an explanation and supporting documentation for items changed. (Do not file an amended return until after your original return has been processed.)

Amended return needed:

. to make changes or adjustments to your original return

. if the IRS examines your federal return for any tax year and changes your net taxable income (required to file an Arkansas amended return within 180 days of IRS notification)

Amended return not needed:

. to correct an address (You must provide a completed Individual Income Tax Account Change Form located on Page 8.)

. to correct a Social Security Number (Call (501) 682-1100 or write to Individual Income Tax Section, P.O. Box 3628, Little Rock, AR 72203. You may be asked to provide documentation.)

. if you are notified by the Income Tax Section that there is an error on your original return

. if filing a federal amended return with no impact on your Arkansas income tax return

FILING STATUS

DETERMINE YOUR FILING STATUS

BOX 1. Filing Status 1 (Single)

Check this box if you are SINGLE or UNMARRIED and DO NOT qualify as HEAD OF HOUSEHOLD. (Read the instructions for BOX 3 to determine if you qualify for HEAD OF HOUSEHOLD.)

BOX 2. Filing Status 2 (Married Filing Joint)

Check this box if you were MARRIED and are filing jointly. IF YOU ARE FILING A JOINT RETURN, YOU MUST ADD BOTH SPOUSES’ INCOME TOGETHER. Enter the total amount in column Aon Lines 8 through 20 under “Your/Joint Income”.

MARRIED COUPLES—CHOOSING THE BEST FILING STATUS

If you and your spouse had separate incomes, you might save money by figuring your tax separately using one of the following two methods. Use the method that suits you best.

METHOD A. List your income separately under Column A (“Your Income”). List your spouse’s income separately under Column B (“Spouse’s Income”). Figure your tax separately and then add your taxes together. See instructions for Married Filing Sepa- rately on the Same Return, Box 4.

If you use Method A, your result will be either a COM- BINED REFUND or a COMBINED TAX DUE. METHOD B. _ File separate individual tax returns. See instructions for Married Filing Separately on Different Returns, Box 5.

If you use Method B, one of you may owe tax and the other may get a refund. The tax due must be paid with the proper tax return and the refund will be due on the other return. YOU MAY NOT OFFSET ONE AGAINST THE OTHER.

BOX 3. Filing Status 3 (Head of House- hold)

To file as Head of Household you must have been unmarried or legally separated on December 31, 2015 and meet either 1 or 2 below. The term “Unmarried” includes certain married persons who lived apart, as discussed at the end of this section.

1. You paid over half the cost of keeping a home for the entire year that was the main home of your parent whom you can claim as a dependent. Your parent did not have to live with you in your home.

OR

2. You paid over half the cost of keeping a home in which you lived, and in which one of the following also lived, for more than six (6) months of the year (temporary absences, such as vacation or school, are counted as time lived in the home):

a. Your unmarried child, grandchild, great- grandchild, adopted child or stepchild. This child did not have to be your depen- dent, but your foster child must have been your dependent.

b. Your married child, grandchild, adopted child or stepchild. This child must have been your dependent.

c. Any other person whom you could claim as a dependent.

MARRIED PERSONS WHO LIVED APART

Even if you were not divorced or legally separated in 2015, you may be considered unmarried and file as Head of Household. See Internal Revenue Service instructions for Head of Household to determine if you qualify.

BOX 4. Filing Status 4 (Married Filing

Separately on the Same Return)

Check this box if you were married and are filing SEPARATELY ON THE SAME TAX RETURN. This method of tax computation may reduce your tax li- ability if both spouses had income. The result will be either a combined refund or a combined tax due.

IF ONE SPOUSE HAD A TOTAL NEGATIVE INCOME, YOU MUST FILE MARRIED FILING JOINTLY.

BOX 5. Filing Status 5 (Married Fil- ing Separately on Different Re-

turns)

Check this box if you were married and are filing separate tax returns.

BOX 6. Filing Status 6 [Qualifying Widow(er)]

Check this box if you are a QUALIFYING WIDOW(ER).

You are eligible to file as a QUALIFYING WIDOW(ER) if your spouse died in 2013 or 2014 and you meet each of the following tests:

1. You were entitled to file MARRIED FILING JOINTLY or MARRIED FILING SEPARATELY ON THE SAME RETURN with your spouse for the year your spouse died. It does not matter whether you actually filed a joint return.

2. You did not remarry before the end of 2015.

3. You had a child, stepchild, adopted child, or foster child who qualified as your dependent for the year.

4. You paid more than half the cost of keeping a home, which was the main home of that child for the entire year except for temporary absences.

DECEASED TAXPAYER

An Arkansas tax return should be filed for a taxpay- er who died during the tax year as if the taxpayer had lived the entire year. The word “DECEASED” should appear after his/her name along with the date of death.

NOTE: Any refund check issued to a deceased taxpayer will be made out to the estate of the deceased taxpayer, i.e. “Estate of John/Jane Doe”. To cash the check, the bank may require documentation such as death certificate, will, or power of attorney.

PERSONAL TAX CREDITS

LINE 7A. Each taxpayer and spouse is entitled to one personal tax credit. You can claim additional personal tax credits if you can answer “Yes” to any of these questions:

ls your filing status Head of Household or

Qualifying Widow(er)?

On January 1, 2016, were you age 65 or over?

On December 31, 2015, were you deaf?

On December 31, 2015, were you blind?

Check the box or boxes that apply to you and/or your spouse. You CANNOT claim any of these credits for your children or dependents.

Blindness is defined as being unable to tell light from darkness, having eyesight in the better eye not exceeding 20/200 with corrective lens, or having a field of vision limited to an angle of 20 degrees.

You can claim the Deaf Credit only if the average loss in speech frequencies (500 to 2000 Hertz) in the better ear is 86 decibels, I.S.O., or worse.

Any taxpayer age 65 or over not claiming a re- tirement income exemption on Line 17 is eligible for an additional $26 (per taxpayer) tax credit. Check the box(es) marked “65 Special”.

Add the number of boxes you checked on Line 7A. Write the total in the box provided. Multiply the number by $26 and write amount in space provided.

LINE 7B. List the name(s) of your dependent(s), Social Security Numbers, and relationship to you in the space provided. DO NOT INCLUDE YOURSELF AND/OR YOUR SPOUSE. The individual(s) you can claim as dependent(s) are described on Page 10. (Attach schedule if more than 3 dependents.)

Add the number of dependents listed on Line 7B. Write the total in the box provided. Multiply the number by $26 and write that amount in the space provided.

LINE 7C. If one or more of your dependents had developmental disabilities, enter his/her name(s) on the line. Multiply $500 by number of depen- dents with developmental disabilities. Enter the total. (Individual must qualify for credit. See Form AR1000RC5 to check if eligible.)

NOTE: You must attach Form AR- 1000RC5 to your return if this is the first year you claim the Credit for Individuals with Developmen- tal Disabilities.

A certified AR1000RC5 must be filed with your tax return every five (5) years. If credit was re- ceived on a prior year’s return, do not file another AR1000RC5 until the Individual Income Tax Section notifies you.

LINE 7D. Total the tax credits from Lines 7A, 7B, and 7C. Enter the total on this line and on Line 32.

INCOME

FULL YEAR RESIDENTS

If your filing status is Married Filing Separately on the Same Return, both Column A and Column B must be used. Write your income in Column Aand your spouse’s income in Column B. For all other filing statuses, write all income in Column A only.

PART YEAR AND NONRESIDENTS Complete Column A (and Column B if using Filing Status 4) of the AR1000NR as if you were a full year resident. List all of your income from all sources for the entire year in these two columns.

List in Column C the total combined income (for both spouses) earned while Arkansas residents and income derived from Arkansas sources.

The total tax must be computed on the income totals in Columns A and B. After all allowable tax credits have been subtracted from the total tax, prorate the remaining balance. See instructions for Lines 36A, 36B, 36C, and 36D on Page 16.

PART YEAR RESIDENTS AND NONRESI- DENTS MUST ATTACH A COPY OF YOUR FEDERAL RETURN, OR YOUR ARKANSAS RETURN WILL NOT BE PROCESSED.

Round all amounts to the nearest dollar. (For example, if your Form W-2 shows $10,897.50, round to $10,898. If your Form W-2 shows $10,897.49, round to $10,897.)

Staple the state copy of each of your W- 2(s) and 1099-R(s) to the left margin of the front of the return.

LINE 8. Add the wages, salaries, tips, etc. re- ported on your W-2(s). Enter the total on this line. Attach W-2(s).

Enter U.S. Military Compensation on Line 9A or 9B.

Ministers Income:

If you were a duly ordained or licensed minister, you received a housing allowance from your church, and you do not file a federal Schedule C or C-EZ, enter your gross compensation from the ministry less rental value of your home. The balance is subject to tax. The rental value of your home must be shown on Form AR4, Part III. Attach AR4 and W-2(s).

Page 13

LINE 9A. Beginning with tax year 2014, all of the service pay or allowance received by an active duty member of the armed services is exempt from Arkansas income tax. If you had U.S. Military Compensation, enter gross amount in the space provided. Do not enter an amount in Column A. Attach W-2(s).

Filing Status 2 (Married Filing Joint): If you and your spouse both had U.S. Military Compensation, add both gross amounts to- gether and enter here.

Enter U.S. Military Retirement on Line 17A.

LINE 9B. (Filing Status 4 Only) [If your spouse had U.S. Military Compensation, enter gross income in the space provided. Do not enter an amount in Column B. Attach W-2(s).

Enter U.S. Military Retirement on Line 17B (filing Status 4 only).

HOME OF RECORD OTHER THAN ARKANSAS: If your Home of Record is not Arkansas, do not report to Arkansas your income or your nonresident spouse’s income. Fill out and submit AR-NRMIL- ITARY Form to have a note put on your account that you are not required to file a return.

Your spouse’s income is exempt from Arkansas tax if your Home of Record is not Arkansas and your spouse’s domicile is the same as your Home of Record.

However, if your spouse had Arkansas income tax withheld, he/she will need to file a return to get a refund. Write the words “military spouse” at top of tax return and attach a completed Form AR-MS (available at www.arkansas.gov/incometax) and a copy of service member’s LES to verify Home of Record.

(For future tax purposes, your nonmilitary spouse must submit a new payroll withholding form, ARW- AMS to his/her employer each year to exempt withholding.)

LINE 10. If you received interest from bank depos- its, notes, mortgages, corporation bonds, savings and loan association deposits, and credit union deposits, enter all interest received or credited to your account during the year. If the total is over $1,500, complete and attach Form AR4.

LINE 11. If you received dividends and other distributions, enter amounts received as dividends from stocks in any corporation. If the total is over $1,500, complete and attach Form AR4.

LINE 12. Enter alimony or separate maintenance received as the result of a court order.

LINE 13. If you had business or professional in- come and filed a federal Schedule C or C-EZ, enter the total dollar amount(s) of net income (or loss) from your federal Schedule C or C-EZ. If you did not file a federal Schedule C or C-EZ, submit a similar schedule and enter the net income (or loss).

Page 14

If you filed a federal Schedule C or C-EZ, attach it to your return.

Business income may not be split be- tween you and your spouse unless a part- nership was legally established. Report partnership income on Form AR1050 and attach K-1(s) for each partner.

Include on Line 20, Other Income, any federal/state depreciation differences.

LINE 14. If you had gains or losses from the sale of real estate, stocks or bonds, or gains or losses from capital assets from partnerships, S corpora- tions, or fiduciaries, enter your taxable share. Adjust the amount of gain or loss for any federal/state depreciation differences.

If, after the netting process, you had a capital gain or loss reported on federal Schedule D or on Form 1040/1040A, use Arkansas Form AR1000D to determine the taxable amount to enter. Attach federal Schedule D and Form AR1000D to your return.

The amount of capital loss that can be deducted after offsetting capital gains is limited to $3,000 ($1,500 per taxpayer for filing Status 4 or 5). If your capital loss was more than the yearly limit on capital loss deduc- tions, you can carry over the unused part to later years until used up.

The gain on the sale of your personal residence is exempt up to $250,000 per taxpayer ($500,000 for married couples filing on the same return). The property must, during the 5 year period end- ing on the day of sale, be owned and used by the taxpayer(s) as the principal residence for periods aggregating 2 years or more.

LINE 15. Enter the ordinary gain or (loss) from Part \l of federal Form 4797. Adjust for any differenc- es in Arkansas and federal depreciation. The capital loss limit does not apply. Attach fed- eral Form 4797 and/or 4684 if applicable.

LINE 16. Use this line to report taxable lump-sum dis- tributions, annuities, and traditional IRA distributions. In- clude early withdrawal of traditional IRA distributions on this line. List only the amount of withdrawal and attach the federal Form 5329 showing the tax on premature distribution. Also, enter ten percent (10%) of the tax from the federal Form 5329, Part | and Part Il, on Line 30. If you received a distribution which does not qualify for the Lump-Sum Distribution Averaging Schedule (AR1000TD), list the total distribution received in 2015. (See AR1000TD to determine if you qualify to use the averaging method.) Attach 1099-R(s).

Premature distributions are amounts you withdrew from your traditional IRA, deferred compensation, or thrift savings plans before you were either age 59 % or disabled. Rollovers of premature distribu- tions are tax exempt.

NOTE: /f you filed a claim under McFadden v. Weiss or Maples v. Weiss and your ba- sis has been fully recovered, enter the amount from Box 1 of your 1099-R(s) as the “Gross” and “Taxable Amount” on

Line 17A or B.

LINE 17A. If you had income from an employ- ment-related pension plan or a qualified traditional IRA distribution, enter the gross amount(s) from Box 1 of your 1099-R(s) in the space provided. Enter the federal taxable amount from Box 2a of your 1099-R(s) in the space provided. If Box 2a is blank, use the Simplified Method Worksheet in the federal 1040 Instruction Booklet to calculate the taxable amount of your distribution. You are entitled to a $6,000 exemption from the taxable amount; the balance is taxable to Arkansas. Enter the balance on Line 17A, Column A. Attach 1099-R(s).

FILING STATUS 2 (Married Filing Joint) ONLY: If you and your spouse both had income from a retirement plan and/or qualified traditional IRA dis- tribution, enter the combined gross income amount from Box 1 of your 1099-R(s). Enter the combined federal taxable amount from Box 2a of your 1099- R(s). If Box 2a is blank, use the Simplified Method Worksheet in the federal 1040 Instruction Booklet to calculate the taxable amount of your distribution. Both you and your spouse are entitled to a $6,000 exemption from your respective taxable retirement plan income; the balance is taxable to Arkansas. Enter the balance on Line 17A. Attach 1099-R(s).

LINE 17B. FILING STATUS 4 (Married Filing Separately on the Same Return) ONLY: If your spouse had income from an employ- ment related pension plan or a qualified traditional IRA distribution, enter the gross income from Box 1 of his or her 1099-R(s). Enter the federal taxable amount from Box 2a of his or her 1099-R(s). If Box 2a is blank, use the Simplified Method Worksheet in the federal 1040 Instruction Booklet to calculate the taxable amount of his or her distribution. Your spouse is entitled to a $6,000 exemption from the taxable amount; the balance is taxable to Ar- kansas. Enter the balance on Line 17B. Attach 1099-R(s).

You are eligible for the $6,000 exemption for retire- ment or disability benefits provided the distribution was from public or private employment-related retirement systems, plans, or programs. (The recipient does not have to be retired.) The method of funding is irrelevant. The exemption may be taken from either lump-sum or installment payments. The early withdrawal penalty may be applicable even though the exemption is granted.

If you received a traditional IRA distribution after reaching the age of fifty-nine and one-half (59 1/2), the first $6,000 is exempt from tax. Premature distributions made on account of the participant’s death or disability also qualify for the exemption. All other premature distributions or early withdraw- als including, but not limited to, those taken for medical expenses, higher education expenses, or a first-time home purchase do not qualify for the exemption.

Note: If you made nondeductible contributions to your traditional IRA, enter taxable amount from federal Form 8606 in the space provided. Attach federal Form 8606.

LINE 18. If you had income from rents, royalties, estates or trusts, profits (whether received or not) from partnerships, fiduciaries, small business cor- porations, etc., enter the amounts as reported on your federal Schedule E. If you are filing a return for a taxable year that is not the same as the an- nual accounting period of your partnership or trust, report your distributive share(s) of net profits in the accounting period that ends in your taxable year. Attach federal Schedule E.

Nonresident beneficiaries pay tax only on Arkansas income.

LINE 19. If you had farm income, enter the amount reported on your federal Schedule F. Farm income may not be split between you and your spouse unless a partnership was legally established. Partnership income must be reported on Form AR1050, with K-1(s) for each partner. Attach federal Schedule F.

LINE 20. Enter net other income/loss and depre- ciation differences. Attach Form AR-OI. Some examples of what must be reported are:

Gambling winnings of any type , with the following exception: Gambling winnings from Arkansas electronic games of skill are not included as income and the 3% tax withheld is excluded from Line 37.

Reimbursement of medical expenses from a previous year: if you itemized deduc- tions in that year and it reduced your tax.

Amounts recovered on bad debts that you deducted in an earlier year.

Net operating loss (NOL) from an earlier year to carry forward to 2015: enter as a negative amount on Form AR-OI. Attach a state- ment showing how you calculated the amount of loss and the year the loss occurred. Anet operating loss may be carried forward for five (5) years. (NOL carrybacks not allowed.)

Scholarships, fellowships, and grants: A qualified scholarship, fellowship, or grant is exempt from tax only if:

1) You were a candidate for a degree at an educational institution, and

2) Received a qualified scholarship, fellowship, or grant.

A qualified scholarship, fellowship, or grant is any amount you received that was used under the terms of the grant for:

1) Tuition and fees required for enrollment, or

2) Fees, books, supplies and equipment required for the course(s) at the educational institution. (These items must have been required of all students in that course.)

Foreign students who are exempt from federal taxes because of a tax treaty must file and pay tax on all income including non-qualified scholarship or fellowship income.

Stipends are taxable. LINE 21. Add Lines 8 through 20 and enter total

in the appropriate columns on this line. This is your Total Income.

ADJUSTMENTS

LINE 22. If you are claiming an adjustment from the list below, use Form AR1000ADJ and include the total on this line. Attach Form AR1000ADJ.

Border city/Texarkana exemption

Arkansas Tax Deferred Tuition Savings Program Payments to IRA

Payments to MSA

Payments to HSA

Deduction for interest paid on student loans Contributions to Intergenerational Trust

Moving expenses

Self-employed health insurance deduction KEOGH, Self-employed SEP and Simple Plans Forfeited interest penalty for premature with- drawal

Alimony/Separate Maintenance Paid

Support for permanently disabled individual Organ Donor Deduction

Military Reserve Expenses

Reforestation Deduction

LINE 23. Subtract Line 22 from Line 21, Total Income. Enter amount on this line. This is your Adjusted Gross Income (AGI).

LINE 24. Enter the amount(s) from Line 23, Columns A and B.

TAX COMPUTATION

LINE 25. SELECT THE PROPER TAX TABLE and check the appropriate box. You will be in one of the following categories:

1) You qualify for the Low Income Tax Table, or 2) You must use the Regular Tax Table

See tax tables and qualifications for each table on pages 26-30.

If you use an exclusion for military compensation, employer sponsored pension income, or a quali- fied traditional IRA distribution, you do not qualify for a Low Income Tax Table. You may elect NOT TO USE the exclusion(s) to which you are entitled and use a Low Income Tax Table if you fall within the income limits.

Caution: If you qualify to use a Low Income Tax Table, enter zero (0) on Line 25, Column A. (The Standard Deduction is already built into the table.)

If you use the regular tax table, enter the larger of your itemized deductions (from Form AR3) or your Standard Deduction on Line 25.

Itemized Deductions:

To compute your itemized deductions, complete Form AR3 and attach it to your return. Make sure that your total itemized deductions exceed the Standard Deduction. (For Form AR3 instructions see pages 18-19 of this booklet.)

NOTE: /f you are filing Status 4 or 5 and one spouse itemizes, then both spouses must itemize. (If you are filing status 5 and your spouse itemizes on a separate return, check the appropriate box.)

Standard Deduction:

The Standard Deduction for your filing status is the amount shown below. (If the amount on Line 24 is less than the Standard Deduction, enter the amount from Line 24 on Line 25.)

Filing Standard

Status Deduction

1-Single $2,200

2-Married Filing Joint $4,400

3—Head of Household $2,200

4-Married Filing Separately $2,200 each on Same Return

5—Married Filing Separately $2,200 on Different Returns

6—Qualifying Widow(er) $2,200

NOTE: The $2,200 Standard Deduction does

not apply to taxpayer’s dependent(s).

LINE 26. Subtract Line 25 from Line 24. This is your Net Taxable Income.

LINE 27. Using the appropriate tax table locate the tax for your income and enter here.

LINE 28. Add Lines 27(A) and 27(B) and enter the total.

LINE 29. If you received a lump-sum (total) distri- bution from a qualified retirement plan during 2015, you may be eligible to use the averaging method to figure some of your tax at a lower rate. Read the instructions for Form AR1000TD to determine if you are eligible to use this method. If so, complete Form AR1000TD and enter amount here. Attach Form AR1000TD.

Page 15

LINE 30. Taxpayers subject to additional tax on their federal return from a traditional IRA or em- ployer qualified retirement plan are subject to ad- ditional tax on their state return. Enter ten percent (10%) of the federal amount from Part | of federal Form 5329. Be sure to enter total distribution(s) from Part I, Form 5329, on Line 16 or 17 of Form AR1000F/AR1000NR.

Taxpayers subject to additional tax on a distribu- tion from a Coverdell Education Savings Account, include ten percent (10%) of the federal amount from Part II of federal Form 5329 on this line. Be sure to include the taxable amount of the Coverdell Education Savings Account distribution on Line 20 of Form AR1000F/AR1000NR (Other Income).

LINE 31. Add Lines 28 through 30 and enter the total.

TAX CREDITS

LINE 32. Enter the total personal tax credits from Line 7D.

LINE 33. The Child Care Credit allowed is twenty percent (20%) of the amount allowed on your federal return. A copy of federal Form 2441, “Credit for Child and Dependent Care Expenses” must be attached to your Arkansas return.

LINE 34. Complete Form AR1000TC if you are eligible for any credit(s) listed below and include the total on this line. Attach Form AR1000TC.

State Political Contribution Credit Other State Tax Credit

Credit for Adoption Expenses Phenylketonuria Disorder Credit Business Incentive Tax Credit(s)

LINE 35. Add Lines 32 through 34 and enter the total.

LINE 36. Subtract Line 35 from Line 31. This is your Net Tax. If Line 35 is greater than Line 31, enter zero (0).

If Total Credits on Line 35 is more than Total Tax on Line 31, the difference is not refundable.

NOTE: If your net tax is $1,000 or more, and you failed to make a declaration of Estimated Tax (Form AR1000ES, Voucher 1), or pay withholding equal to 90% of your net tax, a penalty of ten percent (10%) will be assessed. See instructions for Lines 50A and 50B for more information.

Page 16

PRORATION

IF FILING A FULL YEAR RESIDENT RE- TURN, go to instructions for Line 37. The instructions for Line 36A through Line 36D apply only to nonresidents and part year residents.

NONRESIDENTS AND PART YEAR RESI- DENTS ONLY, read the following instructions to determine your correct Arkansas tax liability. Attach a complete copy of your federal return.

LINE 36A. Enter adjusted gross income from Line 23, Column C.

LINE 36B. Enter total of Columns A and B from Line 23.

LINE 36C. Divide amount on Line 36A by amount on Line 36B to arrive at your Arkansas percentage of income. Enter percentage as a decimal rounded to six places. Do not exceed 100%.

Example: $2,500/$525,000 = 0.004762 or $10,000/$60,000 = 0.166667

LINE 36D. Multiply amount on Line 36 by decimal on Line 36C for Arkansas apportioned tax liability.

PAYMENTS

LINE 37. Enter Arkansas tax withheld from your W-2(s)/1099-R(s). You have already paid this amount of tax during the year. If you have MORE THAN ONE W-2/1099-R, be sure to add the Arkan- sas income tax withheld from all W-2(s)/1099-R(s). Enter the total withheld.

IF YOUAND YOUR SPOUSE ARE FILING ON THE SAME RETURN, add the Arkansas state income tax withheld from all your W-2(s)/1099-R(s). Enter the combined total withheld.

If you did not receive (or lost) your W-2(s) and Arkansas tax was withheld from your income, you should take the following steps IN THE ORDER LISTED BELOW:

1) Ask your employer for copies of your W-2(s). If you cannot obtain them from your employer you should

2) Contact the Social Security Administration at (800) 772-1213. Only if you cannot obtain your W-2(s) from your employer or SSA you may

3) Complete federal Form 4852 and attach a copy of your final pay stub to

support your amounts.

CAUTION: You WILL NOT receive credit for tax withheld or receive a tax refund, unless you attach CORRECT AND LEGIBLE W-2(s) or other approved documentation to your tax return.

DO NOT include FICA, federal income tax, tax paid to another state or 3% tax withheld from winnings on electronic games of skill. Gambling winnings from Arkansas electronic games of skill are not included as income and the 3% tax withheld is excluded from Line 37.

DO NOT correct a W-2 yourself. Your em- ployer must issue you a corrected W-2.

LINE 38. If you made an estimated declaration and paid estimated tax payments on 2015 income OTHER THAN wages, salaries, tips, etc., write the total paid in this space. The only amount to enter here is total payments you made on a 2015 Decla- ration of Estimated Income Tax (includes January 15, 2016 installment and/or credit brought forward from 2014 tax return).

DO NOT include PENALTIES OR INTEREST as part of the amount paid.

If you and your spouse filed a JOINT dec- laration and you and your spouse choose to file your tax returns on separate forms this year, payments made under the joint declaration of estimate will be credited to the primary filer.

If you are filing prior year tax returns past the due date of the tax return, the refund/ overpayment from those tax returns can- not be carried forward as estimated tax.

LINE 39. If you filed an Arkansas extension request and paid tax with your request, enter the amount paid.

LINE 40. PREVIOUS PAYMENTS: This line is for amended returns only. Enter the total of any previous payment(s) made with your original return and/or billing notices and amended return(s).

LINE 41. Enter the APPROVED Early Child- hood Program Credit (20% of the federal child care credit). This is for individuals with a dependent child placed in an APPROVED child care facility while the parent or guardian worked or pursued employ- ment. (Facility must be approved by the Arkansas Department of Education as having an appropriate early childhood program as defined by Arkansas law.) Enter the certification number and attach federal Form 2441 and Certifica- tion Form AR1000EC. Contact your child care facility for Form AR1000EC.

LINE 42. Add the amounts on Lines 37,38,39,40 and 41. This is your TOTAL PAYMENTS.

O15 090 en AR1 ARKANSAS INDIVIDUAL INCOME TAX RETURN CHECK BOX IF Full Year Resident Dept. Use Only AMENDED RETURN Jan. 1 - Dec. 31, 2015 or fiscal year ending , 20 e e e PRIMARY FIRST NAME MI LAST NAME PRIMARY SOCIAL SECURITY NUMBER e e e e Sa SPOUSE FIRST NAME MI LAST NAME al Be ° ° ° SPOUSE’S SOCIAL SECURITY NUMBER q ae MAILING ADDRESS (number and Street, P.O. Box or Rural Route) e card >a|e CITY, STATE AND ZIP CODE ° A A x] 1.6 C] SINGLE (Or widowed before 2015 or divorced at end of 2015) 4.e LC] MARRIED FILING SEPARATELY ON THE SAME RETURN oa es 2.@ | MARRIED FILING JOINT (Even if only one had income) 5.e@ | MARRIED FILING SEPARATELY ON DIFFERENT RETURNS fc nD 8| 3.0 | HEAD OF HOUSEHOLD (See Instructions) Enter spouse’s name here and SSN above at 4 zs If the qualifying person was your child, but not your dependent, 6.e L] QUALIFYING WIDOW(ER) with dependent child ° enter child’s name here: Year spouse died: (See Instructions) > e CO Check this box if you have filed a state extension or an automatic federal extension 7a[_]yoursetr e[ ]e5orover e[ ]|esspeciaL e[ | Biind e[ ]pear [_| HEAD OF HOUSEHOLD/QUALIFYING WIDOWER) [_]srouse e[_]e5orover e[ ]é6ssPeciaL e[ | BLIND e[ |] DEAF Multiply number of boxes checked = 00 fe Dependents (Do not list yourself or spouse) 8 First Name Last Name Dependent’s Social Security Number Dependent’s relationship to you 4 ° FE: F [2 FA é [s. Q i 7B. Multiply number of dependents from ADOVE ..........ceseseseeseseseeseseeseseeseeeeseeseseseeseeeeeueensuceteneeneeeeesaesneateneeneeee 7B @ im X $26 = 00 7C. First name of individual(s) with developmental disability: (See Instructions) Multiply number of individuals with developmental disabilities frOM 7C 0... cece LO @ | X $500 = 00 7D. TOTAL PERSONAL TAX CREDITS: (Add Lines 7A, 7B, and 7C. Enter total here and on Lin€ 32)......:00cccceeee 7D 00 (A) Your/Joint (B) Spouse’s Income ROUND ALL AMOUNTS TO WHOLE DOLLARS Income Status 4 Only 8. Wages, salaries, tips, etc: (Attach W-2s).. hd Joo e [oo 9A. U.S. Military compensation: (Your/joint gross amount) |e 00} 9A 9B. U.S. Military compensation: (Spouse’s gross amount) |e 00} +98 10. Interest income: (If over $1,500, attach AR4).......cccecsececsecesesecseseesesseseeseeeeseeeesseesseensseeessetseeeesess e@ O0|e 00 11. Dividend income: (if over $1,500, attach AR4) e OO e 00 12. Alimony and separate maintenance received:. : e O0}e 00 13. Business or professional income: (Attach federal Schedule C Or C-EZ) ....s.sccccsceeseseseteeseeeeees e OO} 00 14. Capital gains/(losses) from stocks, bonds, etc: (See Instr. Attach Schedule D). e O0|e 00 15. Other gains or (losses): (Attach federal Form 4797 and/or 4684 if applicable)... . e@ O0|e 00) 16. Non-Qualified IRA distributions and taxable annuities: (Attach All 1099RS)......:ceccsseeeeeeee e OO} 00) 17A.Your/Joint Employer pension plan(s)/Qualified IRA(s): (See Instructions - Attach All 1099Rs) Gross Distribution [e ————«([00| Taxable Amount fo «(00 se SSot 7A\2@ 00) 17B.Spouse’s Employer pension plan(s)/Qualified IRA(s): (Filing Status 4 Onl, Gross Distribution l- ~———sio Taxable Amount - —| s6°S0017 Ld 00 18. Rents, royalties, partnerships, estates, trusts, etc: (Attach federal Schedule E) @ O0l\e 00 19. Farm income: (Attach federal Schedule F) e OO} e 00 20. Other income/depreciation differences: (Attach Form AR-Ol) e O0|e 00 21. TOTAL INCOME: (Aad Lines 8 through 20)... e wi 00 22. TOTAL ADJUSTMENTS: (Attach Form AR1000ADJ) .. 22 |@ oo} e 00} 23. ADJUSTED GROSS INCOME: (Subtract Line 22 from Lin@ 21).........:.cceeeseteeeeteteeeneeeeee e ooje 00

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| ITAR152

AR2

Primary SSN - - (A) Your/Joint (B) Spouse’s Income Income Status 4 Only 24. ADJUSTED GROSS INCOME: (From Line 23, Columns A and B).......ssssssssesseeeeees 24 00 00 25. Select tax table: (See Instructions, Line 25) e (Low INCOME Table LJ REGULAR Table fa If you qualify for the Low Income Tax Table, enter zero (0) on Line 25A. If not, then: & Enter eC] Itemized Deductions (See /nstructions, Line 25 and attach AR3) 2 the larger OR _ If your spouse itemizes on a separate return, check here @ oO 5 of your: UO standard Deduction (See Instructions, Lin@ 25) .....c.ccsceee 25 @| 00; | 00 x | 26. NET TAXABLE INCOME: (Subtract Line 25 from Line 24) 00} e 00 © | 27. TAX: (Enter tax from tax table) 00 00 28. Combined tax: (Add amounts from Line 27, Columns A and B)........ssesscesseesssessseesseeseeseeesseeseesseesesssnessesseesneesueeeeeene 28 00 29. Enter tax from Lump Sum Distribution Averaging Schedule: (Attach AR1000TD) 29 @ 00 30. Additional tax on IRA and qualified plan withdrawal and overpayment: (Attach federal Form 5329, if required) 30 @ 00 31. TOTAL TAX: (Add Lines 28 through 30) 31 @| 00 @ | 32. Personal Tax Credit(s): (Enter total from Line 7D).... 00 E 33. Child Care Credit: (20% of federal credit allowed; Attach federal Form 244 i). 00 & 34. Other Credits: (Attach AR1000TC) 00 % | 35. TOTAL CREDITS: (Add Lines 32 through 34) 35 @| 00 F | 36. NET TAX: (Subtract Line 35 from Line 31. If Line 35 is greater than Line 31, enter 0) 36 @| 00 37. Arkansas income tax withheld: [Attach state copies of W-2 and/or 1099R Form(s)]......... 38. Estimated tax paid or credit brought forward from 2014:.. 39. Payment made with extension: (See Instructions) e 40. AMENDED RETURNS ONLY - Previous payments: (See instructions) . g 41. Early childhood program: Certification Number: x (20% of federal credit; Attach federal Form 2441 and Form AR1000EC) .......:.cccccesseeeees 41 @| 00} 42. TOTAL PAYMENTS: (Add Lines 37 through 41) 00 43. AMENDED RETURNS ONLY - Previous refund: (See instructions) . 00) 44. Adjusted Total Payments: (Subtract Line 43 from Line 42).. 00 45. AMOUNT OF OVERPAYMENT/REFUND: (/f Line 44 is greater than Line 36, enter differeNCe) ...........-ecees 45 @ 00 46. Amount to be applied to 2016 estimated tax: ......... ee 46 @| 00 47. Amount of Check-off Contributions: (Attach Schedule AR1000- 0-C0). 00 3 48. AMOUNT TO BE REFUNDED TO YOU: (Subtract Lines 46 and 47 from Line 45) REFUND 48 e|© 00 z DIRECT DEPOSIT? If you want your refund direct deposited you must check this box @ [_] and x complete Form ARDD and attach it to your return. (Direct deposit is not available for amended returns.) Z 49. AMOUNT DUE: (If Line 44 is less than Line 36, enter difference; If over $1,000, continue to S0A).......... TAX DUE 49 Ce 0) i I50A.UEP: Attach Form AR2210 or AR2210A. If required, enter exception in box 50A@ LC] Penalty 50Be@ 00 I50C.Add Lines 49 and 50B. Attach Form AR1000V with 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.........0 TOTAL DUE 50C@ 00 51. Amount of income not subject to Arkansas tax from AR4, Part Ill: (Memorandum only) May the Arkansas Revenue Agency discuss this return with the preparer shown below? oO Yes Oo No PLEASE SIGN HERE: under penalties of perjury, | declare that | 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 Telephone: Spouse’s Signature Occupation Date Alternate Telephone: Paid Preparer’s Signature ID Number/Social Security Number ° eC | Preparer’s Name City/State/Zip Fy Address Telephone Number

Page AR2 (R 5/19/15)

O15 090 en AR1 ARKANSAS INDIVIDUAL INCOME TAX RETURN CHECK BOX IF Full Year Resident Dept. Use Only AMENDED RETURN Jan. 1 - Dec. 31, 2015 or fiscal year ending , 20 e e e PRIMARY FIRST NAME MI LAST NAME PRIMARY SOCIAL SECURITY NUMBER e e e e Sa SPOUSE FIRST NAME MI LAST NAME al Be ° ° ° SPOUSE’S SOCIAL SECURITY NUMBER q ae MAILING ADDRESS (number and Street, P.O. Box or Rural Route) e card >a|e CITY, STATE AND ZIP CODE ° A A x] 1.6 C] SINGLE (Or widowed before 2015 or divorced at end of 2015) 4.e LC] MARRIED FILING SEPARATELY ON THE SAME RETURN oa es 2.@ | MARRIED FILING JOINT (Even if only one had income) 5.e@ | MARRIED FILING SEPARATELY ON DIFFERENT RETURNS fc nD 8| 3.0 | HEAD OF HOUSEHOLD (See Instructions) Enter spouse’s name here and SSN above at 4 zs If the qualifying person was your child, but not your dependent, 6.e L] QUALIFYING WIDOW(ER) with dependent child ° enter child’s name here: Year spouse died: (See Instructions) > e CO Check this box if you have filed a state extension or an automatic federal extension 7a[_]yoursetr e[ ]e5orover e[ ]|esspeciaL e[ | Biind e[ ]pear [_| HEAD OF HOUSEHOLD/QUALIFYING WIDOWER) [_]srouse e[_]e5orover e[ ]é6ssPeciaL e[ | BLIND e[ |] DEAF Multiply number of boxes checked = 00 fe Dependents (Do not list yourself or spouse) 8 First Name Last Name Dependent’s Social Security Number Dependent’s relationship to you 4 ° FE: F [2 FA é [s. Q i 7B. Multiply number of dependents from ADOVE ..........ceseseseeseseseeseseeseseeseeeeseeseseseeseeeeeueensuceteneeneeeeesaesneateneeneeee 7B @ im X $26 = 00 7C. First name of individual(s) with developmental disability: (See Instructions) Multiply number of individuals with developmental disabilities frOM 7C 0... cece LO @ | X $500 = 00 7D. TOTAL PERSONAL TAX CREDITS: (Add Lines 7A, 7B, and 7C. Enter total here and on Lin€ 32)......:00cccceeee 7D 00 (A) Your/Joint (B) Spouse’s Income ROUND ALL AMOUNTS TO WHOLE DOLLARS Income Status 4 Only 8. Wages, salaries, tips, etc: (Attach W-2s).. hd Joo e [oo 9A. U.S. Military compensation: (Your/joint gross amount) |e 00} 9A 9B. U.S. Military compensation: (Spouse’s gross amount) |e 00} +98 10. Interest income: (If over $1,500, attach AR4).......cccecsececsecesesecseseesesseseeseeeeseeeesseesseensseeessetseeeesess e@ O0|e 00 11. Dividend income: (if over $1,500, attach AR4) e OO e 00 12. Alimony and separate maintenance received:. : e O0}e 00 13. Business or professional income: (Attach federal Schedule C Or C-EZ) ....s.sccccsceeseseseteeseeeeees e OO} 00 14. Capital gains/(losses) from stocks, bonds, etc: (See Instr. Attach Schedule D). e O0|e 00 15. Other gains or (losses): (Attach federal Form 4797 and/or 4684 if applicable)... . e@ O0|e 00) 16. Non-Qualified IRA distributions and taxable annuities: (Attach All 1099RS)......:ceccsseeeeeeee e OO} 00) 17A.Your/Joint Employer pension plan(s)/Qualified IRA(s): (See Instructions - Attach All 1099Rs) Gross Distribution [e ————«([00| Taxable Amount fo «(00 se SSot 7A\2@ 00) 17B.Spouse’s Employer pension plan(s)/Qualified IRA(s): (Filing Status 4 Onl, Gross Distribution l- ~———sio Taxable Amount - —| s6°S0017 Ld 00 18. Rents, royalties, partnerships, estates, trusts, etc: (Attach federal Schedule E) @ O0l\e 00 19. Farm income: (Attach federal Schedule F) e OO} e 00 20. Other income/depreciation differences: (Attach Form AR-Ol) e O0|e 00 21. TOTAL INCOME: (Aad Lines 8 through 20)... e wi 00 22. TOTAL ADJUSTMENTS: (Attach Form AR1000ADJ) .. 22 |@ oo} e 00} 23. ADJUSTED GROSS INCOME: (Subtract Line 22 from Lin@ 21).........:.cceeeseteeeeteteeeneeeeee e ooje 00

Page AR1 (R 5/19/15)

| ITAR152

AR2

Primary SSN - - (A) Your/Joint (B) Spouse’s Income Income Status 4 Only 24. ADJUSTED GROSS INCOME: (From Line 23, Columns A and B).......ssssssssesseeeeees 24 00 00 25. Select tax table: (See Instructions, Line 25) e (Low INCOME Table LJ REGULAR Table fa If you qualify for the Low Income Tax Table, enter zero (0) on Line 25A. If not, then: & Enter eC] Itemized Deductions (See /nstructions, Line 25 and attach AR3) 2 the larger OR _ If your spouse itemizes on a separate return, check here @ oO 5 of your: UO standard Deduction (See Instructions, Lin@ 25) .....c.ccsceee 25 @| 00; | 00 x | 26. NET TAXABLE INCOME: (Subtract Line 25 from Line 24) 00} e 00 © | 27. TAX: (Enter tax from tax table) 00 00 28. Combined tax: (Add amounts from Line 27, Columns A and B)........ssesscesseesssessseesseeseeseeesseeseesseesesssnessesseesneesueeeeeene 28 00 29. Enter tax from Lump Sum Distribution Averaging Schedule: (Attach AR1000TD) 29 @ 00 30. Additional tax on IRA and qualified plan withdrawal and overpayment: (Attach federal Form 5329, if required) 30 @ 00 31. TOTAL TAX: (Add Lines 28 through 30) 31 @| 00 @ | 32. Personal Tax Credit(s): (Enter total from Line 7D).... 00 E 33. Child Care Credit: (20% of federal credit allowed; Attach federal Form 244 i). 00 & 34. Other Credits: (Attach AR1000TC) 00 % | 35. TOTAL CREDITS: (Add Lines 32 through 34) 35 @| 00 F | 36. NET TAX: (Subtract Line 35 from Line 31. If Line 35 is greater than Line 31, enter 0) 36 @| 00 37. Arkansas income tax withheld: [Attach state copies of W-2 and/or 1099R Form(s)]......... 38. Estimated tax paid or credit brought forward from 2014:.. 39. Payment made with extension: (See Instructions) e 40. AMENDED RETURNS ONLY - Previous payments: (See instructions) . g 41. Early childhood program: Certification Number: x (20% of federal credit; Attach federal Form 2441 and Form AR1000EC) .......:.cccccesseeeees 41 @| 00} 42. TOTAL PAYMENTS: (Add Lines 37 through 41) 00 43. AMENDED RETURNS ONLY - Previous refund: (See instructions) . 00) 44. Adjusted Total Payments: (Subtract Line 43 from Line 42).. 00 45. AMOUNT OF OVERPAYMENT/REFUND: (/f Line 44 is greater than Line 36, enter differeNCe) ...........-ecees 45 @ 00 46. Amount to be applied to 2016 estimated tax: ......... ee 46 @| 00 47. Amount of Check-off Contributions: (Attach Schedule AR1000- 0-C0). 00 3 48. AMOUNT TO BE REFUNDED TO YOU: (Subtract Lines 46 and 47 from Line 45) REFUND 48 e|© 00 z DIRECT DEPOSIT? If you want your refund direct deposited you must check this box @ [_] and x complete Form ARDD and attach it to your return. (Direct deposit is not available for amended returns.) Z 49. AMOUNT DUE: (If Line 44 is less than Line 36, enter difference; If over $1,000, continue to S0A).......... TAX DUE 49 Ce 0) i I50A.UEP: Attach Form AR2210 or AR2210A. If required, enter exception in box 50A@ LC] Penalty 50Be@ 00 I50C.Add Lines 49 and 50B. Attach Form AR1000V with 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.........0 TOTAL DUE 50C@ 00 51. Amount of income not subject to Arkansas tax from AR4, Part Ill: (Memorandum only) May the Arkansas Revenue Agency discuss this return with the preparer shown below? oO Yes Oo No PLEASE SIGN HERE: under penalties of perjury, | declare that | 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 Telephone: Spouse’s Signature Occupation Date Alternate Telephone: Paid Preparer’s Signature ID Number/Social Security Number ° eC | Preparer’s Name City/State/Zip Fy Address Telephone Number

Page AR2 (R 5/19/15)

2015 AR1000NR

ARKANSAS INDIVIDUAL Mth INCOME TAX RETURN Nonresident and Part Year Resident

ITNR

IN 151

Dept. Use Only

NR1

CHECK BOX IF AMENDED RETURN

Jan. 1 - Dec. 31, 2015 or fiscal year ending , 20 e e e IPRIMARY FIRST NAME MI LAST NAME YOUR SOCIAL SECURITY NUMBER e e e e ca ISPOUSE FIRST NAME MI LAST NAME ae e e e SPOUSE’S SOCIAL SECURITY NUMBER 20 ae MAILING ADDRESS (Number and Street, P.O. Box or Rural Route) ° Bele CITY, STATE AND ZIP CODE Important: You MUST bd enter your SSN(s) above

ATTACH A COPY OF YOUR COMPLETE FEDERAL RETURN

NONRESIDENT: (List State of residence)

eH

PART YEAR RESIDENT: eC] (Dates Lived in AR)

1.e[_] SINGLE (Or widowed before 2015 or divorced at end of 2015) 2.e[__] MARRIED FILING JOINT (Even if only one had income)

3.e HEAD OF HOUSEHOLD (See /nstructions) If the qualifying person was your child but not your dependent, enter child’s name here:

FILING STATUS heck Only One Box

|

4@ C] MARRIED FILING SEPARATELY ON THE SAME RETURN

MARRIED FILING SEPARATELY ON DIFFERENT RETURNS

Enter spouse’s name here and SSN above

6.e [_] QUALIFYING WIDOW(ER) with dependent child

Year spouse died: (See Instructions)

HAVE YOU FILED AN EXTENSION?

*O

Check this box if you have filed a state extension

or an automatic federal extension

(Filing Status 3 Only)

TA. YOURSELF @ 650rOVER @ 65 SPECIAL @ BLIND @ DEAF HEAD OF HOUSEHOLD/QUALIFYING WIDOW(ER) C O O CO C O (Filing Status 6 Only) (eR)

[_]srouse e[ ]ésoroveR e[ ]essPeciAL e[ ] BLIND e[ | DEAF 0 Multiply number of boxes checked = 00 5 Dependents (Do not list yourself or spouse) & First Name Last Name Dependent’s Social Security Number Dependent’s relationship to you Fs 1. 2 oc #! | 7B. Multiply number of dependents from AbOVE uuu... eee cece ceeeeee es eseeseeeseeseeteesteseeeseeseseseeeseneneaeeesensesneeeeeee 7B @ CL] X $26 = 00} 7C. First name of individual(s) with developmental disability: (See Instructions) Multiply number of individuals with developmental disabilities froM 7C ........eeceeseeeeeeteteeeeeee 10 @ | X $500 = 100 7D. TOTAL PERSONAL TAX CREDITS: (Add Lines 7A, 7B, and 7C. Enter total here and on Lin€ 32).......cceeeee 7D 00} (A) Your/Joint | (B) Spouse’s Income] (C) Arkansas GS ROUND ALL AMOUNTS TO WHOLE DOLLARS Income Status 4 Only Income Only z 8. Wages, salaries, tips, etc: (Attach W-2s). 8 |e 00|e 00}e 00 s 9A. U.S. Military compensation: (Yourjoint gross amt.) =]9B. U.S. Military compensation: (Spouse's gross amt.) =| 10. Interest income: (If over $1,500, attach AR4).... je je le 00 3 11. Dividend income: (If over $1,500, attach AR4 je je le 00 5 12. Alimony and separate maintenance received 12 |e je le 00) we 13. Business or professional income: (Attach federal Schedule C or C-EZ).......0.0000 je 00|e 00|e 00 2 5 14. Capital gains/(losses) from stocks, bonds, etc: (See Instr. Attach Schedule D).... le 00le 00e 00) S52] 15. Other gains or (losses): (Attach federal Form 4797 and/or 4684 if applicable)......15 |@ 00le 00}e 00 5116. Non-Qualified IRA distributions and taxable annuities: (Attach All 1099R8).......+++ bd bd je 00) 8 17A. Your/Joint Employer pension plan(s)/Qualified IRA(s):(See Instructions, Attach All 1099Rs) a Gross Distribution Taxable Amount[e__[00| 36550174 00) Fy 17B. Spouse Employer pension plan(s)/Qualified IRA(s): (Filing Status 4 only) e Gross Distribution[e __[00] Taxable Amount[e__[00] 6880178 000 00 g 18. Rents, royalties, partnerships, estates, trusts, etc.: (Attach federal Schedule E). je je 00}e 00) =|19. Farm income: (Attach federal Schedule F)..... je 00|e 00}e 00 s 20. Other income/depreciation differences: (Attach Form AR-Ol) le 00|e 00}e 00) 21. TOTAL INCOME: (Add Lines 8 through 20) je 00le 00le 00 22. TOTAL ADJUSTMENTS: (Attach Form AR1000ADU) ..sssscsssiscssssssssscsssscessneesse le 00}e 00}e 00) 23. ADJUSTED GROSS INCOME: (Subtract Line 22 from Line 21) ....ss.sssssssssss 23 |e 00}e 00}e 00

Page NR1 (R 5/19/15)

1 eee ITNR152 Primary SSN - - N R2

(A) Your/Joint (B) Spouse's Income Income Status 4 Only 24. ADJUSTED GROSS INCOME: (From Line 23, Columns A and B)....s.::sssssesseeiieeee 24 00 00 25. Select tax table: (Check the appropriate box) e(] LOW INCOME Table = [[] REGULAR Table

6 If you qualify for the Low Income Tax Table, enter zero (0) on Line 25A. If not, then:

z Enter ee] Itemized Deductions (See /nstructions, Line 25 and attach AR3)

2 the larger, OR _ If your spouse itemizes on a separate return, check here @ Oo

8 of your: CJ standard Deduction (See Instructions, Line 25) -.25e| 00] 25¢e) 00

% |26. NET TAXABLE INCOME: (Subtract Line 25 from Line 24) 260) 00} 26¢} 00

"127. TAX: (Enter tax from tax table) 00} 27 00 28. Combined tax: (Add amounts from Line 27, Columns A and B)......sccscesssesscess sess seeseeseeseesseesseesseesiesseeseessnesseesneeseese 28 00 29. Enter tax from Lump Sum Distribution Averaging Schedule: (Attach AR1000TD) 29e) 00 30. Additional tax on IRA and qualified plan withdrawal and overpayment: (Attach federal Form 5329, if required) 30¢ 00 31. TOTAL TAX: (Add Lines 28 through 30) ....sssssssssssssssssssssssssssssssstssssttssntittsstttintiiitittitttinitiiiitiiiiitiiiiiittiitiniinineeeneiee 31e| 00

w |32. Personal Tax Credit(s): (Enter total from Line 7D) 00

6 33. Child Care Credit: (20% of federal credit allowed; Attach federal Form 2441)

& | 34. Other Credits: (Attach AR1000TC)

% |35. TOTAL CREDITS: (Add Lines 32 through 34) 00

. 36. NET TAX: (Subtract Line 35 from Line 31. If Line 35 is greater than Line 31, enter 0) 00

3g 36A. Enter the amount from Line 23, COIUMIN C2... cece

5 36B. Enter the total amount from Line 23, Columns A and B:

5 36C. Divide Line 36A by 36B: (See Instructions)...

2 | 36D. APPORTIONED TAX LIABILITY: (Multiply Line 36 by Lin@ 36C) .......:..-ssessssessesessesissesssrectesesesesesesseseeserenes sen 00 37. Arkansas income tax withheld: [Attach state copies of W-2 and/or 1099R Form(s)] 38. Estimated tax paid or credit brought forward from 2014:... 39. Payment made with extension: (See /nstructions).....

g 40. AMENDED RETURNS ONLY - Previous payments: (See INStrUCtIONS)............00ceeseeeeee

S| 41. Early childhood program: Certification Number:

x (20% of federal credit; Attach federal Form 2441 and Form AR1000EC).........::ssscccseeeeeee 42. TOTAL PAYMENTS: (Add Lines 37 through 41).... we 00 43. AMENDED RETURNS ONLY - Previous refund: (See instructions) 00 44. Adjusted Total Payments: (Subtract Line 43 from Line 42) 00 45. AMOUNT OF OVERPAYMENT/REFUND: (If Line 44 is greater than Line 36D, enter differenCe) ...........ccecee 45e| 00 46. Amount to be applied to 2016 estimated ta: 460 00

w 47. Amount of Check-off Contributions: (Attach Schedule AR1000-CO)

x 48. AMOUNT TO BE REFUNDED TO YOU: (Subtract Lines 46 and 47 from Line 45)

& DIRECT DEPOSIT? If you want your refund direct deposited you must check this box @ Oana

3 complete Form ARDD and attach it to your return. (Direct deposit is not available for amended returns.)

z 49. AMOUNT DUE: (If Line 44 is less than Line 36D, enter difference; If over $1,000, continue to 50A)..... TAX DUE 49e|® 00]

© 150A. UEP: Attach Form AR2210 or AR2210A. If required, enter exception in box 50A@[_ Penalty 50Be| [00] 50C. Add Lines 49 and 50B. Attach Form AR1000V with 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.............. TOTAL DUE 50C @ 00) 51. Amount of income not subject to Arkansas tax from AR4, Part Ill: (Memorandum only) May the Arkansas Revenue Agency discuss this return with the preparer shown below? oO Yes Oo No

PLEASE SIGN HERE: Under penalties of perjury, | declare that | 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 Telephone: Spouse’s Signature Occupation Date Alternate Telephone: Paid Preparer’s Signature ID Number/Social Security Number

ra bd A [e

Zé Preparer’s Name City/State/Zip = Address Telephone Number

Page NR2 (R 5/19/15)

2015 AR1000NR

ARKANSAS INDIVIDUAL Mth INCOME TAX RETURN Nonresident and Part Year Resident

ITNR

IN 151

Dept. Use Only

NR1

CHECK BOX IF AMENDED RETURN

Jan. 1 - Dec. 31, 2015 or fiscal year ending , 20 e e e IPRIMARY FIRST NAME MI LAST NAME YOUR SOCIAL SECURITY NUMBER e e e e ca ISPOUSE FIRST NAME MI LAST NAME ae e e e SPOUSE’S SOCIAL SECURITY NUMBER 20 ae MAILING ADDRESS (Number and Street, P.O. Box or Rural Route) ° Bele CITY, STATE AND ZIP CODE Important: You MUST bd enter your SSN(s) above

ATTACH A COPY OF YOUR COMPLETE FEDERAL RETURN

NONRESIDENT: (List State of residence)

eH

PART YEAR RESIDENT: eC] (Dates Lived in AR)

1.e[_] SINGLE (Or widowed before 2015 or divorced at end of 2015) 2.e[__] MARRIED FILING JOINT (Even if only one had income)

3.e HEAD OF HOUSEHOLD (See /nstructions) If the qualifying person was your child but not your dependent, enter child’s name here:

FILING STATUS heck Only One Box

|

4@ C] MARRIED FILING SEPARATELY ON THE SAME RETURN

MARRIED FILING SEPARATELY ON DIFFERENT RETURNS

Enter spouse’s name here and SSN above

6.e [_] QUALIFYING WIDOW(ER) with dependent child

Year spouse died: (See Instructions)

HAVE YOU FILED AN EXTENSION?

*O

Check this box if you have filed a state extension

or an automatic federal extension

(Filing Status 3 Only)

TA. YOURSELF @ 650rOVER @ 65 SPECIAL @ BLIND @ DEAF HEAD OF HOUSEHOLD/QUALIFYING WIDOW(ER) C O O CO C O (Filing Status 6 Only) (eR)

[_]srouse e[ ]ésoroveR e[ ]essPeciAL e[ ] BLIND e[ | DEAF 0 Multiply number of boxes checked = 00 5 Dependents (Do not list yourself or spouse) & First Name Last Name Dependent’s Social Security Number Dependent’s relationship to you Fs 1. 2 oc #! | 7B. Multiply number of dependents from AbOVE uuu... eee cece ceeeeee es eseeseeeseeseeteesteseeeseeseseseeeseneneaeeesensesneeeeeee 7B @ CL] X $26 = 00} 7C. First name of individual(s) with developmental disability: (See Instructions) Multiply number of individuals with developmental disabilities froM 7C ........eeceeseeeeeeteteeeeeee 10 @ | X $500 = 100 7D. TOTAL PERSONAL TAX CREDITS: (Add Lines 7A, 7B, and 7C. Enter total here and on Lin€ 32).......cceeeee 7D 00} (A) Your/Joint | (B) Spouse’s Income] (C) Arkansas GS ROUND ALL AMOUNTS TO WHOLE DOLLARS Income Status 4 Only Income Only z 8. Wages, salaries, tips, etc: (Attach W-2s). 8 |e 00|e 00}e 00 s 9A. U.S. Military compensation: (Yourjoint gross amt.) =]9B. U.S. Military compensation: (Spouse's gross amt.) =| 10. Interest income: (If over $1,500, attach AR4).... je je le 00 3 11. Dividend income: (If over $1,500, attach AR4 je je le 00 5 12. Alimony and separate maintenance received 12 |e je le 00) we 13. Business or professional income: (Attach federal Schedule C or C-EZ).......0.0000 je 00|e 00|e 00 2 5 14. Capital gains/(losses) from stocks, bonds, etc: (See Instr. Attach Schedule D).... le 00le 00e 00) S52] 15. Other gains or (losses): (Attach federal Form 4797 and/or 4684 if applicable)......15 |@ 00le 00}e 00 5116. Non-Qualified IRA distributions and taxable annuities: (Attach All 1099R8).......+++ bd bd je 00) 8 17A. Your/Joint Employer pension plan(s)/Qualified IRA(s):(See Instructions, Attach All 1099Rs) a Gross Distribution Taxable Amount[e__[00| 36550174 00) Fy 17B. Spouse Employer pension plan(s)/Qualified IRA(s): (Filing Status 4 only) e Gross Distribution[e __[00] Taxable Amount[e__[00] 6880178 000 00 g 18. Rents, royalties, partnerships, estates, trusts, etc.: (Attach federal Schedule E). je je 00}e 00) =|19. Farm income: (Attach federal Schedule F)..... je 00|e 00}e 00 s 20. Other income/depreciation differences: (Attach Form AR-Ol) le 00|e 00}e 00) 21. TOTAL INCOME: (Add Lines 8 through 20) je 00le 00le 00 22. TOTAL ADJUSTMENTS: (Attach Form AR1000ADU) ..sssscsssiscssssssssscsssscessneesse le 00}e 00}e 00) 23. ADJUSTED GROSS INCOME: (Subtract Line 22 from Line 21) ....ss.sssssssssss 23 |e 00}e 00}e 00

Page NR1 (R 5/19/15)

1 eee ITNR152 Primary SSN - - N R2

(A) Your/Joint (B) Spouse's Income Income Status 4 Only 24. ADJUSTED GROSS INCOME: (From Line 23, Columns A and B)....s.::sssssesseeiieeee 24 00 00 25. Select tax table: (Check the appropriate box) e(] LOW INCOME Table = [[] REGULAR Table

6 If you qualify for the Low Income Tax Table, enter zero (0) on Line 25A. If not, then:

z Enter ee] Itemized Deductions (See /nstructions, Line 25 and attach AR3)

2 the larger, OR _ If your spouse itemizes on a separate return, check here @ Oo

8 of your: CJ standard Deduction (See Instructions, Line 25) -.25e| 00] 25¢e) 00

% |26. NET TAXABLE INCOME: (Subtract Line 25 from Line 24) 260) 00} 26¢} 00

"127. TAX: (Enter tax from tax table) 00} 27 00 28. Combined tax: (Add amounts from Line 27, Columns A and B)......sccscesssesscess sess seeseeseeseesseesseesseesiesseeseessnesseesneeseese 28 00 29. Enter tax from Lump Sum Distribution Averaging Schedule: (Attach AR1000TD) 29e) 00 30. Additional tax on IRA and qualified plan withdrawal and overpayment: (Attach federal Form 5329, if required) 30¢ 00 31. TOTAL TAX: (Add Lines 28 through 30) ....sssssssssssssssssssssssssssssssstssssttssntittsstttintiiitittitttinitiiiitiiiiitiiiiiittiitiniinineeeneiee 31e| 00

w |32. Personal Tax Credit(s): (Enter total from Line 7D) 00

6 33. Child Care Credit: (20% of federal credit allowed; Attach federal Form 2441)

& | 34. Other Credits: (Attach AR1000TC)

% |35. TOTAL CREDITS: (Add Lines 32 through 34) 00

. 36. NET TAX: (Subtract Line 35 from Line 31. If Line 35 is greater than Line 31, enter 0) 00

3g 36A. Enter the amount from Line 23, COIUMIN C2... cece

5 36B. Enter the total amount from Line 23, Columns A and B:

5 36C. Divide Line 36A by 36B: (See Instructions)...

2 | 36D. APPORTIONED TAX LIABILITY: (Multiply Line 36 by Lin@ 36C) .......:..-ssessssessesessesissesssrectesesesesesesseseeserenes sen 00 37. Arkansas income tax withheld: [Attach state copies of W-2 and/or 1099R Form(s)] 38. Estimated tax paid or credit brought forward from 2014:... 39. Payment made with extension: (See /nstructions).....

g 40. AMENDED RETURNS ONLY - Previous payments: (See INStrUCtIONS)............00ceeseeeeee

S| 41. Early childhood program: Certification Number:

x (20% of federal credit; Attach federal Form 2441 and Form AR1000EC).........::ssscccseeeeeee 42. TOTAL PAYMENTS: (Add Lines 37 through 41).... we 00 43. AMENDED RETURNS ONLY - Previous refund: (See instructions) 00 44. Adjusted Total Payments: (Subtract Line 43 from Line 42) 00 45. AMOUNT OF OVERPAYMENT/REFUND: (If Line 44 is greater than Line 36D, enter differenCe) ...........ccecee 45e| 00 46. Amount to be applied to 2016 estimated ta: 460 00

w 47. Amount of Check-off Contributions: (Attach Schedule AR1000-CO)

x 48. AMOUNT TO BE REFUNDED TO YOU: (Subtract Lines 46 and 47 from Line 45)

& DIRECT DEPOSIT? If you want your refund direct deposited you must check this box @ Oana

3 complete Form ARDD and attach it to your return. (Direct deposit is not available for amended returns.)

z 49. AMOUNT DUE: (If Line 44 is less than Line 36D, enter difference; If over $1,000, continue to 50A)..... TAX DUE 49e|® 00]

© 150A. UEP: Attach Form AR2210 or AR2210A. If required, enter exception in box 50A@[_ Penalty 50Be| [00] 50C. Add Lines 49 and 50B. Attach Form AR1000V with 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.............. TOTAL DUE 50C @ 00) 51. Amount of income not subject to Arkansas tax from AR4, Part Ill: (Memorandum only) May the Arkansas Revenue Agency discuss this return with the preparer shown below? oO Yes Oo No

PLEASE SIGN HERE: Under penalties of perjury, | declare that | 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 Telephone: Spouse’s Signature Occupation Date Alternate Telephone: Paid Preparer’s Signature ID Number/Social Security Number

ra bd A [e

Zé Preparer’s Name City/State/Zip = Address Telephone Number

Page NR2 (R 5/19/15)

ARDD i

Mai) 2015

ARDD1

Primary Name Social Security Number

To comply with banking rules the question below must be answered: Will this refund go to an account outside the United States? eL]Yes eL|No If no, complete rest of form below. If yes, do not complete form. Direct deposits will not be

deposited into accounts outside the United States; this includes Puerto Rico, Guam and the Virgin Islands.

If you would like your refund direct deposited, complete the banking information below:

Type

of Account: *L] Checking or e[_] Savings

Routing Number e

Account Number®

Note: Direct deposit is not available for amended returns.

Refunds that are not direct deposited because of institutional refusal, erroneous account or routing transit numbers, closed accounts, bank mergers or any other reason are issued as paper checks. While the State of Arkansas ordinarily processes a request for direct deposit, it reserves the right to issue a paper check and does not guarantee a specific date for deposit of the refund into the taxpayer’s account. The State of Arkansas is not responsible for the misapplication of a direct deposit that results from error, negligence or malfeasance on the part of the taxpayer, the provider or preparer, financial institution or any of their agents.

Attach this form to the AR1000F/AR1000NR as the third page of your tax return. If you are filing Form AR1000S, attach it as the second page of your return.

ARDD (R 5/27/15)

AR3

ARKANSAS INDIVIDUAL INCOME TAX ITEMIZED DEDUCTION SCHEDULE

2015

Name

Social Security Number

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

1 00

2. Enter amount from Form AR1000F/AR1000NR, line 24(A) and 24(B): [oo] 3A. Multiply line 2 by 10% (.10) if you and your spouse were under 65 at the end of 2015; otherwise enter 0........3A 00 3B. Multiply line 2 by 7.5% (.075) if you or your spouse were 65 or over at the end of 2015; otherwise enter 0:....3B 00

4. TOTAL MEDICAL EXPENSES: (Subtract lines 3A and 3B from line 1; if more than line 1, enter 0) A> 00 TAXES: (See Instructions)

5. Real estate tax: 0... cece 00

6. Personal property tax or other taxes: (List type and amount) 6 00

7. TOTAL TAXES: (Add lines 5 and 6)... [oo INTEREST EXPENSES: (See /nstructions)

8. Home mortgage interest paid to financial institutions: 00

9. Home mortgage interest paid to an individual: Name:

Address: 9 00

10. Deductible points 00 11. Investment interest: (Attach federal Form 4952) “ 00 12. TOTAL INTEREST EXPENSE: (Add lines 8 through 11) ........2ccccccsccecscscseseseseccecseseseeeeeseseecseseseseeessesscststseeesssseseeeseeeeeeee 12> 00 CONTRIBUTIONS: (See /nstructions) 13. Cash contributions:............... 00 14. Art and literary contributions: 00 15. Other: 00 16. Carryover contributions: (List type and amount) 00 17. TOTAL CONTRIBUTIONS: (Add lines 13 throUgh 16) .....2..:.cccccccccscsesececsescsesesccecsssesseeecseseesstscseseeessescststesseessssseeeeseseneeee 17> | [oo

CASUALTY AND THEFT LOSSES: (See /nstructions) 18. TOTAL CASUALTY AND THEFT LOSSES: (Attach federal Form 4684)

POST-SECONDARY EDUCATION TUITION DEDUCTION(S): (See /nstructions) 19. TOTAL POST-SECONDARY EDUCATION TUITION DEDUCTION(S): [Attach AR1075(s)) ...

MISCELLANEOUS DEDUCTIONS SUBJECT TO 2% AGI LIMIT: (See Instructions)

21. Other expenses: (List type and amount)

20. Unreimbursed employee business expenses: (Attach federal FOr 2106)......:.:11ecceeeeereeee

22. Add the amounts on lines 20 and 21. Enter the total: .................

33. Multiply line 29 by the percentage on line 32. Enter here and on Form AR1000F/AR1000NR, line 25, Col. (A): 34. Subtract line 33 from line 29. Enter here and on Form AR1000F/AR1000NR, line 25, Column (B). If you and

23. Enter amount from Form AR1000F/AR1000NR, line 24(A) and 24(B):.... 23 | [oo]

24. Multiply line 23 above by 2% (.02):

25. 00

OTHER MISCELLANEOUS DEDUCTIONS: (See /nstructions)

26. Volunteer firefighter expense: 00

27. Other miscellaneous deductions: (List type and amount) 00

28. TOTAL MISCELLANEOUS DEDUCTIONS NOT SUBJECT TO THE 2% AGI LIMITATION: (Add lines 26 and 27) .......... 28> 00

TOTAL ITEMIZED DEDUCTIONS:

29. Add amounts on Lines 4, 7, 12, 17, 18,19, 25, and 28 and enter the total NEre?...........cecceccscscesceseseeecseeseesceecseeseesecseeseesensene > 00

Complete lines 30 - 34 ONLY if Filing Status 4 or 5. YOUR SPOUSE’S

Adjusted Gross Income Adjusted Gross Income}

30. Enter adjusted gross income from Form AR1000F/AR1000NR, line 24, Columns (A) and (B) [00] 308 00

31. Total Arkansas adjusted gross income: (Add columns 30A and 30B from above) 00

32. %

00

Page AR3 (R 4/22/15)

AR4

2015

ARKANSAS INDIVIDUAL/FIDUCIARY INCOME TAX INTEREST AND DIVIDEND INCOME SCHEDULE

Name

Social Security Number or FEIN

Part I TAXABLE INTEREST INCOME

Interest on bank deposits, notes, mortgages from individuals, corporation bonds, savings and loan deposits, and credit union deposits are taxable. Interest on obligations of other states and subdivisions are fully taxable.

List below the names of the interest sources and designate ownership by writing Y (Yours), S (Spouse’s) or J (Joint).

Part Il TAXABLE DIVIDEND INCOME

Dividends and other distributions on stock are fully taxable. There is no dividend exclusion applicable to Arkansas.

List below the names of the dividend sources and designate ownership by writing Y (Yours), S (Spouse’s) or J (Joint).

YSJ NAME OF PAYER AMOUNT YSJ NAME OF PAYER AMOUNT 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 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00

Add the amounts listed above and enter the total Add the amounts listed above and enter the total

here and on Line 10, Form AR1000F/AR1000NR or here and on Line 11, Form AR1000F/AR1000NR or

Line 1, Form AR1002F/AR1002NR. 00} Line 2, Form AR1002F/AR1002NR. 00

Part Ill INCOME NOT SUBJECT TO ARKANSAS TAX (See Instructions on pages 11 & 12)

Social Security 00 00

Railroad Retirement Benefits 00 00

Unemployment 00 00

Ministers Housing Allowance 00 00 00 00 00 00 00 00

TOTAL INCOME NOT SUBJECT TO ARKANSAS TAX: (Enter here and on Form AR1000F/AR1000NR, Line 51)............. 00

Page AR4 (R 4/22/15)

AR1000ADJ WA ee

tll 2015

ARKANSAS INDIVIDUAL INCOME TAX SCHEDULE OF ADJUSTMENTS

Name Social Security Number

INSTRUCTIONS

Full Year Resident Filers - Complete columns (A) and (8B), if using filing status 4 (married filing separately on the same return). All other filing statuses must complete column (A) only.

Part Year Resident Filers - Complete columns (A) and (B), if using filing status 4 (married filing separately on the same return). All other filing statuses must complete column (A) only. Enter only the amount of adjustments attributable to Arkansas in column (C).

Full Year Nonresident Filers - Complete columns (A) and (B), if using filing status 4 (married filing separately on the same return). All other filing statuses must complete column (A) only. If an amount is entered in column (C), attach explanation.

Enter the total of each column on Line 17 of this form and on Line 22 of AR1000F or AR1000NR.

See additional instructions on the reverse side of this form.

(A) Yourisoint | agiustments | - Adjustments Status 4 Only Only 14. Border city exemption: (Attach Form AR-TX)....ssssssssssssesssssesssseessssesssseesssssssesssieesssucessneees je Ooje ooje 00 2. Arkansas Tax Deferred Tuition Savings Program: (See Instructions)...........00ccccecseeeeees 2\¢ ooje Ooje 00 3. Payments to IRA: (See INSErUCTIONS) .........c.cesceseesesseseeteseeseeteseeneseeseseeeeseseeseneeneseeneeteneaneeeenes 3}e Ooje ooje 00 4. Payments to MSA: (See INStructions) ........:ssssssssssssessseessessseesseesseessecsneesuessseesnseseesstecsneeseeess 4je ooje ooje 00 5. Payments to HSA: (Attach federal FOr 8889)........sssssssssessesseseeteseeteeeeeeeeeeteneeeeeesneeeeneneeees 5j@ ooje ooje 00 6. Deduction for interest paid on student loans: (See Instructions) ele ooje ooje 00 7. Contributions to Intergenerational Trust: (See INStrUCTIONS) ..........ceecceeeeseseeteeteseetesteteeteeeenes 7\e ooje ooje 00 8. Moving expenses: (Attach federal FOr 3903) ......s.sssssssesessessesseteseeteeeeeseeseeeeteeesneeeeeneeees fo) hd ooje ooje 00 9. Self-employed health insurance deduction: (See /nstructions) . gje ooje ooje 00 10.KEOGH, Self-employed SEP and Simple Plans: ..........:eccscsesseessesesseeseeseeseeseeneeeesseeseenees 10|@ ooje ooje 00 11. Forfeited interest penalty for premature withdrawal: .........cesesseesseseecsesseeseeseesteceeeeeeseeseeneees 11/¢ ooje ooje 00 12. Alimony/Sep. Maint. paid to: Name: SSN: 12/¢ ooje ooje 00 13. Support for individuals with permanent disabilities: (Attach Form AR1000DC) .........:100 13]®@ ooje ooje 00 14. Organ Donor Deduction: (Attach Form AR1000OD) .......ssssssesseestestesseeseeseestestectecneeseeneeneees 14/¢ ooje ooje 00 15. Military Reserve Expenses? .........ecseecssssessessessessessecsessessecsessncsucenecuesuesnecuesseesseeneeneaneeneenens 15/¢ ooje ooje 00 16. Reforestation DeGUCTION: ...........escsceeessssesseseeesessesesssssseessesussessstecsesecsseussseesseeetsetieseseteets 16/¢ ooje ooje 00 17. TOTAL ADJUSTMENTS: (Enter here and on AR1000F/AR1000NR, Line 22)... 17\@ ooje ooje 00

NOTE: Do not enter amounts from categories that are not printed on this form. See instructions for additional information.

AR1000AD4J (R 4/23/15)

AR1000ADJ INSTRUCTIONS

LINE 1. To claim the Texarkana exemption, you must file a return and report all Arkansas income you received during the year. Attach AR-TX Form. (AR-TX Form is supplied by your employer.)

The AR-TX Form is not required for non wage income such as interest, dividends, Schedule C (sole proprietor), Schedule F (farm), Schedule E (rents, royalties, partnerships, etc.) or retire- ment. Additional information may be required for verification if an adjustment for these types of income is allowed.

NOTE: Taxpayers who claim this exemption must file using their street address in Texarkana, Arkansas or Texarkana, Texas. If you use a Post Office Box, this exemption will not be allowed.

If you lived within the city limits of Texarkana, Arkansas, you are allowed a full exemption from Arkansas income tax. Part year Texarkana residents claim the exemption only on income earned while a resident of Texarkana, Arkansas.

If you lived in the city limits of Texarkana, Texas, you may deduct the income you earned in the city limits of Texarkana, Arkansas. All other Arkansas income is taxable to you.

LINE 2. If you made contributions to a tuition savings account established under the Arkansas Tax Deferred Tuition Savings Program enter the amount here. Contributions to plans es- tablished in states other than Arkansas are not deductible. The deductible contribution cannot exceed $5,000 per taxpayer per tax year. Quali- fied withdrawals from a tuition savings account established under the Arkansas Tax Deferred Tuition Savings Program or a tax-deferred tuition savings program established by another state will be exempt from Arkansas income tax with respect to the designated beneficiary's income.

LINE 3. This line is used to report your allow- able contribution to an Individual Retirement Ac- count (IRA). If you contributed to your own IRA, certain limitations may apply to the amount you may use as an adjustment to income. If neither you nor your spouse was covered by an employer provided retirement plan, the entire contribution is deductible up to $5,500 each for all filing statuses. If either you or your spouse was covered by such a plan, the amount of the deduction depends on the amount of your Adjusted Gross Income (AGI) before the IRA deduction, as shown in the table on page 20 of the booklet. Use this table along with your Arkansas AGI to determine your allowable deduction. Catch up Contributions - Individuals who turned 50 before the close of the tax year may increase the maximum permitted annual contribution by up to $1,000.

AR1000AD4J (R 10/21/15)

INSTRBP

LINE 4. This line is used to report your allowable contribution to an Archer Medical Savings account (MSA). An MSAis a trust or custodial account that is created or organized exclusively for the purpose of paying the qualified medical expenses of the tax- payer (account holder) and the taxpayer's spouse and/or dependents. To be eligible, a taxpayer must have had insurance coverage under a high deductible health plan (HDHP) only. A HDHP will have the following deductions and limitations: (1) for self-only coverage, the minimum deductible is $2,200, maximum deductible is $3,300 and the maximum out of pocket expense is $4,450, and (2) for family coverage, the minimum deductible is $4,450, maximum deductible is $6,650 and the maximum out of pocket expense is $8,150. The contribution limitation for any month is the amount equal to 1/12 of 65% of the annual deductible for an individual with self-only coverage and 1/12 of 75% of the annual deductible for family coverage. New Archer MSAs may not be established after 2007 but contributions can be made to existing accounts.

LINE 5. This line is used to report your allowable contribution to a Health Savings Account (HSA). To be eligible, a taxpayer must have had insurance coverage under a HDHP only. AHDHP will have the following deductions and limitations: (1) for self-only coverage, the minimum deductible is $1,300 and the maximum out of pocket expense is $6,450, and (2) for family coverage, the minimum deductible is $2,600 and the maximum out of pocket expense is $12,900. You can make pre-tax contributions of up to $3,350 each year ($6,650 for families) to cover health care costs. Individuals who reached age 55 by the end of the tax year can increase their annual contri- bution by $1,000 for 2015. Maximum contributions allowed to an HSAare reduced by any contributions made to anArcher MSA. Attach federal Form 8889.

LINE 6. You may take an adjustment for inter- est paid on student loans if all of the following

apply:

1.You paid interest in 2015 on a qualified stu- dent loan.

2.Your filing status is any status other than married filing separately on different returns (Status 5). 3.Your AGI is less than: $80,000 if filing Status 1, 3, or 6; $160,000 if filing Status 2 or 4. Status 4 filers, note that this is a combined income amount. 4.You are not claimed as a dependent on another taxpayer’s 2015 tax return.

Figure your allowable deduction using the work- sheet on page 20 of the booklet. Do not enter more than $2,500 on AR1000ADu.

LINE 7. You may take an adjustment for con- tributions made to a long-term intergenerational trust. This is a trust established for an individual under age 18 to provide funds for the minor’s retirement. The trustee must be a resident of Arkansas and cannot distribute any of the trust funds to the beneficiary until the beneficiary reaches age 55. Contributions are limited to $4,000 per year.

LINE 8. Employees and self-employed persons can deduct certain moving expenses incurred in 2015.

You can take this deduction if you moved for your job or business and added at least fifty 50 miles to the distance from your old home to your workplace. If you had no former workplace, your new workplace must be at least 50 miles from your old home. (Attach a completed copy of federal Form 3903.)

If you were reimbursed for any moving expenses and the amount was included on your W-2, re- port this amount as income on Form AR1000F/ AR1O000NR, Line 8.

LINE 9. If you were self-employed and had a net profit for 2015, you may be able to deduct part of the amount paid for health insurance for yourself, your spouse, and/or dependents. Com- plete the worksheet on page 21 of the booklet to determine your deduction.

LINE 10. If you were self-employed and con- tributed to a “Keogh”, H.R. 10 retirement plan, or a SIMPLE plan, enter the total contributions. The amount of the deduction depends upon the type of plan.

LINE 11. Enter the total penalties paid for early withdrawal of certificates of deposit.

LINE 12. If you paid alimony or separate maintenance as the result of a court order, enter the total amount. Enter the name and Social Security Number of the person you paid.

LINE 13. If you have an individual with disabili- ties who qualifies for the deduction you can take an adjustment from income of $500 for each indi- vidual with disabilities. Attach Form AR1000DC.

LINE 14. If you paid unreimbursed expenses for yourself or one of your dependents related to the donation of an organ (part of a liver, pancreas, kidney, intestine, lung or bone marrow) you may take a tax deduction up to $10,000. The deduction must be claimed for the year in which the trans- plantation occurs. Allowable expenses include travel, lodging, medical expenses and lost wages related to the organ donation. An individual may claim the deduction only once in his or her lifetime. The deduction does not apply to organs harvested from a deceased donor. Attach Form AR1000-OD.

LINE 15. Ifyou have military reserve expenses, enter the total amount.

LINE 16. Ifyou have reforestation deductions, enter the total amount.

LINE 17. Total Adjustments. Add Lines 1 through 16 and enter on this line and on Forms AR1000F or AR1000NR, Line 22.

AR1000D |

env ITD151

2015

ARKANSAS INDIVIDUAL INCOME TAX

CAPITAL GA

INS SCHEDULE

Name

Social Security Number

For net capital gains realized from:

Jan 1, 2015 - Jan 31, 2015.. Feb 1, 2015 - Dec 31, 2015.

. 50% is tax exempt . 45% is tax exempt

Net capital gains in excess of ten million dollars ($10,000,000) per taxpayer from a gain realized after January 1, 2014, is tax exempt.

Complete this schedule if you have a CAPITAL GAIN OR LOSS reported on federal Schedule D, or if Schedule D is not required, a gain reported on federal Form 1040, Line 13. The amount of capital loss that can be deducted after offsetting capital gains is limited to $3,000 ($1,500 per taxpayer for filing Status 4 or 5). See instructions for Line 14, Form AR1000F/AR1000NR.

Arkansas did not adopt the federal “bonus depreciation” provision from previous years. Therefore, there may be a difference in federal and Ar- kansas amounts of depreciation allowed. Adjust your gains and losses for

depreciation differences, if any, in the federal and Arkansas amounts using Lines 2, 5 and 10.

(A) (B) : spouse Per federal Sch D You/Joint (If Filing Status 4) 1. Enter federal long-term capital gain or loss reported on Line 15, federal Schedule D or Form 1040, Line 13 ........cceceesessessesessesesseeees 1 00 00 00} Enter adjustment, if any, for depreciation differences in federal and state amounts. 2 00 00 Arkansas long-term capital gain or loss, add (or subtract) Line 1 and Line 2.. e 00 e 00} Enter federal net short-term capital loss, if any, reported on Line 7, federal Schedule Do... eects ceeeeeneeee 00 00; 00 5. Enter adjustment, if any, for depreciation differences in federal and state AMOUNIS...........c cece eeeeeeeee teste eeeee ee 00) 00 6. Arkansas net short-term capital loss, add (or subtract) Line 4 and Line 5... 00 00 7a. Arkansas net capital gain or loss (combine lines 3 and 6).........cccceeeseeeeeteeeee A [© 00 00 If Line 7a (Column B or C) is more than $10,000,000, you MUST use the WORKSHEET. If Line 7a is a loss skip to line 8. If Line 7a is a gain, answer questions A and B. Question A: Were there any transactions in the month January 2015? wees | OYes ONo OYes ONo If NO then enter zero (0) on line 7b; if YES continue to Question B. Question B: Did the transactions in January 2015 result in a net gain?....eessseecccccessseeeeeee | OYes ONo OYes ONo If NO then enter zero (0) on line 7b; if YES then enter the January net long-term capital gain on line 7b. 7b. Net long-term capital gain --- January 2015 transactions Only...........0cceeeeeeeeeee 7D 00 00} 7c. Enter the SMALLER of Line 78 OF 7D...ssssssssssssssssssssssssstessstnsssisstiissstnssstnssteestssnTC 00 00 7d. Subtract Line 7c from Line 7a. 00) 00 7e. Multiply Line 7c by 50 percent (.50) 00 00 7f. Multiply Line 7d by 55 percent (.55) ....7f 00) 00 8. Arkansas taxable amount (add Lines 7e and 7f, or if Line 7a is a loss enter the loss) If the WORKSHEET was used, then Line 9........ssssssssseeeeesccssesssssnpumeniiseesseeessssssnnes 8 00) 00 9. Enter federal short-term capital gain, if any, reported on Line 7, federal Schedule D............c cece cece 00) 00 00 10. Enter adjustment, if any, for depreciation differences in federal and state AMOUNTS. ...........::ceeeee eee |. 00 00 11. Arkansas short-term capital gain, add (or subtract) Line 9 and Line 10..........cc cece 11/¢@ 00 e 00 12. Total taxable Arkansas capital gain or loss, add Lines 8 and 11. (Loss limited to $3,000, for filing status 1, 2, 3 and 6, $1,500 per taxpayer if filing status 4 or 5.) Enter here and on Line 14, AR1/NA1............0::00.12 00) 00}

AR1000D (R 11/10/15)

WORKSHEET CAPITAL GAINS/LOSSES

Use this worksheet only if your total Arkansas capital gains are over $10,000,000. If filing status 2 AND both spouses have a gain, you MUST allocate the income earned by each spouse if applicable.

Taxpayer (A)|} Spouse (B)

1. Enter the total from Line 7a, Form AR1000D If filing status 2 allocate between spouses if both have a gain. If filing status 4 and the amount on Line 1 is a loss enter that amount ON LING Qo. eeesessssssessesecesssteeeseeecsnsneeeeeecesssseeeseeeesnsaseeeeecensniseseeeessnuueeeseeeenuuaeeseeeeesnieeeeeeetete 1

2. Enter the net capital gain or loss from January 1, 2015 to Saamliary 31, 2015. ceeecsssssesescessssssteeeeeeeesssnseeeeeeecsnseeeeeeeesnneeeeeeeeenueeeeeeeeeaaen 2

3. Enter the net capital gain or loss from February 1, 2015 to

4. Divide Line 2 by Line 1 and round to six decimal places. If more than 1, enter 1. If less than 0, ENter O......ccssssssscsssseccsssseessssssecssnseeceesnseesed 4

5. Divide Line 3 by Line 1 and round to six decimal places. If more than 1, enter 1. If less than 0, Enter O.......ccssssssscsssssccssnseessssssesssnseessesnseesen 5

Multiply Line 4 by 50 percent (.50) and round to six decimal places............. 6

Multiply Line 5 by 55 percent (.55) and round to six decimal placez.......... 7

Ad Lin@S 6 AN 7.....ccssssssscsssssessssseesssssneessssnsesssssscesssssessssnseessssueeessnueeeessnsecessnsceessaneeeed 8

eo @ NN ©

Ifthe amount on Line 1 is MORE than $10,000,000, muttply

Line 8 by $10,000,000 and enter on Line 8, Form AR1000D.

Ifthe amount on Line 1 is LESS than $10,000,000, multiply

Line 8 by Line 1 and enter on Line 8, Form AR1000D

If fling status 2 add columns A and B Line 9 together, and enter on Line 8, FOr AR1OOOD ..eeesssssssssesssssssesesssssnssceseeesesesssceseeststnnunsceeseeeenessereeseeetssnenssseeseetes 9

AR1000D Worksheet (R 11/02/15)

AR1000TC

Wee ITTC151

ARKANSAS INDIVIDUAL INCOME TAX SCHEDULE OF TAX CREDITS

2015

Primary Taxpayer Name/ Trust (Fiduciary)

Primary Social Security Number/ FEIN (Fiduciary)

IMPORTANT: SEE INSTRUCTIONS ON REVERSE SIDE OF THIS FORM

1. State Political Contribution Credit: (See instructions)... e 00 2. Other State Tax Credit: [Attach copy of other state tax return(S)]....-2..000 2 @ 00 3. Credit for Adoption Expenses: (Attach federal Form 8839). e 00 4. Phenylketonuria Disorder Credit: (See instructions. Attach AR1113) 00 5. Business Incentive Tax Credit(s): (Add amounts from 5A-5F below) e 00 A copy of the tax credit certificate(s) or appropriate documentation of the credit(s) claimed must be attached. If certificate is issued to an individual, leave FEIN box below blank. Primary: 5A. BIC Code |e FEIN Je Amount je 00 5B. BIC Code |e FEIN Je Amount je 00 5C. BICCode |e FEIN |e Amount |e 00 Spouse: 5D. BIC Code |e FEIN |e Amount |e 00 5E. BIC Code |e FEIN |e Amount je 00 5F. BIC Code |e FEIN Je Amount Je 00 6. TOTAL CREDITS: Add Lines 1 through 5. Enter total on Line 34, Form AR1000F/AR1000NR, or Line 23, Form AR1002/AR1002NR............ 6e@ 00

BUSINESS INCENTIVE CREDIT TYPES

Code Credit Type

0001....Advantage Arkansas 0002....Affordable Housing

0003....AR Plus

0004....AR Plus 50% Technology-Based 0005....AR Plus 75% Technology-Based 0006....AR Plus 100% Technology-Based 0008....Capital Development Company 0009....Child Care Facility

0010....Coal Mining Producing and Extracting 0011....Delta Geotourism 0013....Enterprise Zone 0014....Equipment Donation/Sale 0015....Equity Investment Incentive 0016....Existing Workforce Training

0017...

‘amily Savings Initiative Act

0018....Historic Rehabilitation

0019....Low Income Housing

0020....Public Roads Incentive

0021....Research Park Authority

0022....Research and Development with Universities 0023....In-House Research Income Tax Credit

Code Credit Type

0024....In-House Research by Targeted Business Income Tax Credit 0025....In-House Research Area of Strategic Value Income Tax Credit 0026....Qualified Research

Rice Straw

0028....Tourism Development

0029.... Tuition Reimbursement Program 0030.... Targeted Business Payroll 0031....Venture Capital Investment

Youth Apprenticeship

0033.... Youth Apprenticeship Work Base Learning 0034....Waste Reduction, Reuse or Recycle Equipment 0035....Water Impounded Outside Critical 0036....Water Impounded Within Critical

Water Surface Outside Critical

0038....Water Surface Inside Critical

0039....Water Surface Inside Critical-Industrial or Commercial 0040....Water Land Leveling

0041....Wetland Riparian Zone Creation/Restoration

Wetland Riparian Zone Conservation

Central Business Improvement District Rehab and Dev Biodiesel Incentive

...Recycle Equipment for Steel Manufacturer

AR1000TC (R 5/27/15)

LINE 1.

LINE 2.

LINE 3.

LINE 4.

LINE 5.

LINE 6.

INSTRBP

INSTRUCTIONS FOR AR1000TC

Acredit of up to $50.00 per taxpayer ($100.00 for a joint return) is allowed against your Arkansas individual income tax liability for cash contributions made by the taxpayer(s) to one of the following:

(1) Acandidate seeking nomination or election to a public office or to the candidate’s campaign committee. (2) An approved political action committee as defined by Arkansas Code Annotated § 7-6-201. (3) An organized political party as defined in Arkansas Code Annotated § 7-1-101.

For the purposes of this credit, “public office” means any office created by or under the authority of the laws of the State of Arkansas, or a subdivision thereof, that is filled by the voters. The credit does not apply to contributions made to candidates for federal offices. The contribution must be made by April 15, 2016 to be claimed on the 2015 tax return.

Enter the amount of allowable State Political Contributions Credit(s) on this line. The allowable credit(s) cannot exceed $50 for Filing Status 1, 3, 5 or 6 or $100 total for Filing Status 2 or 4.

If you are an Arkansas resident and included income on your Arkansas Return that was also taxed by another state, you may claim a credit for the income tax portion of taxes paid to the other state on that income.

The income tax withheld from your wages by another state is NOT the amount of tax you owed the other state. For that reason, YOU MUST ATTACH TO YOUR ARKANSAS RETURN A SIGNED COPY OF THE TAX RETURN(S) YOU FILED WITH THE OTHER STATE(S). Enter the amount of net income tax liability to the other state(s).

NOTE: This credit cannot exceed the Arkansas income tax on the same income and cannot exceed the total tax you owe Arkansas.

Nonresidents cannot claim this credit on their Arkansas return. Part year residents will not be allowed this credit unless they continued to have taxable income from another state and the other state income is included as taxable income in Column C of Form AR1000NR.

A tax credit is allowed for a resident shareholder’s pro rata share of any net income tax paid by a Sub S Corpora- tion to a state that does not recognize Sub S Corporation status.

The State of Mississippi enacted a special tax that applies exclusively to gambling winnings. This tax is separate and distinct from Mississippi’s income tax. As such, an Arkansas taxpayer cannot claim a credit against his/her Arkansas income tax liability for payment of the gambling winnings tax to the State of Mississippi.

The Adoption Expense Credit allowed is twenty percent (20%) of the amount allowed on your federal return. A copy of federal Form 8839 must be attached to your Arkansas return.

Enter the allowable Phenylketonuria Disorder Credit. Attach Form AR1113.

Enter the total allowable credit(s) claimed. Enter the BIC Code(s) and amount(s) on Lines 5A to 5F. If the primary and/or spouse are claiming credits earned by a pass-through entity, then the FEIN of that entity must also be entered. Enter the total amounts from Lines 5A to 5F in box 5. A copy of the tax credit certificate(s) or appropriate documentation relevant to the tax credit(s) claimed must be attached to AR1000TC.

NOTE: Recent legislation may have amended, increased, or extended some of the provisions for Business In- centive Credits. Use of any credit is subject to the limitations and carryover provisions provided by the respective Arkansas statute. A summary of the Business Incentive Credit Programs can be found at www.dfa.arkansas.gov. If you have questions, please contact the Tax Credits/Special Refunds Section at (501) 682-7106.

Enter total on Line 34, Form AR1000F/AR1000NR, or Line 23, Form AR1002/AR1002NR.

AR1000TC (R 5/27/15)

AR1000-CO tl

| ua) ITCO151

ARKANSAS INDIVIDUAL INCOME TAX SCHEDULE OF CHECK-OFF CONTRIBUTIONS

2015

NAME SSN

SPOUSE’S NAME SSN

ADDRESS

CITY STATE ZIP

SEE INSTRUCTIONS ON REVERSE SIDE OF THIS FORM

1. ARKANSAS DISASTER RELIEF PROGRAM. .......cssssssssssssesssssssssssseesssseeesstesesststecssnseesnneeeestes o |S [ ]$1 [ ]$5 [ ]$10f $20 [ J_____ [ ] Your Total Refun

2. ARKANSAS GAME AND FISH FOUNDATION e |$ [ ]$1 [ ]$5 [ ]$10 [ Jo [ ] Your Total Refund

3. ARKANSAS SCHOOL FOR THE BLIND/SCHOOL FOR THE DEAF ....ssseecsstsessstesseeteeseoee e |$ [ ]$1 [ ] $5 [ ] $10 [ ] —— [ ] Your Total Refund

4. BABY SHARON’S CHILDREN’S CATASTROPHIC ILLNESS PROGRAM........:.c:ssseeese e |$ [ ]$1 [ ]$5 [ ]$10f[ ]$20 [ ]_____ [ ] Your Total Refun:

5. ORGAN DONOR AWARENESS EDUCATION PROGRAM ........:ssssssssssseessessessesstesessneesesseess e |$ [ ]$1 [ ]$5 [ ]$10 [ }__ [ ] Your Total Refun

6. AREA AGENCIES ON AGING PROGRAM...........- — secesasssecsssseesstsecsstsesstecesssieteseeeessees e |$ [ ]$1 [ ]$5 [ ]$10 [ )__ [ ] Your Total Refun

7. MILITARY FAMILY RELIEF PROGRAM .......:cssssssssssssssssseessssesecsssecessuscesstnsesssneeesnnsseesteeeessnsses e |$ [ ]$1 [ ]$5 [ ]$10f[ ]$20 [ J_____ [ ] Your Total Refund

8. NEWBORN UMBILICAL CORD BLOOD INITIATIVE... seseesusseesssseesssscesssiseessiceessveseeaneeeeseee e |S [ ]$1 [ ]$5 [ ]$10[ ]$20 [ }___ [ ] Your Total Refun

9. ARKANSAS TAX DEFERRED TUITION SAVINGS PROGRAM

IMPORTANT: To contribute to your Arkansas Tax Deferred Tuition Savings Program, you MUST enter the account number below. You may contribute part or all of your refund to one or two accounts, provided a minimum of $25 is

contributed to each account. (You cannot send a check for this check-off.)

CHOOSE ACCOUNT TYPE: = [_]GIFT — [J iShares... ceeeeeesccseeseeeeeeeeceseessnnneees ° [ $25 [ ]$50 [ ]$100 [ J [ ] Your Total Refun Account Number. CHOOSE ACCOUNT TYPE: = [GIFT — [J iShares. n.cscsseseessssssssssssseeneseeeeeseneennnnens ° [ $25 [ ]$50 [ ]$100 [ J____ [ ] Your Total Refun

Account Number 10. TOTAL CHECK-OFF CONTRIBUTIONS 00... cecceceeceeeeeeeseeseeeeeeeeeeeecaeeeceeeecaecaeeaeeesesaeeeseeeeteatenes

AR1000-CO (R 6/15/15)

INSTRBP

INSTRUCTIONS FOR AR1000-CO

GENERAL INSTRUCTIONS:

Check the appropriate box and enter the designated amount for each check-off contribution in the box provided. Total your contributions and enter the amount in Box 10. Contributions are limited to whole dollar amounts only.

FOR TAXPAYERS WHO ARE DUE A REFUND:

Attach this schedule to any return claiming a check-off contribution. Enter the amount in Box 10 on Line 47 of Form AR1000F/AR1000NR or Line 27 of Form AR1000S. The total amount you contribute will reduce your refund by a corresponding amount.

If this schedule is not attached to your return or if the amount in Box 10 is not entered on your return, your contribution will not be recognized and the amount will be refunded to you.

FOR TAXPAYERS WHO OWE ADDITIONAL TAXES:

Detach this schedule and submit a separate check for the total amount of your check-off contributions. (You can send a check for check-off contributions #1 through #8. You cannot send a check for check-off contribution #9.) Mail to: Arkansas Individual Income Tax, P.O. Box 3628, Little Rock, AR 72203.

FOR INFORMATION ABOUT PROGRAMS/ORGANIZATIONS ON AR1000-CO GO TO:

1. Arkansas Disaster Relief Program: www.adem.arkansas.gov

2. Arkansas Game and Fish Foundation: www.agff.org

3. Arkansas School for the Blind: www.arkansasschoolfortheblind.org

Arkansas School for the Deaf: www.arschoolforthedeaf.org

4. Baby Sharon’s Children’s Catastrophic Illness Program: www.babysharonfund.arkansas.gov

5. Organ Donor Awareness Education Program: www.arora.org

6. Area Agencies on Aging Program: www.daas.ar.gov/aaamap.html

7. Military Family Relief Program: www.arguard.org/Family/docs/MFRTF.pdf

8. Newborn Umbilical Cord Blood Initiative: www.cordbloodbankarkansas.org/

9. Arkansas Tax Deferred Tuition Savings Program: www.arkansas529.org

AR1000-CO Instr. (R 6/12/15)

State of Arkansas Department of Finance and Administration Sales and Use Tax Section

CONSUMER USE TAX FORM

If you purchased taxable merchandise outside the State of Arkansas for use, storage, consumption or distribution within the state, a state and local consumer use tax may be due on the purchase price, including transportation charges. Due to the rapid increase in purchases being made through mail order, telephone, and the Internet, it has become a concern that individuals may not be aware of their obligation to report the consumer use tax on untaxed out of state purchases. Examples of merchandise subject to the consumer use tax include cas- settes, CD’s, books, furniture, jewelry, food, and clothing.

The use tax is a companion tax to the sales tax whose purpose is to not only raise revenue for the state, but more importantly to protect local merchants, who must collect sales tax, from the unfair advantage of out of state sellers who do not collect Arkansas’s sales tax. The use tax has been in effect since 1949.

The use tax rate is the same as the sales tax rate, 6.50% for all transactions except food purchases which has a reduced rate of 1.5% plus the applicable city and/or county rates where the merchandise is delivered in the state. The tax applies to the purchase price of the merchandise plus any shipping and handling charges that the merchant adds to your bill. If the total tax due is greater than $100 per month, the use tax report should be filed on a monthly basis. If the total tax due is $25 - $100 per month, the use tax report should be filed on a quarterly basis. If the total tax due is less than $25 per month, the use tax report should be filed on an annual basis.

Line 1 Indicate the month and year you are reporting. (mm/yyyy) Report all taxable purchases except food in Column A, food purchases are reported in Column B. Line 3 Fill in the County Rate where you reside (Column A and/or Column B) Line 4 Fill in the City rate where you reside. (Column A and/or Column B) Line 5 Enter total rate - the sum of lines 2 through 4. (Column A and/or Column B) Line 6 Enter total purchases (column A is for all items except food) (column B is for Food only) Line 7 Enter your total tax rate from line 5 Line 8 Multiply line 7 by line 6 and enter the product. Line 9 Add lines 8A and 8B and enter the total. (This is the TOTAL tax to remit with this report.)

If you have questions or need additional forms, please call the Sales and Use Tax Office at (501) 682-7104.

Individual Consumer Use Tax Report | 1 Report Period >

A B Arkansas Department of Finance and Administration General State Reduced Food Sales and Use Tax Section Tax Tax P. O. Box 8054, Little Rock, AR 72203 2. State Rate 6.500% 1.500% 3. County Rate + Purchaser(s): 4. City Rate + Social Security Number: 5. Total Tax Rate = Home Address: 6. Purchases $ 7. Total Tax Rate 8. Total Tax $ City/State/Zip:

Phone Number: 9. TOTAL Tax Due s—.

County of Residence:

Check here if this is an aviation purchase > [] (Attach a copy of the bill of sale)

If you live outside the city limits check here > ” Y LI City and county rate may be obtained from our website.

If you live in a city other than what is shown in your mailing | http:/Avww.state.ar.us/salestax address above, please indicate that city here and use that tax | °F by calling (501) 682-7104 rate to compute your tax

CU-1 (R 07/2013)

Individual Consumer Use Tax Report | 1 Report Period >

A B Arkansas Department of Finance and Administration General State Reduced Food Sales and Use Tax Section Tax Tax P. O. Box 8054, Little Rock, AR 72203 2. State Rate 6.500% 1.500% 3. County Rate + Purchaser(s): 4. City Rate + Social Security Number: 5. Total Tax Rate = Home Address: Purchases $ 7. Total Tax Rate - - 8. Total Tax $ City/State/Zip:

Phone Number: 9. TOTAL Tax Due |

County of Residence:

Check here if this is an aviation purchase > [ ] (Attach a copy of the bill of sale)

If you live outside the city limits check here > y y LI City and county rate may be obtained from our website.

If you live in a city other than what is shown in your mailing | http-//www.state.ar.us/salestax address above, please indicate that city here and use that tax | °F by calling (501) 682-7104 rate to compute your tax

State of Arkansas Department of Finance and Administration Sales and Use Tax Section

CONSUMER USE TAX FORM

If you purchased taxable merchandise outside the State of Arkansas for use, storage, consumption or distribution within the state, a state and local consumer use tax may be due on the purchase price, including transportation charges. Due to the rapid increase in purchases being made through mail order, telephone, and the Internet, it has become a concern that individuals may not be aware of their obligation to report the consumer use tax on untaxed out of state purchases. Examples of merchandise subject to the consumer use tax include cas- settes, CD’s, books, furniture, jewelry, food, and clothing.

The use tax is a companion tax to the sales tax whose purpose is to not only raise revenue for the state, but more importantly to protect local merchants, who must collect sales tax, from the unfair advantage of out of state sellers who do not collect Arkansas’s sales tax. The use tax has been in effect since 1949.

The use tax rate is the same as the sales tax rate, 6.50% for all transactions except food purchases which has a reduced rate of 1.5% plus the applicable city and/or county rates where the merchandise is delivered in the state. The tax applies to the purchase price of the merchandise plus any shipping and handling charges that the merchant adds to your bill. If the total tax due is greater than $100 per month, the use tax report should be filed on a monthly basis. If the total tax due is $25 - $100 per month, the use tax report should be filed on a quarterly basis. If the total tax due is less than $25 per month, the use tax report should be filed on an annual basis.

Line 1 Indicate the month and year you are reporting. (mm/yyyy) Report all taxable purchases except food in Column A, food purchases are reported in Column B. Line 3 Fill in the County Rate where you reside (Column A and/or Column B) Line 4 Fill in the City rate where you reside. (Column A and/or Column B) Line 5 Enter total rate - the sum of lines 2 through 4. (Column A and/or Column B) Line 6 Enter total purchases (column A is for all items except food) (column B is for Food only) Line 7 Enter your total tax rate from line 5 Line 8 Multiply line 7 by line 6 and enter the product. Line 9 Add lines 8A and 8B and enter the total. (This is the TOTAL tax to remit with this report.)

If you have questions or need additional forms, please call the Sales and Use Tax Office at (501) 682-7104. CU-2 (R 07/2013)

PLEASE PRINT AND USE BLACK INK TO COMPLETE Rev. 7/12

ARKANSAS VOTER REGISTRATION APPLICATION

Check all that appl: Office Use Only

This is a new registration.

This is a name change. This is an address change.

This is a party change. [assigned ed

Mr. Last Name Jr. Sr. | First Name Middle Name 4 Mrs.

Miss

Ms. I ML IV.

Address Where You Live (See Section “C” Below) Apt. or Lot #| City/Town County State | Zip Code 2 (Rural addresses must draw map.)

Address Where You Receive Mail If Different From Above Apt. or Lot #| City/Town County State | Zip Code 3

Home & Work Phone Numbers (Optional Party Affiliation (Optional Q | Date of Birth | | 5 lam we 6/ (Optional) Month Day Year

7 E-mail Address (Optional) 8 | Have you ever voted in a federal election in this State? O Yes O No

ID Number - Check the applicable box and provide the appropriate number. Signature of elector - Please sign full name or put mark.

00 Arkansas Driver's license number

9 0 If you do not have a driver’s license provide the last 4 digits of social security number

01 [have neither a driver's license nor social security number.

(A) Are you a citizen of the United States of America and an Arkansas resident?

Yes No

(B) o you be ON (18) years of age or older on or before election day? The information | have provided is true to the best of my knowledge. | do not claim the right to O ves ONo : vote in another county or state. If | have provided false information, | may be subject to a fine

(C) Are you presently adjudged mentally incompetent by a court of competent of up to $10,000 and/or imprisonment of up to 10 years under state and federal laws. jurisdiction?

10 O Yes DINo Date: | |

(D) Have you ever been convicted of a felony without your sentence having been Month Day Year

ov acon” 1 1 If applicant is unable to sign his/her name, provide name, address es jo and phone number of the person providing assistance: If you checked No in response to either questions A or B, do not complete this form. Name: Address: If you checked Yes in response to either questions C or D, do not complete this form. City: State: Phone#:

Please complete the sections below if: | MAIL REGISTRANTS: PLEASE SEE SECTION D. « You were previously registered in another county or state, or Agency Code (For Official Use Only) * You wish to change the name or address on your current registration.

Mr. Previous Last Name Jr. Sr. | First Name Middle Name(s)

Mrs. A Miss

Ms. He WL IV. Date of Birth / /

Month Day Year Previous House Number and Street Name Apt. or Lot # | City or Town State Zip Code

B

If you live in a rural area but do not have a house or street number, or if you have no address, please show on the map where you live.

+ Write in the names of the crossroads (or streets) nearest where you live. IDENTIFICATION REQUIREMENTS

+ Draw an “X” to show where you live.

Cc + Use a dot to show any schools, churches, stores or other landmarks near where you live and write the name of the landmark. IMPORTANT: If your voter registration application form is

submitted by mail and you are registering for the first time,

and you do not have a valid Arkansas driver’s license wort f D number or social security number, in order to avoid the additional identification requirements upon voting for the

Example

* Grocery Store Woodchuck Road

first time you must submit with the mailed registration form: (a) a current and valid photo identification; or (b) a copy| of a current utility bill, bank statement, government check,

Route #2

* Public School

paycheck, or other government document that shows your} xX name and address.

Deadline Information

To qualify to vote in the next election, you must apply to register to vote 30 days before the election. If you mail this form, it must be postmarked by that date. You may also present it to a voter registration agency representative by that date. If you miss the deadline you will not be registered in time to vote in that election. Please don’t delay. Make sure your vote counts.

If you are qualified and the information on your form is complete, you will be notified of your voting precinct by your local

County Clerk. Mail the completed form to:

Arkansas Secretary of State ATTN: Voter Registration P. O. Box 8111 Little Rock, 72203-8111

Questions? Call your local County Clerk or Arkansas Secretary of State Mark Martin Elections Division - Voter Services 1-800-482-1127

Contact your County Clerk if you have not received confirmation of this application within two weeks

LINE 43. PREVIOUS REFUND: This line is for amended returns only. Enter the total of any previous refund(s) from your original return and amended return(s).

LINE 44, Subtract Line 43 from Line 42. This is your ADJUSTED TOTAL PAYMENTS.

REFUND OR TAX DUE

LINE 45. If Line 44 is more than Line 36 on Form AR1000F or Line 36D on Form AR1000NR, you overpaid your tax. Write the difference here. If you want a refund only, skip Lines 46 and 47 and enter the amount of your refund on Line 48.

LINE 46. You can apply part or all of the tax you OVERPAID in 2015 to your tax in 2016. Enter the amount you would like to have carried forward. The overpayment will be applied directly to your 2016 estimated account. If you wish to apply only part of Line 45 to pay 2016 tax, you will be issued a refund for the balance of your overpayment.

NOTE: The amount you carry over to pay 2016 taxes will only be credited to the primary filer. /t cannot be divided between the primary filer and spouse.

LINE 47. [If you wish to contribute a portion or all of your overpayment to one or more of the pro- grams listed below, complete Schedule AR1000- CO and enter total amount of your donation. Attach Schedule AR1000-CO after Form AR1000F/AR1000NR.

Area Agencies on Aging Program

Arkansas Disaster Relief Program

Arkansas Game and Fish Foundation

Arkansas Schools for the Blind and Deaf Arkansas Tax Deferred Tuition Savings Program Baby Sharon's Children’s Catastrophic Illness Program Military Family Relief Program

Newborn Umbilical Cord Blood Initiative

Organ Donor Awareness Education Program

LINE 48. Subtract Lines 46 and 47 from Line 45. This is the amount of your REFUND.

Get your refund faster with direct de- posit. For direct deposit to your checking or savings account, check the box on line 48, then fill out Form ARDD and attach it as the third page of your return. Check your form carefully, since any error could prevent your bank from accepting your direct deposit. (If your refund cannot be direct deposited for any reason, you will receive a paper check.) See Form ARDD for additional information. Direct deposit is not available for amended returns.

The Director is allowed 90 days from the return due date or the date the return was filed, whichever occurs later, to refund an overpayment of tax without interest (Act 262 of 2005).

SET OFF REFUNDS

If you, your spouse, or former spouse owes a debt to one of the agencies below, all or part of your refund is subject to being withheld to satisfy the debt. You will receive a letter advising which agency has claimed your refund.

Any housing authority

Arkansas circuit, county, district, or city courts AR colleges, universities, and technical institutes Arkansas Highway and Transportation Dept. Arkansas Public Defender Commission Arkansas Real Estate Commission

County tax collectors or treasurers Department of Finance and Administration Department of Health

Department of Higher Education

Department of Human Services

Employee Benefits Division of DFA

Internal Revenue Service

Office of Child Support Enforcement

Office of Personnel Management of DFA

It is the agency’s responsibility to refund any set off amount paid to the agency in error.

If you owe a debt for Arkansas income tax, your federal refund may be captured to satisfy your state income tax debt.

NOTICE TO MARRIED TAXPAYERS:

If only one of the married taxpayers owes the debt, the taxpayer who is not liable can avoid having his/her refund applied to the debt if both taxpayers file Status 5, Married Filing Separately on Different Returns.

LINE 49. If Line 36 of Form AR1000F or Line 36D of Form AR1000NR is more than Line 44, you owe additional tax. Subtract Line 44 from Line 36 of Form AR1000F or Line 36D of Form AR1000NR. Enter amount here. This is the TAX YOU OWE.

LINE 50A and 50B. UNDERESTIMATE PENALTY: If required enter the exception number from Part 3 of the AR2210, or the computed penalty from Line 18 of AR2210 in the appropriate box. If you completed AR2210A, enter “6” in box 50A. Enter amount from Line 46 of AR2210A in box 50B.

Form AR2210 or AR2210A must be attached and the exception number entered in box 50A to claim any exclusion from the Underestimate Penalty.

LINE 50C. Add Lines 49 and 50B. Enter total on this line.

LINE 51. Enter the total amount from Form AR4, Part Ill in the space provided.

Your tax return will not be legal and can- not be processed unless you SIGN IT.

Write in the DATE. If you and your spouse are filing a joint tax return or filing separately on the same return, both of you must sign it.

If someone else prepares your return, that person must sign and complete the Paid Preparer sec- tion. If you prepare your own return, DO NOT use this section.

PAYMENT INFORMATION

Complete Form AR1000V (available at www. arkansas.gov/incometax) and attach a check or money order to your return. Write the tax year and your Social Security Number or account num- ber on the check or money order, and make your check payable in U.S. Dollars to the Department of Finance and Administration. Mail on or before April 15, 2016. If the payment is for an amended return, mark the box yes on Form AR1000V for “Is Payment for an Amended Return’.

Credit card payments may be made by calling 1-800-2PAY-TAX*"' (1-800-272-9829), or by visit- ing www.officialpayments.com and clicking on the “Payment Center” link.

Credit card payments will be processed by Of- ficial Payments Corporation, a private credit card payment services provider. A convenience fee will be charged to your credit card for the use of this service. The State of Arkansas does not receive this fee. You will be informed of the exact amount of the fee before you complete your transaction. After you complete your transaction you will be given a confirmation number to keep with your records.

NOTE: Do not send currency or coin by mail.

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PENALTIES & INTEREST

o¥FF ORp

You must mail your tax return by April 15, 2016. Any return not postmarked by April 15, 2016 (unless you have an extension) will be delinquent. A penalty of one percent (1%) per month for failure to pay and five percent (5%) per month for failure to file, up to a maximum of thirty-five percent (35%), will be as- sessed on the amount of tax due on an original return. Interest of ten percent (10%) per year will also be assessed on any additional tax due, calculated from the original due date to the date you paid the tax due on an original or amended return.

An extension to file is not an extension to pay. If you have not paid the amount due by the original due date you will be subject to a failure to pay penalty of one percent (1%) per month of the unpaid balance.

In addition to any other penalties assessed, a pen- alty of $500 will be assessed, if any taxpayer files what purports to be a return, but the return does not contain information on which the correctness of the return may be judged, and such conduct is due to a position which is frivolous or an effort to delay or impede the administration of any State law.

Page 17

INSTRUCTIONS FOR ITEMIZED DEDUCTIONS (FORM AR3)

MEDICAL AND DENTAL EXPENSES

List only amounts you paid and for which you were not reimbursed.

LINE 1. Enter total medical and dental expenses, less reimbursements from insurance or other sources. See chart on Page 19 for examples of deductible and nondeductible expenses.

LINE 2. Enter total amount from Form AR1000F/ AR1000NR, Lines 24A and 24B.

LINE 3A. If you and your spouse were under the age of 65 at the end of 2015, multiply Line 2 by 10% (.10). Otherwise enter zero (0).

LINE 3B. If either you or your spouse were age 65 or over at the end of 2015, multiply Line 2 by 7.5% (.075). Otherwise enter zero (0)

LINE 4. Subtract Lines 3A and 3B from Line 1.

TAXES

LINE 5. You may deduct real estate taxes you paid on property you own that was not used for business. Do notinclude any special assessments or levy taxes.

Some taxes you cannot deduct are:

Arkansas income taxes

Car tags

Cigarette and beverage taxes Dog licenses

Estate taxes

Federal income taxes Federal Social Security taxes Hunting and fishing licenses Improvement taxes

Sales taxes

LINE 6. Taxes you may deduct on this line: City income taxes Mississippi gambling taxes Personal property taxes

Taxes paid to a foreign country on income taxed on this return

LINE 7. Add the amounts on Lines 5 and 6.

Page 18

INTEREST EXPENSE

LINE 8. You may deduct the home mortgage interest paid to a bank or other financial institution.

The deduction is generally limited to interest at- tributable to a debt for not more than the cost of the principal, and/or second residence, plus improvements.

LINE 9. Deduct home mortgage interest paid to an individual on this line, and list that person’s name and address.

LINE 10. Enter the amount of deductible points paid on this line. Deductible points are those that:

1. Are incurred in the purchase or improvement of the taxpayer's principal residence; and

2. Reflect an established business practice of charging points in the geographical area where the loan is made; and

3. Donot exceed the number of points generally charged for the type of transaction. (Points paid in refinancing a mortgage must be am- ortized over the life of the loan.)

NOTE: /n order to deduct the full amount of the

points paid, payment of the points must

be made from separate funds brought to the loan closing.

LINE 11. Enter deductible investment interest. The deduction is limited to the amount of invest- ment income. Interest that is disallowed because of the limitation can be carried forward to the next year and deducted to the extent of the limitation in the carryover year. Attach federal Form 4952.

LINE 12. Add Lines 8, 9, 10, and 11.

CONTRIBUTIONS

LINE 13. Enter the total contributions you made by cash or check. If you gave $3,000 or more to any one organization, list the donee and amount given. If you have non-cash contributions of $500 or more, attach federal Form 8283.

LINE 14. In addition to other contributions, a de- duction is allowed for the donated value of artistic, literary, and musical creations if the following qualifications are met:

1. The taxpayer making the donation derived at least fifty percent (50%) of his/her current or prior year income from an art related profes- sion;

2. The fair market value of the art work has been verified by an approved independent appraiser, and a copy of the appraisal is attached;

3. The artwork was donated to a museum, art gal- lery, or nonprofit charitable organization quali- fied under Internal Revenue Code § 501(C)(3) and located in the State of Arkansas; and

4. The deduction for donated art work does not exceed fifteen percent (15%) of the donor’s gross income in the calendar year of donation.

LINE 15. List other deductible contributions:

1. Unreimbursed amounts spent to maintain an elementary or high school student (other than a dependent or relative) in a taxpayer’s home under a program sponsored by a charitable organization.

2. Agift of property to a non-profit organization. Attach a description of the property, date of gift, and method of valuation. For each gift in excess of $500, list any conditions attached to the gift, manner of acquisition, and cost or basis if owned by you for less than five (5) years.

NOTE: Payments to private academies or other

schools for the education of dependents

are not deductible as contributions.

LINE 16. If you made contributions in excess of fifty percent (50%) of your adjusted gross income, you may carry the excess deduction over for a period of five (5) years.

If you are deducting an excess contribution from a previous year, enter the amount and year of the original contribution.

LINE 17. Add lines 13, 14, 15, and 16.

CASUALTY AND THEFT LOSSES

LINE 18. The method of computing casualty or theft losses is the same as the federal method with the $100 exclusion. The amount of each loss must exceed ten percent (10%) of your adjusted gross income. Attach federal Form 4684 and provide necessary supporting documents.

If you have a Disaster Loss in 2016 on property in a federal disaster area, you may elect to deduct the loss as an itemized deduction in 2015. If you elect to report the loss on your 2015 return, you cannot report the loss on your 2016 return.

Adisaster loss is the only loss which may be carried back. You may amend your 2014 return to report a disaster loss incurred in 2015. If you elect to amend your 2014 return, you cannot report the loss on your 2015 return. If loss in federal disaster area, list location on Line 18.

LINE 19. Enter your Post-Secondary Edu- cation Tuition Deduction and attach Form AR1075(s).

MISCELLANEOUS DEDUCTIONS SUBJECT TO THE 2% AGI LIMI- TATION

LINE 20. Enter unreimbursed employee busi- ness expenses. Arkansas recognizes the federal mileage allowance for computing business travel expenses. Attach federal Form 2106.

LINE 21. Other deductions include:

Union or professional dues

Tax return preparation fees Expenses for safety equipment Expenses of entertaining customers Tools and supplies

Fees paid to employment agencies

Attach supporting schedule or statement.

LINE 22. Add Lines 20 and 21.

LINE 23. Enter combined amount from Form AR1000F/AR1000NR, Lines 24A and 24B.

LINE 24. Multiply Line 23 by 2% (.02).

LINE 25. Subtract Line 24 from Line 22. This is your total allowable miscellaneous deductions.

OTHER MISCELLANEOUS DEDUCTIONS

LINE 26. Volunteer firefighters may deduct unreimbursed expenses of firefighting equipment required by the volunteer fire department and/ or loss of value of personal property damaged or destroyed during volunteer firefighting activi- ties. To qualify, you must have received less than $5,000 total compensation for the taxable year from the volunteer fire department you served. This deduction may not exceed $1,000 per volunteer firefighter.

LINE 27. Enter your other miscellaneous de- ductions not subject to the 2% AGI limit. Attach detailed schedule of each deduction.

LINE 28. Add Lines 26 and 27.

LINE 29. Add Lines 4,7,12,17,18,19, 25 and 28.

PRORATED ITEMIZED DEDUCTIONS

LINE 30. If you are married filing separately, Status 4 or 5, you must prorate your itemized deductions between spouses. Enter your AGI from Line 24, Column A and your spouse’s AGI from Line 24, Column B of Form AR1000F/AR1000NR.

LINE 31. Add Lines 30A and 30B.

LINE 32. Divide Line 30A by Line 31 and enter the percentage here. Round to the nearest whole percent.

LINE 33. Multiply the total itemized deductions reported on Line 29 by your percentage on Line 32. Enter result here and on Form AR1000F/ AR1000NR, Line 25, Column A.

LINE 34. Subtract Line 33 from Line 29. Enter result here and on Form AR1000F/AR1000NR, Line 25, Column B. If you and your spouse are using Filing Status 5, this is the amount of the total itemized deductions your spouse is allowed to claim on his/her tax return.

Deductible

Deductible vs. Non-deductible Medical Expenses The chart below lists specific types of expenses and whether or not a deduction for the ex- pense is permitted.

Non-deductible

Alcoholism, treatment of

Ambulance hire

Attendant to accompany blind or deaf student

Chiropractor

Contact lenses

Contraceptives, prescription

Dental fees

Drug addiction, recovery from

Drugs, prescription

Eye examinations and glasses

Hearing aids

Insulin

Laser eye surgery

Long-term care expenses

Orthopedic shoes

Psychiatric care

Psychologist

Smoking, program to stop

Wheelchair

X-rays

Anticipated medical expenses

Baby-sitting expenses to enable parent to see doctor

Cosmetic surgery, unnecessary

Diaper service

Ear piercing

Electrolysis

Funeral expenses

Gravestone

Hair transplants, surgical

Health club dues

Hygienic supplies

Insurance premiums-loss of income

Insurance premiums-loss of limb

Marriage counseling

Maternity clothes

Spiritual guidance

Tattoos

Teeth, whitening

Toilet articles

Trips, general health improvement

Page 19

STUDENT LOAN INTEREST WORKSHEET

1. Enter the total interest you paid in 2015 on qualified student loans ..........ceeeeeeeeeee recta 1 2 Enter the smaller of Line 1 above Or $2,500. .......ccccccccccccsscesecsscesecesecsutsueceusceesseseusesesseesaneaess 2 3. Enter the amount(s) from Form AR1000F/AR1000NR, Line(s) 21A and 21B....... eee 3 4 Enter total adjustments from Form AR1000F/AR1000NR, Line(s) 22A and 22B.

(Do not include the deduction for interest paid on student loans, Line 6, AR1000ADJ.)........ 4 5. Modified AGI. Subtract Line 4 from Line 3 oo... ccc ccc ec eee cee ceeeeeeeceeeeeeteeteseeseeseteeeeneeees 5

Note: If line 5 is $80,000 or more and you are filing Status 1, 3, or 6 or $160,000 or more and you are filing Status 2 or 4, STOP HERE. You cannot take the deduction.

6. Enter: $65,000 if filing Status 1, 3, or 6; $130,000 if filing Status 2 OF 4.00.0... cece 6 7. Subtract Line 6 from Line 5.

If zero or less, enter -0- here and on Line 9, skip Line 8, and go to Line 10.0... 7 8. Divide Line 7 by $15,000 ($30,000 if filing status 2 or 4).

Enter result as a decimal (rounded to at least three places). oo... eee eeeeeeeeeeeeeeeeeeeeeeeeeneees 8 9. Multiply Line 2 by Line 8 ooo... eee c ee eeeeeee terete eeeeteeeteesseeseeeseesseeeeeeseeeeeeteeseeeseeeneeneeee 9

10. Allowable Deduction: Subtract Line 9 from Line 2. Enter result here and on Form AR1000ADyU, Line 6 ..........ccccceccccccccceeesseeeceeesssseeeeessseeeeeeeeees 10

FILING STATUS 4 ONLY

Yours Spouse 11. Enter the total interest for each spouse up to the combined amount on Line 1.0... eee eeeeeeeeeeeeeeneees 11A 11B 12. Total amount paid from Line 1... eee eee eee eeeeeeeeneeeneeeeeeneees 12 13. Divide Line 11A by Line 12. Enter result as a decimal (rounded to at least three places) ......... 13 14. Multiply Line 10 by the amount on Line 13. Enter here and on AR1000AD4J, Line 6, Column A.................000 14 15. Subtract Line 14 from Line 10. Enter here and on AR1000AD4, Line 6, Column B............. 15 IRA PHASE OUT CHART YOUR ALLOWABLE IF YOUR FILING TRADITIONAL IRA DEDUCTION STATUS IS: Phases out when Will be zero when Arkansas AGI exceeds: Arkansas AGI is: Single, Head of Household $61,000 $71,000 Married Filing on Same Return (Status 2 or 4), or Qualifying Widow(er) $98,000 $118,000 Married Filing on Separate Returns (Status 5) $0 $10,000 Nonactive Spouse (Income Computed Jointly) $183,000 $193,000

If your Arkansas AGI is within one of the above phaseout ranges, see IRS Publication 590 to figure your allowable IRA deduction.

Page 20

SELF-EMPLOYED HEALTH INSURANCE DEDUCTION WORKSHEET

Enter the total amount paid in 2015 for health insurance coverage established under

your business for 2015 for you, your spouse, and your dependent. ............cccceeeeeeeseeeeeeeeeeeeeeeeeeeeneeeteeeeeaeees 1 2. — Enter your net profit and any other earned income* from the business under which the

insurance plan was established, less any deductions on Form AR1000ADJ, Line 10......00.00000. 2 3. Enter the smaller of Line 1 or Line 2 here and on Form AR1000AD4J, Line 9.

(Do not include this amount in figuring your medical expense deduction on the Itemized Deduction Schedule.) ...3

*Earned income includes net earnings and gains from the sale, transfer, or licensing of property you created. It does not include capital gain income. If you were more than a 2% shareholder in an S corporation, earned income is your wages from that corporation.

MILEAGE AND DEPLETION ALLOWANCES

Mileage Allowance BUSINESS... eee eee eeee teeter eee 57.5 cents/mile

Charitable... cece eee 14 cents/mile Medical/MOving .........::ceeeeereeeeeeee 23 cents/mile Mail Carrier (rural)...... Reimbursement received

ear . A~ Depletion Allowance A Depletion (gas and Oil)... eee eee eeenees Same as federal (15% for most gas and oil production)

DEPRECIATION INFORMATION

Section 179 Facts

Arkansas adopted IRC §179 as in effect on January 1, 2009, allowing greater dollar limits and phase out thresholds.

> Deduction Limit — $25,000

> Cost of qualifying property limit — $200,000 >» No deduction allowed above $225,000 >

More than one property placed in service — limit $25,000 deduction per taxpayer per year

> Any cost not deducted in one year may be carried forward to next year > Deduction may not be used to reduce taxable income below zero

Note: Arkansas has not yet adopted the most recent federal changes. Page 21

HOW TO FILL OUT YOUR CHECK

Date and mail payment on Make your check payable to "Dept. or before April 15th, 2016. of Finance and Administration".

\

: Lynne Taxpayer 3169

: 2222 Austin Ave ; | Tony, AR 11122 Date April 15, 2016

| Phone (501) 555-1552

_ PAY TO THE | ORDER OF: Dept. of Finance and Administration 7 $ 125.00

Ouc4e hundred twenty five aud uel 100 DOLLARS

: Tax year 2015 _ MEMO: 12345678-IIT Lynne “Taxpayer

Make sure both amounts match

. ; Don't forget to sign your check! Include your Account ID or Social Security

Number and the tax year on the memo line.

PRESERVATION OF TAX RECORDS

A taxpayer who files an Arkansas income tax return is required to retain records to prove the accuracy of that return. The records must be retained for at least six (6) years (unless otherwise provided by law) and are subject to examination by the Director at any reason- able time during that period.

When a taxpayer fails to preserve and maintain the required records, the director may make an estimated assessment based upon any available information as to the amount of tax due by the taxpayer. Per ACA 26-18-506, the burden of proof of refuting this estimated assess- ment is upon the taxpayer.

Page 22

IF THE IRS AUDITS YOU

If the Internal Revenue Service examines your return for any tax year and changes your net taxable income, you must report the changes to the Arkansas Department of Finance and Administration within one hundred eighty (180) days from the receipt of the notice and demand for payment from the Internal Revenue Service.

File an amended return using Arkansas Form AR1000F/AR1000NR (or Form AR1000A/ AR1000ANR for tax years 2009 and prior) to report changes to your state return for the year(s) in question. Attach a copy of the federal changes.

If you fail to notify this Department within one hundred eighty (180) days and do not file the required amended return, the statute of limitations will remain open for three (3) years on the year(s) in question. Additional interest will be calculated on any tax you owe the State of Arkansas.

INFORMATION EXCHANGE PROGRAMS WITH THE IRS

Under authorization of Internal Revenue Code Section 6103(D) the State of Arkansas par- ticipates in several information exchange programs with the Internal Revenue Service:

@ CP2000:

The IRS matches income reported on a taxpayer’s federal income tax return with documents (W-2s, 1099s, etc.) provided to the IRS by the payer to determine whether income was omitted from the taxpayer’s return. If unreported income is discovered, the IRS assesses additional federal tax on the omitted income then notifies the State of Arkansas. The taxpayer’s state tax return is then reviewed for unreported income. (Some examples of commonly omitted income include wages, pensions, and cancel- lation of debt.)

@ Revenue Agent Reports “RARs”: When the IRS adjusts a taxpayer’s federal income tax return as the result of an audit, details are provided to the State of Arkansas. The taxpayer’s state tax return is then reviewed and adjusted if appropriate. (Some examples of RAR adjustments include disallowance of deductions, expenses, or dependents and assessment of early with- drawal penalties.)

® Non-filer Identification:

The IRS provides the Arkansas Department of Finance and Administration with a list of taxpayers who filed federal returns using Arkansas addresses. This information is then compared with Arkansas income tax records to identify individuals who filed federal returns using Arkansas addresses but did not file Arkansas returns. Letters are sent inquiring whether the taxpayer is required to file. The taxpayer should file the return in question or provide documentation why he/she is not required to file. If a sufficient response is not received, state tax is assessed using amounts reported on the taxpayer’s federal return, and the taxpayer is mailed a Notice of Tax Adjust- ment.

Page 23

IDENTITY THEFT

In recent years identity theft associated with income tax returns has become an increasingly severe problem. Sometimes thieves steal a taxpayer’s Social Security Number and other private information then use this information to file tax returns and receive refunds that were not due to them.

If you believe your identity may have been used to file an Arkansas state tax return, these are the steps we suggest you take:

>» Contact us at (501) 682-1100 to report that your identity may have been stolen.

e@ Request a hold on your account to stop all fraudulent refunds.

>» Contact the IRS Identity Protection Specialized Unit at (800) 908-4490 and inform them that your identity was stolen and may have been used to file a fraudulent tax return.

e You should complete IRS Form 140339, an identity theft affidavit, to support your claim.

» Send a copy of the stamped IRS identity theft affidavit form to: Arkansas Individual Income Tax

PO Box 3628 Little Rock, AR 72203-3628

>» Contact the credit bureaus to ensure there have not been any other thefts related to your identity, and ask to have a fraud alert put on your credit report. The numbers to the credit bureaus are listed below:

@ Equifax - (800) 525-6285 © e Experian - (888) 397-3742 ¥Z

e Trans-Union - (800) 680-7289

Page 24

TAXPAYER BILL OF RIGHTS

You have the right to a full explanation of all actions by any employee of the Director of the Department of Finance and Administration both during an audit and during collection activities.

e All tax information contained in the records and files of the Director of the Department of Finance and Administration (hereinafter “Director”) pertaining to you or your business is confidential subject to exceptions in Ark. Code Ann. § 26-18-303.

You may represent yourself in any proceeding or interview before the Director or you may be represented by anyone whom you authorize in writing to be your representative.

You have the right to consult with a lawyer, accountant, or other representative at any time during an interview with an employee of the Director. The Director shall suspend the interview to allow you to consult with your representative.

You may record any interview with the Director or his or her employee at your own expense. You should let the Director or his or her employee know in advance of your intention to record the interview. The Director may likewise record an interview, and a copy may be obtained within a reasonable time at your expense.

You may request an administrative review of any proposed assessment of tax. You must request this review within 60 days of your receipt of a Notice of Proposed Assessment. The administrative review may be based on an in-person hearing, a telephone hearing, or consideration of writ- ten documents. If you do not request an administrative hearing, you may still pursue your judicial remedies by filing an action in the circuit court.

If you receive an unfavorable decision from your administrative review, then you may request a review of the decision by the Director. This request must be received by the Director within 20 days of the mailing of the hearing decision. If you receive an unfavorable decision from the Director on any issue, you may pursue judicial remedies as discussed below.

After the issuance of the Notice of Final Assessment or the final determination of the hearing officer or Director, you may appeal the tax assess- ment to circuit court, regardless of whether you protested the assessment and requested an administrative review. To pursue your appeal of a tax assessment to circuit court you must do one of the following:

File suit within 180 days of the date of the Notice of Final Assessment or final determination of the hearing officer or Director if the tax- payer does not make any payment of the tax, penalty, or interest due; or

Pay the entire amount of tax due within one year of the date of the Notice of Final Assessment or final determination of the hearing officer or Director and file suit within one year of the date of payment; or

File suit within one year of the date of the final determination of the hearing officer or Director to recover assessed tax, penalty, and inter- est paid prior to the time for issuance of the Notice of Final Assessment.

A taxpayer may file an amended return or a verified claim for credit or refund of an overpayment of any state tax within three years from the date the return was filed or two years from the date the tax was paid, whichever is later. Any amended return or claim for refund should be filed with the office of the Revenue Division which administers the type of tax in question.

If the Director disallows the refund claim either in whole or in part, the Director will issue a Notice of Claim Denial. You may request an administra- tive review of the Notice of Claim Denial. This request must be made within 60 days of your receipt of the Notice of Claim Denial. If you receive an unfavorable decision from your administrative review, you may request a review of the decision by the Director. This request must be made within 20 days of the mailing of the hearing decision.

Following an administrative hearing and corresponding review, the taxpayer may seek judicial relief from the Notice of Claim Denial by appealing the decision to circuit court. Judicial review is available whether or not you requested an administrative review. To pursue your appeal to circuit court, you must file suit within one year of the date of the mailing of the Notice of Claim Denial, the final determination of the hearing officer, or revision decision of the Director, whichever is later. If the Director fails to issue a written decision in response to the refund claim within six months of the date a claim for refund is filed, the taxpayer may then file suit to recover the amount claimed.

Any taxpayer who wishes to file a complaint regarding any activity concerning the administration or collection of any state tax by the Revenue Division should make the complaint in writing to:

ASSISTANT COMMISSIONER FOR POLICY AND LEGAL Mailing Address: LEDBETTER BUILDING, ROOM 2440 P.O. BOX 1272 LITTLE ROCK, AR 72203-1272

Overnight Mailing Address: LEDBETTER BUILDING, ROOM 2440 1816 W. 7TH ST. LITTLE ROCK, AR 72201

Email Address: John.Theis@dfa.arkansas.gov

In administering the state tax laws, the Director is authorized by law to make an examination or investigation of the business, books, and records of the taxpayer. If the Director determines that an additional amount of tax is due, then a Notice of Proposed Assessment shall be issued to the taxpayer. The taxpayer may seek relief from the Notice of Proposed Assessment as outlined above. If the taxpayer fails to preserve and maintain records suitable to determine the amount of tax due or to prove accuracy of any return, the Director may make an estimated assessment based upon the best information available as to the amount of tax due by the taxpayer.

The Director may issue a jeopardy assessment against any taxpayer (1) whose tax liability exceeds any bond on file indemnifying the state for the payment of a state tax, (2) who intends to leave the state, remove his or her property, or conceal himself or herself or his or her property, (3) who intends to discontinue his or her business without making adequate provisions for payment of state taxes, or (4) who does any other act tending to prejudice or jeopardize the Director’s ability to compute, assess, or collect any state tax. Any taxpayer seeking relief from a jeopardy assessment must request an administrative hearing within five days from the receipt of the Notice of Proposed Assessment.

When collecting any state tax due from a taxpayer, the Director is authorized to file a Certificate of Indebtedness (state tax lien) with the circuit clerk of any county of this state certifying that the person named therein is indebted to the state for the amount of tax due as established by the Director. The Certificate of Indebtedness shall have the same force and effect as the entry of a judgment rendered by a circuit court and shall constitute a lien upon the title of any real and personal property of the taxpayer in the county where the Certificate of Indebtedness is recorded.

After the filing of the Certificate of Indebtedness, the Director may take all steps authorized by law for the collection of the tax, including the is- suance of a writ of execution, garnishment, and cancellation of any state tax permits or registrations.

Any court costs or sheriffs fees which result from the Director’s attempt to collect delinquent taxes shall be collected from the taxpayer in addition to the tax, interest, and penalties included in the Certificate of Indebtedness.

Page 25

2015 Low Income Tax Tables QUALIFICATIONS:

1. Your total income from all sources (regardless of whether the income is taxable to Arkansas) must fall within the limits of the appropriate table based on your filing status.

2. Married couples must file a joint return (Filing Status 2) to qualify to use these tables. 3. If you use an exemption for military compensation or employment related pension income, you do not qualify. 4. — If you itemize your deductions, you must use the Regular Tax Table. 5. Find your Adjusted Gross Income from Line 24, AR1000F/AR1000NR, in the appropriate table below. Your tax is to the right of this amount. Enter the tax on Line 27, AR1000F/AR1000NR. Head of Head of . Household/Qualifying Household/Qualifying Single Widow(er) with 1 or No Widow(er) with 2 or More (FILING STATUS 1) Dependents Dependents (FILING STATUS 3 or 6) (FILING STATUS 3 or 6) IF YOUR ADJUSTED IF YOUR ADJUSTED IF YOUR ADJUSTED GROSS INCOME IS GROSS INCOME IS GROSS INCOME IS YOUR YOUR YOUR FROM To TAX IS FROM TO TAX IS FROM To TAX IS 0 11,643 0 0 16,553 0 0 19,733 0 11,644 11,700 35 16,554 16,600 71 19,734 19,800 99 11,701 11,800 42 16,601 16,700 81 19,801 19,900 112 11,801 11,900 50 16,701 16,800 92 19,901 20,000 126 41,901 42,000 57 16,801 16,900 102 20,001 20,100 139 16,901 17,000 113 20.101 20.200 152 te 40! to 00 * 17,001 17,100 128 20,201 20,300 166 aie 12200 ” 17.101 17,200 133 20,301 20,400 179 12,201 12,300 79 17,201 17,300 144 , , 12,301 12,400 87 17,301 17,400 154 20,401 20,500 193 17,501 17,600 175 , » 12,501 12,600 101 , 7 12.601 42.700 109 17,601 17,700 185 20,701 20,800 233

’ , 17,701 17,800 196 20,801 20,900 246 12,701 12,800 116 17,801 17,900 206 20,901 21,000 260 12,801 12,900 124 17,901 18,000 217 21,001 21,100 273 12,901 13,000 131 18,001 18,100 227 21,101 21,200 286 13,001 13,100 138 18,101 18,200 237 21.201 21.300 300 13,104 13,200 146 18,201 18,300 248 21,301 21,400 313 13,201 | 13,300 153 18,301 18,400 258 21,401 21,500 327 13,301 | 13,400 161 18,401 18,500 269 21,501 21,600 340 13,401 13,500 168 18,501 18,600 279 ‘ :

F 5 18,601 18,700 289 21,601 21,700 353 13,501 13,600 175 18.701 18.800 300 21,701 21,800 367 13,601 13,700 183 18,801 18,900 310 21,801 21,900 380 13,701 13,800 190 18,901 19,000 321 21,901 22,000 394 13,801 13,900 198 19,001 19,100 331 22,001 22,100 407 13,901 14,000 205 19,101 19,200 341 22,101 22,200 420 14,001 14,100 212 19,201 19,300 352 22,201 22,300 434 14,101 14,200 220 19,301 19,400 362 22,301 22,400 447

19,401 19,500 373 22,401 22,500 461 14,201 14,300 227 2 ’

19,501 19,600 383 22,501 22,600 474 14,301 14,400 235 19,601 19,700 393 2 601 22 700 487 14,401 14,500 242 19,701 19,800 404 2 701 22 800 501 14,501 14,600 249 19,801 19,900 414 , ’ 14,601 | 14,700 | 257 19,901 | 20,000 425 22,801 | 22,800 OM

20,001 20,100 435 22,901 23,000 528 14,701 14,800 264 , , 14,801 14,900 272 20,101 20,200 445 23,001 23,100 oat 14,901 15,000 280 20,201 20,300 456 23,101 23,200 $54

, , 20,301 20,400 466 23,201 23,300 568

15,001 15,100 288 20,401 20,500 477 23,301 23,400 599

*Above $15,100 use Standard or Itemized 20,501 20,600 487 23,401 23,500 614 Deductions and Regular Tax Table 20,601 20,700 497 23,501 23,600 629 (Rev 10/9/15) 20,701 20,800 508 23,601 23,700 644 20,801 20,900 518 23,701 23,800 659 20,901 21,000 529 , : 21,001 21,100 539 23,801 23,900 674 21,101 21,200 549 23,901 24,000 689 21,201 21,300 560 24,001 24,100 704 ; 24,101 24,200 719 *Above $21,300, use Standard or Itemized - Deductions and Regular Tax Table *Above $24,200, use Standard or Itemized Deductions and Regular Tax Table

Page 26

2015 Low Income Tax Tables

QUALIFICATIONS:

Your total income from all sources (regardless of whether the income is taxable to Arkansas) must fall within the limits of the

1.

ARON

appropriate table based on your filing status.

Married couples must file a joint return (Filing Status 2) to qualify to use these tables. If you use an exemption for military compensation or employment related pension income, you do not qualify.

If you itemize your deductions, you must use the Regular Tax Table.

Find your Adjusted Gross Income from Line 24, AR1000F/AR1000NR, in the appropriate table below. Your tax is to the right of this amount. Enter the tax on Line 27, AR1000F/AR1000NR.

Married Filing Joint With One or No Dependents

(FILING STATUS 2)

IF YOUR ADJUSTED GROSS INCOME IS

YOUR TAX IS

FROM TO

0 19,635 0 19,636 19,700 79 19,701 19,800 90 19,801 19,900 101 19,901 20,000 113, 20,001 20,100 124 20,101 20,200 136 20,201 20,300 147 20,301 20,400 158 20,401 20,500 170 20,501 20,600 181 20,601 20,700 193 20,701 20,800 204 20,801 20,900 215 20,901 21,000 227 21,001 21,100 238 21,101 21,200 250 21,201 21,300 261 21,301 21,400 272 21,401 21,500 284 21,501 21,600 295 21,601 21,700 307 21,701 21,800 318 21,801 21,900 329 21,901 22,000 341 22,001 22,100 352 22,101 22,200 364 22,201 22,300 375 22,301 22,400 386 22,401 22,500 398 22,501 22,600 409 22,601 22,700 421 22,701 22,800 432 22,801 22,900 443 22,901 23,000 455 23,001 23,100 466 23,101 23,200 478 23,201 23,300 489 23,301 23,400 500 23,401 23,500 512 23,501 23,600 523 23,601 23,700 535 23,701 23,800 546 23,801 23,900 557 23,901 24,000 569 24,001 24,100 580 24,101 24,200 592

*Above $24,200, use Standard or Itemized Deductions and Regular Tax Table

(Rev 10/9/15)

Married Filing Joint With Two or More Dependents (FILING STATUS 2) IF YOUR ADJUSTED GROSS INCOME IS FROM TO YOUR TAX IS 0 23,631 0 23,632 23,700 114 23,701 23,800 125 23,801 23,900 136 23,901 24,000 148 24,001 24,100 159 24,101 24,200 171 24,201 24,300 182 24,301 24,400 193 24,401 24,500 205 24,501 24,600 216 24,601 24,700 228 24,701 24,800 239 24,801 24,900 250 24,901 25,000 262 25,001 25,100 273 25,101 25,200 285 25,201 25,300 296 25,301 25,400 307 25,401 25,500 319 25,501 25,600 348 25,601 25,700 361 25,701 25,800 374 25,801 25,900 387 25,901 26,000 400 26,001 26,100 413 26,101 26,200 426 26,201 26,300 439 26,301 26,400 452 26,401 26,500 465 26,501 26,600 478 26,601 26,700 491 26,701 26,800 504 26,801 26,900 517 26,901 27,000 530 27,001 27,100 543 27,101 27,200 556 27,201 27,300 569 27,301 27,400 582 27,401 27,500 595 27,501 27,600 608 27,601 27,700 621 27,701 27,800 634 27,801 27,900 647 27,901 28,000 660 28,001 28,100 673 28,101 28,200 686 28,201 28,300 699 28,301 28,400 712 28,401 28,500 725 28,501 28,600 738 28,601 28,700 751 28,701 28,800 764 28,801 28,900 777 28,901 29,000 790 29,001 29,100 803 29,101 29,200 816 29,201 29,300 829 29,301 29,400 842 29,401 29,500 855 29,501 29,600 868 29,601 29,700 881 29,701 29,800 894 29,801 29,900 907 29,901 30,000 920 30,001 30,100 933 30,101 30,200 946 *Above $30,200 use Standard or Itemized Deductions and Regular Tax Table

Page 27

Instructions:

2015 Regular Tax Table

1. Find your net taxable income from Line 26, AR1000F/AR1000NR, in the table below. Your tax is to the right of this amount. 2. Married couples must use the same filing status and tax table. If one spouse uses the Regular Tax Table, then both must use the Regular Tax Table. 3. Be sure to subtract your standard deduction or your itemized deductions from Line 24 before using the regular tax table. If you and your spouse use

Filing Status 4 or 5, make sure you prorate your itemized deductions between you and your spouse.

Current year indexed tax brackets are available on the Individual Income Tax website at www.arkansas.gov/incometax

If Your Income If Your Income If Your Income is is is YOUR YOUR YOUR As Much But Less TAX As Much But Less TAX As Much But Less TAX As Than Is As Than Is As Than Is 5,000 0 100 0 5,000 5,100 57 10,000 10,100 193 100 200 1 5,100 5,200 59 10,100 10,200 197 200 300 2 5,200 5,300 62 10,200 10,300 200 300 400 3 5,300 5,400 64 10,300 10,400 203 400 500 4 5,400 5,500 66 10,400 10,500 207 500 600 5 5,500 5,600 69 10,500 10,600 210 600 700 6 5,600 5,700 71 10,600 10,700 214 700 800 7 5,700 5,800 74 10,700 10,800 217 800 900 8 5,800 5,900 76 10,800 10,900 220 900 1,000 9 5,900 6,000 78 10,900 11,000 224 1,000 6,000 1,000 1,100 9 6,000 6,100 81 11,000 11,100 227 1,100 1,200 10 6,100 6,200 83 11,100 11,200 231 1,200 1,300 11 6,200 6,300 86 11,200 11,300 234 1,300 1,400 12 6,300 6,400 88 11,300 11,400 237 1,400 1,500 13 6,400 6,500 90 11,400 11,500 241 1,500 1,600 14 6,500 6,600 93 11,500 11,600 244 1,600 1,700 15 6,600 6,700 95 11,600 11,700 248 1,700 1,800 16 6,700 6,800 98 11,700 11,800 251 1,800 1,900 17 6,800 6,900 100 11,800 11,900 254 1,900 2,000 18 6,900 7,000 102 11,900 12,000 258 2,000 7,000 2,000 2,100 18 7,000 7,100 105 12,000 12,100 261 2,100 2,200 19 7,100 7,200 107 12,100 12,200 265 2,200 2,300 20 7,200 7,300 110 12,200 12,300 268 2,300 2,400 21 7,300 7,400 112 12,300 12,400 271 2,400 2,500 22 7,400 7,500 114 12,400 12,500 275 2,500 2,600 23 7,500 7,600 117 12,500 12,600 278 2,600 2,700 24 7,600 7,700 119 12,600 12,700 282 2,700 2,800 25 7,700 7,800 122 12,700 12,800 286 2,800 2,900 26 7,800 7,900 124 12,800 12,900 290 2,900 3,000 27 7,900 8,000 126 12,900 13,000 294 3,000 8,000 3,000 3,100 27 8,000 8,100 129 13,000 13,100 299 3,100 3,200 28 8,100 8,200 131 13,100 13,200 303 3,200 3,300 29 8,200 8,300 134 13,200 13,300 308 3,300 3,400 30 8,300 8,400 136 13,300 13,400 312 3,400 3,500 31 8,400 8,500 139 13,400 13,500 316 3,500 3,600 32 8,500 8,600 142 13,500 13,600 321 3,600 3,700 33 8,600 8,700 146 13,600 13,700 325 3,700 3,800 34 8,700 8,800 149 13,700 13,800 330 3,800 3,900 35 8,800 8,900 152 13,800 13,900 334 3,900 4,000 36 8,900 9,000 156 13,900 14,000 338 4,000 9,000 4,000 4,100 36 9,000 9,100 159 14,000 14,100 343 4,100 4,200 37 9,100 9,200 163 14,100 14,200 347 4,200 4,300 38 9,200 9,300 166 14,200 14,300 352 4,300 4,400 40 9,300 9,400 169 14,300 14,400 356 4,400 4,500 42 9,400 9,500 173 14,400 14,500 360 4,500 4,600 45 9,500 9,600 176 14,500 14,600 365 4,600 4,700 47 9,600 9,700 180 14,600 14,700 369 4,700 4,800 50 9,700 9,800 183 14,700 14,800 374 4,800 4,900 52 9,800 9,900 186 14,800 14,900 378 4,900 5,000 54 9,900 10,000 190 14,900 15,000 382 (Rev 10/9/15)

Page 28

2015 Regular Tax Table

If Your Income If Your Income If Your Income is YOUR YOUR YOUR As Much But Less TAX As Much But Less TAX As Much But Less TAX As Than Is As Than Is As Than Is

15,000 27,000 15,000 15,100 387 21,000 21,100 651 27,000 27,100 1,027 15,100 15,200 391 21,100 21,200 673 27,100 27,200 1,033 15,200 15,300 396 21,200 21,300 679 27,200 27,300 1,039 15,300 15,400 400 21,300 21,400 685 27,300 27,400 1,045 15,400 15,500 404 21,400 21,500 691 27,400 27,500 1,051 15,500 15,600 409 21,500 21,600 697 27,500 27,600 1,057 15,600 15,700 413 21,600 21,700 703 27,600 27,700 1,063 15,700 15,800 418 21,700 21,800 709 27,700 27,800 1,069 15,800 15,900 422 21,800 21,900 715 27,800 27,900 1,075 15,900 16,000 426 21,900 22,000 721 27,900 28,000 1,081

16,000 28,000 16,000 16,100 431 22,000 22,100 727 28,000 28,100 1,087 16,100 16,200 435 22,100 22,200 733 28,100 28,200 1,093 16,200 16,300 440 22,200 22,300 739 28,200 28,300 1,099 16,300 16,400 444 22,300 22,400 745 28,300 28,400 1,105 16,400 16,500 448 22,400 22,500 751 28,400 28,500 1,111 16,500 16,600 453 22,500 22,600 757 28,500 28,600 1,117 16,600 16,700 457 22,600 22,700 763 28,600 28,700 1,123 16,700 16,800 462 22,700 22,800 769 28,700 28,800 1,129 16,800 16,900 466 22,800 22,900 775 28,800 28,900 1,135 16,900 17,000 470 22,900 23,000 781 28,900 29,000 1,141

17,000 29,000 17,000 17,100 475 23,000 23,100 787 29,000 29,100 1,147 17,100 17,200 479 23,100 23,200 793 29,100 29,200 1,153 17,200 17,300 484 23,200 23,300 799 29,200 29,300 1,159 17,300 17,400 488 23,300 23,400 805 29,300 29,400 1,165 17,400 17,500 492 23,400 23,500 811 29,400 29,500 1,171 17,500 17,600 497 23,500 23,600 817 29,500 29,600 1,177 17,600 17,700 501 23,600 23,700 823 29,600 29,700 1,183 17,700 17,800 506 23,700 23,800 829 29,700 29,800 1,189 17,800 17,900 510 23,800 23,900 835 29,800 29,900 1,195 17,900 18,000 514 23,900 24,000 841 29,900 30,000 1,201

18,000 30,000 18,000 18,100 519 24,000 24,100 847 30,000 30,100 1,207 18,100 18,200 523 24,100 24,200 853 30,100 30,200 1,213 18,200 18,300 528 24,200 24,300 859 30,200 30,300 1,219 18,300 18,400 532 24,300 24,400 865 30,300 30,400 1,225 18,400 18,500 536 24,400 24,500 871 30,400 30,500 1,231 18,500 18,600 541 24,500 24,600 877 30,500 30,600 1,237 18,600 18,700 545 24,600 24,700 883 30,600 30,700 1,243 18,700 18,800 550 24,700 24,800 889 30,700 30,800 1,249 18,800 18,900 554 24,800 24,900 895 30,800 30,900 1,255 18,900 19,000 558 24,900 25,000 901 30,900 31,000 1,261

19,000 31,000 19,000 19,100 563 25,000 25,100 907 31,000 31,100 1,267 19,100 19,200 567 25,100 25,200 913 31,100 31,200 1,273 19,200 19,300 572 25,200 25,300 919 31,200 31,300 1,279 19,300 19,400 576 25,300 25,400 925 31,300 31,400 1,285 19,400 19,500 580 25,400 25,500 931 31,400 31,500 1,291 19,500 19,600 585 25,500 25,600 937 31,500 31,600 1,297 19,600 19,700 589 25,600 25,700 943 31,600 31,700 1,303 19,700 19,800 594 25,700 25,800 949 31,700 31,800 1,309 19,800 19,900 598 25,800 25,900 955 31,800 31,900 1,315 19,900 20,000 602 25,900 26,000 961 31,900 32,000 1,321

20,000 32,000 20,000 20,100 607 26,000 26,100 967 32,000 32,100 1,327 20,100 20,200 611 26,100 26,200 973 32,100 32,200 1,333 20,200 20,300 616 26,200 26,300 979 32,200 32,300 1,339 20,300 20,400 620 26,300 26,400 985 32,300 32,400 1,345 20,400 20,500 624 26,400 26,500 991 32,400 32,500 1,351 20,500 20,600 629 26,500 26,600 997 32,500 32,600 1,357 20,600 20,700 633 26,600 26,700 1,003 32,600 32,700 1,363 20,700 20,800 638 26,700 26,800 1,009 32,700 32,800 1,369 20,800 20,900 642 26,800 26,900 1,015 32,800 32,900 1,375 20,900 21,000 646 26,900 27,000 1,021 32,900 33,000 1,381

(Rev 10/9/15)

Page 29

2015 Regular Tax Table

If Your Income If Your Income If Your Income is is is YOUR YOUR YOUR As Much But Less TAX As Much But Less TAX As Much But Less TAX As Than Is As Than Is As Than Is 33,000 39,000 45,000 33,000 33,100 1,387 39,000 39,100 1,784 45,000 45,100 2,204 33,100 33,200 1,393 39,100 39,200 1,791 45,100 45,200 2,211 33,200 33,300 1,399 39,200 39,300 1,798 45,200 45,300 2,218 33,300 33,400 1,405 39,300 39,400 1,805 45,300 45,400 2,225 33,400 33,500 1,411 39,400 39,500 1,812 45,400 45,500 2,232 33,500 33,600 1,417 39,500 39,600 1,819 45,500 45,600 2,239 33,600 33,700 1,423 39,600 39,700 1,826 45,600 45,700 2,246 33,700 33,800 1,429 39,700 39,800 1,833 45,700 45,800 2,253 33,800 33,900 1,435 39,800 39,900 1,840 45,800 45,900 2,260 33,900 34,000 1,441 39,900 40,000 1,847 45,900 46,000 2,267 34,000 40,000 46,000 34,000 34,100 1,447 40,000 40,100 1,854 46,000 46,100 2,274 34,100 34,200 1,453 40,100 40,200 1,861 46,100 46,200 2,281 34,200 34,300 1,459 40,200 40,300 1,868 46,200 46,300 2,288 34,300 34,400 1,465 40,300 40,400 1,875 46,300 46,400 2,295 34,400 34,500 1,471 40,400 40,500 1,882 46,400 46,500 2,302 34,500 34,600 1,477 40,500 40,600 1,889 46,500 46,600 2,309 34,600 34,700 1,483 40,600 40,700 1,896 46,600 46,700 2,316 34,700 34,800 1,489 40,700 40,800 1,903 46,700 46,800 2,323 34,800 34,900 1,495 40,800 40,900 1,910 46,800 46,900 2,330 34,900 35,000 1,501 40,900 41,000 1,917 46,900 47,000 2,337 35,000 41,000 47,000 35,000 35,100 1,507 41,000 41,100 1,924 47,000 47,100 2,344 35,100 35,200 1,513 41,100 41,200 1,931 47,100 47,200 2,351 35,200 35,300 1,519 41,200 41,300 1,938 47,200 47,300 2,358 35,300 35,400 1,525 41,300 41,400 1,945 47,300 47,400 2,365 35,400 35,500 1,532 41,400 41,500 1,952 47,400 47,500 2,372 35,500 35,600 1,539 41,500 41,600 1,959 47,500 47,600 2,379 35,600 35,700 1,546 41,600 41,700 1,966 47,600 47,700 2,386 35,700 35,800 1,553 41,700 41,800 1,973 47,700 47,800 2,393 35,800 35,900 1,560 41,800 41,900 1,980 47,800 47,900 2,400 35,900 36,000 1,567 41,900 42,000 1,987 47,900 48,000 2,407 36,000 42,000 48,000 36,000 36,100 1,574 42,000 42,100 1,994 48,000 48,100 2,414 36,100 36,200 1,581 42,100 42,200 2,001 48,100 48,200 2,421 36,200 36,300 1,588 42,200 42,300 2,008 48,200 48,300 2,428 36,300 36,400 1,595 42,300 42,400 2,015 48,300 48,400 2,435 36,400 36,500 1,602 42,400 42,500 2,022 48,400 48,500 2,442 36,500 36,600 1,609 42,500 42,600 2,029 48,500 48,600 2,449 36,600 36,700 1,616 42,600 42,700 2,036 48,600 48,700 2,456 36,700 36,800 1,623 42,700 42,800 2,043 48,700 48,800 2,463 36,800 36,900 1,630 42,800 42,900 2,050 48,800 48,900 2,470 36,900 37,000 1,637 42,900 43,000 2,057 48,900 49,000 2,477 37,000 43,000 49,000 37,000 37,100 1,644 43,000 43,100 2,064 49,000 49,100 2,484 37,100 37,200 1,651 43,100 43,200 2,071 49,100 49,200 2,491 37,200 37,300 1,658 43,200 43,300 2,078 49,200 49,300 2,498 37,300 37,400 1,665 43,300 43,400 2,085 49,300 49,400 2,505 37,400 37,500 1,672 43,400 43,500 2,092 49,400 49,500 2,512 37,500 37,600 1,679 43,500 43,600 2,099 49,500 49,600 2,519 37,600 37,700 1,686 43,600 43,700 2,106 49,600 49,700 2,526 37,700 37,800 1,693 43,700 43,800 2,113 49,700 49,800 2,533 37,800 37,900 1,700 43,800 43,900 2,120 49,800 49,900 2,540 37,900 38,000 1,707 43,900 44,000 2,127 49,900 50,000 2,547 38,000 44,000 38,000 38,100 1,714 44,000 44,100 2,134 . 38,100 38,200 1,721 44,100 44,200 2,141 PLEASE NOTE: 38,200 38,300 1,728 44,200 44,300 2,148 38,300 38,400 1,735 44,300 44,400 2,155 For $50,000 and over, 38,400 38,500 1,742 44,400 44,500 2,162 . 38,500 38,600 1,749 44,500 44,600 2,169 your tax is $2,547 + 7% of 38,600 38,700 1,756 44,600 44,700 2,176 38,700 38,800 1,763 44,700 44,800 2,183 the excess over $49,999 38,800 38,900 1,770 44,800 44,900 2,190 38,900 39,000 1,777 44,900 45,000 2,197

(Rev 10/9/15)

Page 30

ARKANSAS INDIVIDUAL INCOME TAX INDEX TO INSTRUCTIONS

2015

H Adjustments to INCOME............::ceeeeeeees 15 Head of Household.........0.0.. cece 12-13 Adoption Expense Credit. AR1000TC, 16 Alimony Paid ... AR1000ADJ I Alimony Received. Identity Theft......ccccccccccscccscsccssssscssssesesessseeeseee

Amended Returns. Amount You Owe or Refund Due

Annuities Arkansas Tax Deferred Tuition Savings Program............ AR1000-CO, 15, 17 AR1000ADJ B

Baby Sharon’s Children’s Catastrophic

Illness Program AR1000-CO, 17 Blindness - Personal Credit 13 Border City Exemption.... .AR1000ADJ, 15 Business Income and Expenses 214 Business Incentive Tax Credits... AR1000TC, 16

c

Capital Gains and Losses... Capital Gains Distributions Casualty and Theft Losses . Check Offs AR1000-CO, 6, 17 Child and Dependent Care Expense -

Credit for. Child Support - Exempt Income. Contributions - Charitabl Credits Against Tax.. AR1000TC, 13, 16 Credit for Tax Paid to Another State...AR1000TC, 16

- AR1000D, 6, 14

D Deafness - Personal Credit .............0:cccce 13 Dependent - Definition... Depletion Allowance Rates Depreciation Developmentally Disabled Individual - Credit for. Disability Income Disabled Individual Adjustment...AR1000ADJ, 15 Disaster Relief Program . . AR1000-CO, 17

Dividends. 14 Domicile - Definition. 10 E

Early Childhood Credit........0.0.00.0cceeeeeees 16

Electronic Filing . Estimated Tax.

Extension of Time to File ............ccceceseeeeeees 11 F

Farm Income and Expenses.............:::cccee 15 Filing Requirements.

Filing Status Forms (How to Obtain)... Full Year Resident - Defi

G

Gambling Gifts - Exempt Income Gifts to Charity Gross Income - Definition

Inheritances - Exempt from Tax Income - Exempt from Tax. Income to be Reported Individual Retirement Accounts: Contributions to ... Distributions from Phaseout Chart ... Interest Expense Interest Income.

Interest Income - Tax Exempt............::-0+ 11-12 Interest - Penalty on Premature Withdrawal of Savings.............2.. AR1000ADJ

Interest Paid on Student Loans ..AR1000AD4J, 20 Itemized Deductions or

Standard Deduction............... AR3, 15, 18, 19 IRA Distributions and

Fully Taxable Annuities .......0.0.0.cce 14, 16 K

Keogh Plan - Deduction for ...... AR1000ADy, 15

L

Life Insurance

Long-Term Intergenerational Trus' Lump-sum Distributions

M Mailing Information Married Persons - Filing Joint or Separate Returns Medical and Dental Expenses. Medical Savings Accounts. Mileage Allowance Rates .. Military Compensation -

Exempt Amount ...........::cceeeeeeeee 12, 13, 14 Military Personnel - Home of ReCOrd ...........cccceeeeseeeseeeeee 7, 10, 14

Minister’s Income -

N Net Operating Loss (NOL).........0.0.0ceeeee 15 Newborn Umbilical Cord Blood

Initiative Nonresident - Definition.

. AR1000-CO, 17 10

fe}

Organ Donor Awareness Education Program....

Other Gains and Losses

Other INCOME... cscseecseeeeeececeteneeeeeeeeeeeeeneneee

. AR1000-CO, 17

P

Partnerships Part-year Resident - Definition Pay by Credit Card Payments........0..:ccccceeecseeeeeeseeeneeeeeeeeeee

P (continued) Penalty: Early Withdrawal of Saving: Frivolous Return Late Filing Late Payment Pensions and Annuities . Personal Tax Credits .. Proration of Itemized Deductions Proration of Tax Liability

R Railroad Retirement Benefits Refund or Amount You Owe. Rental Income ..............0.. Request Copies of Tax Returns Retirement -

First $6,000 Exempt .........:.:::ccseeeeeeeee 12,14 Royalties .......0.ccecc cece e eee eee eeeeeeeeeeeeeeeeeeees 15

s

Sale of Home

Scholarships, Fellowships, and Grants...

School for the Blind,

Contribution t School for the Deaf,

Contribution to... AR1000-CO, 17 Self-employed Health Insurance... AR1000AD4J, 21 Set Off Refunds 65 Special Personal Credit Social Security Benefits... Standard or Itemized Deduction. Stipends. Student - Definition... Student Loan Interest .

. AR1000-CO, 17

T Tax Proration .... Tax Computation

Taxes You May Deduct.. Texarkana - Exemption.. Tuition Savings Program

sees eeeeeeeeeeeeeeeees AR1000ADJ, AR1000-CO, 15

.AR1000ADJ, 15

U

Underestimate Penalty

Unemployment Compensation ................0 12 Vv

Veterans Benefits - Exempt.............::cceeee 12 VOUCHELS.......sccecccceteeseeeeeeceseeseseeesteneeneneeeseeee 17 WwW.

Wages, Salaries, Tips. 13 When to File ..

Where to File.

Who Must File...

Widow(er), Qualifying .

Workers Compensation ............::c:cccceeeeeeee 12

Page 31

397207 PRESORTED State of Arkansas STANDARD State Income Tax US. pape P. O. Box 1000 STATE OF Little Rock, AR 72203-1000 ARKANSAS.

PLACE THE ADDRESS LABEL ABOVE ON THE FRONT OF YOUR RETURN

BEFORE YOU MAIL YOUR RETURN CHECKLIST

YOU MUST FILE BY APRIL 15, 2016

[.] 1. Is your name and address correct on the preprinted color label? If so, it should be placed on the front of your return. (Use this label even if you take your return to another person for preparation or you use software to prepare it.) If not, did you enter the name(s) and address for you and your spouse in the space provided on the front of your return?

2. Did you enter the Social Security Number(s) for you and your spouse? (You must enter the SSN(s) on the return whether you use the colored peel off label or not.)

3. Did you use the correct filing status and the correct taxable income to find your tax from the tax table?

4. Did you attach all W-2(s) and 1099 Forms?

5. Did you add and subtract correctly when calculating refund or amount owed?

. Did you sign and date your return?

7. If you are filing Form AR1000NR, did you attach a copy of your federal return?

8. Did you keep a complete copy of your return for your records? (Keep for 6 years).

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©

Have you mailed your return by APRIL 15, 2016?

PLEASE ALLOW 6 WEEKS FOR YOUR RETURN TO PROCESS.