$ 18 999 00
$ 19 000 00
$ 19 999 00
$ 39 00
$ 4 299 00
$ 4 300 00
$ 4 999 00
$ 576 00
% OF THE
(: 1) Unchecked
(: 1) Unchecked
(: 1) Unchecked
(: 2) Unchecked
(: 2) Unchecked
(: 2) Unchecked
(501) 682 1100
(c)a participant in the plan for at least 5 years before the year of the distribution? 4
(Clear Form of all entries) CLICK HERE TO CLEAR FORM
(However
(TD 1)
(TD 15)
(TD 16)
(TD 17)
(TD 18)
(TD 19)
(TD 2)
(TD 20)
(TD 21)
(TD 22)
(TD 23)
(TD 24)
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(TD 32)
1 026 00
1 086 00
1 146 00
1 206 00
1 266 00
1 326 00
1 386 00
1 446 00
1 506 00
1 512 00
1 Income from Form 1099 R Box 2a: (Enter on this line instead of on AR1000F/AR1000NR) 1
1 Wasthisadistributionofaplanparticipant sentirebalancefromallofanemployer squalifiedplansofonekind(pension profit sharing or stock bonus)? If No do not use this form 1
10 000 00
10 999 00
10 Tax on the amount on Line 9: (Use tax rate schedule on reverse side) 10
10) A lump sum credit or payment from the Federal Civil Service Retirement
106 00
11 000 00
11 999 00
11 Multiply Line 10 by ten (10) If Line 2 is zero skip Lines 12 through 17 and enter on Line 18: 11
11) A distribution from a tax sheltered annuity
12 000 00
12 599 00
12 600 00
12 999 00
12 Divide Line 2 by Line 3: (Carry to four places to the right of the decimal) 12
13 000 00
13 999 00
13 Multiply Line 7 by Line 12: 13
13) A distribution from a privately purchased commercial annuity
131 00
14 000 00
14 999 00
14 Subtract Line 13 from Line 2: 14
14) A distribution from a Section 457 deferred compensation plan of a state
141 00
15 000 00
15 999 00
15 Multiply Line 14 by 10% ( 10): 15
16 000 00
16 999 00
16 Tax on amount on Line 15: (Use tax rate schedule on reverse side) 16
162 00
17 000 00
17 999 00
17 Multiply Line 16 by ten (10): 17
18 000 00
18 999 00
18 Subtract Line 17 from Line 11: (Enter this amount on Line 29 of Form AR1000F/AR1000NR) 18
19 999 00
197 00
2 Current actuarial value of annuity from Form 1099 R Box 8: (If none enter 0 ) 2
2 Did you roll over any part of the distribution? If Yes do not use this form 2
2 Enter that amount on Line 1 of AR1000TD in Part ll
20 000 00
20 999 00
21 000 00
21 999 00
22 000 00
22 999 00
23 000 00
23 999 00
232 00
24 000 00
24 999 00
25 000 00
25 999 00
26 000 00
26 999 00
267 00
27 000 00
27 999 00
28 000 00
28 999 00
288 00
29 000 00
29 999 00
3 Complete as instructed on the form
3 Total taxable amount: (Add Lines 1 and 2 If total is $70 000 or more skip Lines 4 through 7 and enter amount on Line 8) 3
3 Was this distribution paid to you as a beneficiary of a plan participant who was born before January 2 1936? 3
30 000 00
30 999 00
306 00
31 000 00
31 999 00
32 000 00
32 999 00
33 000 00
33 999 00
34 000 00
34 999 00
35 000 00
35 099 00
35 100 00
351 00
396 00
4 999 00
4 Multiply Line 3 by 50% ( 50); but do not enter more than $10 000: 4
4 Were you (a) a plan participant who received this distribution (b) born before January 2 1936 and
4) The current actuarial value of an annuity contract included in a lump sum
441 00
486 00
5 000 00
5 999 00
5 Subtract $20 000 from Line 3 and enter the difference
531 00
56 00
5a Did you use Form AR1000TD for a previous distribution from your own plan? If Yes do not use this form 5A
5b Ifyouarereceivingthisdistributionasabeneficiaryofaplanparticipantwhodied wastheAR1000TDusedforaprevious distribution received for that plan participant? If Yes do not use this form 5B
6 000 00
6 999 00
6 Multiply Line 5 by 20% ( 20): 6
6) A distribution from an IRA
621 00
666 00
7 000 00
7 999 00
7 Minimum distribution allowance: (Subtract Line 6 from Line 4) 7
7) A distribution of the redemption proceeds of bonds rolled over tax free
726 00
786 00
8 000 00
8 399 00
8 400 00
8 999 00
8 Subtract Line 7 from Line 3: 8
8) if applicable
81 00
846 00
9 000 00
9 999 00
9 Multiply Line 8 by 10% ( 10): 9
9) A corrective distribution of excess deferrals excess contributions excess
906 00
966 00
A distribution of your deductible voluntary employee contributions and any
a) Was made by the employee in a tax year beginning after 1981
After you have completed Part l of this form and determined that you qualify
aggregate contributions or excess annual additions
and over
another
AR1000F/AR1000NR With this method the lump sum is taxed as if you
AR1000TD
AR1000TD
AR1000TD (R 2/3/14)
AR1000TD 2014
AR1000TD Instr (R 10/23/14)
ARKANSAS INDIVIDUAL INCOME TAX
Attach to AR1000F/AR1000NR See Instructions on Reverse Side
averaging
b) Was not designated by the employee as nondeductible and
because
before
benefits
BUT NOT
c) Was not mandatory
complete
Complete Part I above to see if you qualify for 10 year averaging before completing Part II
complete Part II to determine the amount of tax to include on Line 29 of Form
contact
contribution is a contribution that:
determine
different
distribution
distribution
distribution
distribution
distribution
distribution
distributions
Distributions that do not qualify:
during
election Combine the tax on Line 29 of Form AR1000F/AR1000NR
employee
employer
estate If you do not use the ten year averaging method report the lumpsum
exceeds
EXCESS OVER:
figure
figure
filed
filing
first
follows:
for any year after 1982 and before 1989 and used Form AR1000TD for
formula
General
government
If result is zero or less enter 0 : 5
If you answered No to both questions 3 and 4 do not use this form
If you make an election this year you cannot make an election another year with
If you received another lump sum distribution or an annuity contract distribution
IF YOUR NET
If your NET TAXABLE INCOME is less than $4 300 your tax is nine tenths of one percent ( 9%) of your net taxable income [Example: If your net
Income
INCOME IS:
income part of the distribution under the 10 year tax option method )
Individual
Instructions
joint
lump sum
LUMP SUM DISTRIBUTION AVERAGING
lumpsum
method
method
MORE THAN:
Multiply your percentage of the total distribution by the total amount
Name Social Security Number
net earnings on these contributions A deductible voluntary employee
not use AR1000TD if the distribution was passed through an
NOYES
of distribution shown in Boxes 1 2a 3 and 8 of the Form 1099 R
of your distribution The amounts to use in completing AR1000TD are the
Office
on Line 16 of Form AR1000F/AR1000NR
on Line 18 of Part ll
on the lump sum distributions for the previous years from the amount of tax
on the total amount
or local government or a tax exempt organization
ordinary
original or amended return You have three (3) years from the due date of
Other Information
owner
PART I Complete this part to see if you qualify to use the AR1000TD
PART II 10 YEAR AVERAGING
participant
participant in the plan unless it was made because the employee died
penalty
plan that allows such contributions
provided
purchase
qualified
qualified
qualified
qualified
qualifies
questions
received
recipients
respect to another lump sum distribution
retirement
return
return
rolled
shared
spouse
spouse s
subject
surviving spouse previously received an eligible rollover distribution from
System (or the Federal Employees Retirement System)
TAX IS:
tax on AR1000TD for the combined distributions Subtract the tax you paid
TAX RATE SCHEDULE
TAXABLE
taxable annuity (Box 2a) and the current actuarial value of the annuity (Box
taxable income is $2 750 your tax is nine tenths of one percent ( 9%) of that amount ($25) ]
The Form 1099 R provided to you by the payer reports the different parts
the same plan (or another plan of the employer required to be combined
those
together
tribution
trusts
U S Retirement Plan Bonds distributed as a lump sum
under
value
were to receive it in equal amounts over the next ten years You should
with that plan for the lump sum distribution rules) and the previous dis
years