Schedule AR1000ADJ — Individual Adjustments Schedule Instructions

# INSTR

INSTRUCTIONS FOR FORM AR1000ADJ LINE 1 LINE 4 To claim the Texarkana exemption you must file a return and report all Contribution to an Archer Medical Savings Account MSA  An MSA is Arkansas income you received during the year Attach ARTX Form a trust or custodial account that is created or organized exclusively for (AR-TX Form is supplied by your employer.) 7KH$57;)RUPLVQRW the purpose of paying the qualified medical expenses of the taxpayer required for nonwage income such as interest dividends Schedule C

account holder and the taxpayer¶s spouse andor dependents To Schedule F Schedule E or retirement Additional information may be be eligible a taxpayer must have had insurance coverage under a required if an adjustment for these types of income is claimed High Deductible Health Plan HDHP only klqbW Taxpayers who claim this exemption must file using their A HDHP will have the following deductions and limitations

 for self street address in Texarkana Arkansas or Texarkana Texas Physical only coverage the minimum deductible is  maximum deductible is  and the maximum out of pocket expense is  and address must be entered on your return

 for family coverage the minimum deductible is  maximum deductible is  and the maximum out of pocket expense is If you lived within the city limits of Texarkana Arkansas you are allowed  The contribution limitation for any month is the amount a full exemption from Arkansas income tax Part year Texarkana equal to  of  of the annual deductible for an individual with residents claim the exemption only on income earned while a resident selfonly coverage and  of  of the annual deductible for family of Texarkana Arkansas coverage New Archer MSAs may not be established after  but If you lived in the city limits of Texarkana Texas you may deduct the contributions can be made to existing accounts income you earned in the city limits of Texarkana Arkansas All other Arkansas income is taxable to you LINE 5 LINE 2 Contribution to a Health Savings Account HSA  To be eligible a taxpayer must have had insurance coverage under a HDHP only A If you made contributions to a tuition savings account established HDHP will have the following deductions and limitations

 for self under the Arkansas Tax Deferred Tuition Savings Program enter the only coverage the minimum deductible is  and the maximum amount here The deductible contribution cannot exceed  per out of pocket expense is  and  for family coverage the taxpayer If you contribute more than  in a tax year you can carry minimum deductible is  and the maximum out of pocket expense forward the amount over  to the next  succeeding tax years is  You can make pretax contributions of up to  each The deductible contributions for a tax deferred tuition savings program year  for families to cover health care costs Individuals who established by another state that is rolledover into an Arkansas Tax reached age  by the end of the tax year can increase their annual Deferred Tuition Savings program shall not exceed  per taxpayer contribution by  for  Maximum contributions allowed to in the tax year in which it was rolled provided that the rolledover an HSA are reduced by any contributions made to an Archer MSA amount was not previously deducted in computing Arkansas taxable Attach federal Form   income in a prior year LINE 6 For Tuition Savings Programs established in other states a deduction of up to  is allowed if the amount is not deducted on the other You may take an adjustment for interest paid on student loans if all state¶s income taxes Qualified withdrawals from a tuition savings account of the following apply

established under the Arkansas Tax Deferred Tuition Savings Program or a taxdeferred tuition savings program established by another state  You paid interest in  on a qualified student loan will be exempt from Arkansas income tax with respect to the designated  Your filing status is any status other than married filing beneficiary¶s income

separately on diႇerent returns status    Your AGI is less than  if filing status   or 

LINE 3  if filing status  or  Status  filers note that Contribution to a Traditional Individual Retirement Account IRA  If this is a combined income amount you contributed to your own IRA certain limitations may apply to the  You are not claimed as a dependent on another taxpayer¶s amount you may use as an adjustment to income If neither you nor WD[UHWXUQ your spouse was covered by an employer provided retirement plan the entire contribution is deductible up to  each for all filing Figure your allowable deduction using the worksheet on page  of statuses If either you or your spouse was covered by such a plan WKHERRNOHWDo not enter more than $2,500 on$5$'- the amount of the deduction depends on the amount of your Adjusted Gross Income AGI before the IRA deduction as shown in the table LINE 7 .- page  of the booklet Use this table along with your Arkansas Contributions made to a longterm intergenerational trust This is a AGI to determine your allowable deduction Individuals who turned  trust established for an individual under age  to provide funds for before the close of the tax year may increase the maximum permitted the minor¶s retirement The trustee must be a resident of Arkansas annual contribution by up to  and cannot distribute any of the trust funds to the beneficiary until 3'$ beneficiary reaches age  Contributions are limited to  SHU\HDU ARADJ Inst Page  R 

INSTR INSTRUCTIONS FOR FORM AR1000ADJ (cont.) LINE 8 LINE 16 Employees and selfemployed persons can deduct certain moving expenses incurred in  If you have reforestation deductions enter the total amount You can take this deduction if you moved for your job or business LINE 17 and added at least fifty  miles to the distance from your old home to your old workplace If you had no former workplace your new If you are a teacher and have unreimbursed expenses for your workplace must be at least  miles from your old home Attach a classroom you may be able to claim an adjustment to your total income completed copy of Form AR 

For more details see Form ARCE If you qualify complete and attach Form ARCE for each taxpayer claiming an adjustment If you were reimbursed for any moving expenses and the amount was included on your W report this amount as income on Form LINE 18 ARFARNR line  ABLE Contributions If you made contributions to a disability savings LINE 9 account established under the Achieving A Better Life Experience Program ABLE enter here The deductible contribution cannot exceed If you were selfemployed and had a net profit for  you more than  per taxpayer in a tax year If you contribute more may be able to deduct part of the amount paid for health than  in a tax year you can carry forward the amount over insurance for yourself your spouse andor dependents  to the next  succeeding tax years Complete the worksheet on page  of the booklet to determine your deduction LINE 19 LINE 10 Total Adjustments Add lines  through  and enter on this line and on Forms ARF or ARNR line  If you were selfemployed and contributed to a ³Keogh´ HR  retirement plan or a SIMPLE plan enter the total contributions The amount of the deduction depends upon the type of plan For a detailed breakdown of the deduction limits please consult IRS Publication  LINE 11 Enter the total penalties paid for early withdrawal of certificates of GHSRVLW 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 disabilities who qualifies you can take an adjustment from income of  for each individual with disabilities Attach a Form ARDC for each individual LINE 14 If you paid unreimbursed expenses for yourself or one of your dependents related to the donation of an organ you may take a tax deduction up to  The deduction does not apply to organs harvested from a deceased donor For more details see Form AROD If you qualify complete and attach Form AROD LINE 15 If you have military reserve expenses enter the total amount ARADJ Inst Page  R