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AR4PT Nonresident Member Withholding Exemption Affidavit
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AR4PT.pdf

Form Instructions

INSTRUCTIONS: ARKANSAS NONRESIDENT MEMBER WITHHOLDING EXEMPTION AFFIDAVIT (Form AR4PT)

A nonresident member of a pass-through entity operating in Arkansas can file a form AR4PT if they do not wish to have income tax withheld from their share of distributed income. This document can be found on the website of the Arizona Department of Finance and Administration.

Arkansas Nonresident Member Withholding Exemption Affidavit AR4PT Step 1: Part A requires information about the pass-through entity. In the first box, enter its name.

Arkansas Nonresident Member Withholding Exemption Affidavit AR4PT Step 2: In the second box, enter the pass-through entity's federal employer identification number.

Arkansas Nonresident Member Withholding Exemption Affidavit AR4PT Step 3: In the third box, enter the pass-through entity's street address.

Arkansas Nonresident Member Withholding Exemption Affidavit AR4PT Step 4: In the fourth box, enter the pass-through entity's city, state and zip code.

Arkansas Nonresident Member Withholding Exemption Affidavit AR4PT Step 5: In the fifth box, indicate with a check mark whether the pass-through entity is an S-corporation, partnership, limited liability company, trust or other.

Arkansas Nonresident Member Withholding Exemption Affidavit AR4PT Step 6: Part B requires information about the nonresident member filing this affidavit. In the first box, enter your name.

Arkansas Nonresident Member Withholding Exemption Affidavit AR4PT Step 7: In the second box, enter your Social Security number or Federal Employer Identification Number.

Arkansas Nonresident Member Withholding Exemption Affidavit AR4PT Step 8: In the third box, enter your street address.

Arkansas Nonresident Member Withholding Exemption Affidavit AR4PT Step 9: In the fourth box, enter your city, state and zip code.

Arkansas Nonresident Member Withholding Exemption Affidavit AR4PT Step 10: On the first blank line of Part C, enter your name.

Arkansas Nonresident Member Withholding Exemption Affidavit AR4PT Step 11: On the second blank line, enter the tax year for which you are filing.

Arkansas Nonresident Member Withholding Exemption Affidavit AR4PT Step 12: Part D should only be completed if revoking a previous affidavit. Enter your name on the first blank line, the date of the election you are revoking on the second blank line, and the tax year for which you are filing.

Arkansas Nonresident Member Withholding Exemption Affidavit AR4PT Step 13: Sign and date your name where indicated in Part E, as well as entering your daytime telephone number, including the area code.

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