The Ar1000Dc form from Architectural Forms is a great way to add contemporary style and functionality to your home. With its sleek design and versatile use, the Ar1000Dc can be used in a variety of ways to improve your home's appearance and usability. Whether you're looking for an attractively styled room divider, a modern desk or console table, or simply want to add some extra storage space, the Ar1000Dc is sure to meet your needs. Plus, its durable construction means that it will last for years to come. So if you're searching for a stylish and functional addition to your home décor, be sure to check out the Ar1000Dc form from Architectural Forms.
| Question | Answer |
|---|---|
| Form Name | Ar1000Dc Form |
| Form Length | 1 pages |
| Fillable? | No |
| Fillable fields | 0 |
| Avg. time to fill out | 15 sec |
| Other names | impairment, AR1000DC, abnormalities, entirety |
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STATE OF ARKANSAS |
AR1000DC |
DISABLED CHILD CERTIFICATE |
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INDIVIDUAL INCOME TAX RETURN |
Name:
Social Security Number:
Child’s Name:
This certificate must be completed in its entirety to receive the $500.00 disabled child deduction. This deduction is taken in the adjustment section of your Arkansas Individual Income Tax Return. This certificate is good for one year and must be attached to your Individual Income Tax Return.
To take advantage of this deduction, the taxpayer and/or child must meet the following conditions and standards:
1.The child is the natural or adopted child of the taxpayer.
2.The taxpayer is maintaining, supporting and caring for a totally and permanently disabled child in his/her home.
3.Totally and permanently disabled means and includes any child who is unable to engage in any substantial gainful activity by reason of any medically determinable physical or mental impairment which can be expected to result in death or has lasted or can be expected to last for a continuous period of not less than twelve (12) months.
4.A physical or mental impairment is an impairment which results in the anatomical, physiological, or psychological abnormalities which are demonstrable by medically acceptable clinical or laboratory diagnostic techniques.
5.The above child has been diagnosed by a physician as totally and permanently disabled as outlined in conditions 3 and 4 listed above.
I certify that ________________________________________________________________________is a totally and permanently
disabled child based upon the above criteria.
____________________________________________________________________ |
______________________________ |
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Doctor Signature |
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Date |
____________________________________________________________________ |
______________________________ |
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Doctor’s Name (print or type) |
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Office Phone |
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Street Address |
City |
State |
Zip |
AR1000DC (R9/98)