Form AR4PT at a glance
What it is: This is a State of Arkansas Nonresident Member Withholding form.
Who signs: In Part E, the nonresident member signs the Signature of Nonresident Member line and enters the Date and a Daytime Telephone Number.
A filled-in Form AR4PT example: a partner asks for the exemption
How to fill out Form AR4PT, box by box
Part A: Pass-Through Entity Information
In Part A, enter the Name of Entity, FEIN, Address and City, State, Zip of the pass-through entity, and mark the Type of Pass-Through Entity: S-Corporation, Trust, Partnership or Limited Liability Co.
Part B: Nonresident Member Information
In Part B, enter the Name of Member, mark the Type, SSN or FEIN, and enter the ID, Address and City, State, Zip.
Part C: Withholding Tax Exemption
In Part C, a nonresident member of the pass-through entity requests to be exempt from Arkansas income tax withholding for a tax year and all subsequent years, until you notify the Arkansas Department of Finance and Administration of a change in this election (see Part D).
Part D: Withholding Tax Exemption Revocation
In Part D, a nonresident member of the pass-through entity revokes a previous withholding election dated, for a tax year and all subsequent years, until you notify the Arkansas Department of Finance and Administration of a change of this election.
Part E: Signature
Sources
[1] Form AR4PT, Nonresident Member Withholding Exemption Affidavit, State of Arkansas Department of Finance and Administration (the Official source link on this page).