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AR1000-OD                                                                                                                                                2008
                                                                                2008A1

                                                      ARKANSAS INDIVIDUAL INCOME TAX
                                                    ORGAN DONOR DEDUCTION                                                       CLICK HERE TO CLEAR FORM

 Taxpayer’s Name:                                                                                                 Taxpayer’s Social Security Number:


 Donor’s Name: (If different than taxpayer’s)                                                                     Donor’s Relationship to Taxpayer:




 Act 668 of 2005 established a deduction of up to $10,000 for unreimbursed expenses related to the
 donation of an organ (part of a liver, pancreas, kidney, intestine, lung, or bone marrow) to another human
 being. The expenses must have been incurred by the taxpayer or one of his/her dependents, and the
 deduction must be claimed for the taxable year in which the transplantation of the
 organ occurred. Allowable expenses include travel, lodging, medical expenses, and lost wages that
 were related to the organ donation. An individual may claim the deduction only once in his/her lifetime.
 This deduction does not apply to organs harvested from a deceased donor.


 1. Enter total medical expenses incurred in 2008 related to the donation of an organ (part of a liver,
                                                                                                                                                                00
    pancreas, kidney, intestine, lung, or bone marrow) to another human being:..........................................1

                                                                                                                                                                00
 2. Enter total travel expense incurred: .........................................................................................................2

                                                                                                                                                                00
 3. Enter total lodging expense incurred:.......................................................................................................3

                                                                                                                                                                00
 4. Enter total lost wages incurred: ................................................................................................................4

                                                                                                                                                                00
 5. Total expenses: (Add lines 1 through 4) ...................................................................................................5

                                                                                                                                                         $10,000 00
 6. Maximum allowable deduction: ................................................................................................................6

                                                                                                                                                                00
 7. Deduction: (Enter the smaller of Lines 5 or 6 here and on Line 12, AR1000ADJ) ...................................7

    PLEASE SIGN: Under penalties of perjury, I declare that the above information is true, correct
    and complete.




                               Taxpayer                                                         Date

AR1000-OD (Rev 8/4/08)

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  • 1. AR1000-OD 2008 2008A1 ARKANSAS INDIVIDUAL INCOME TAX ORGAN DONOR DEDUCTION CLICK HERE TO CLEAR FORM Taxpayer’s Name: Taxpayer’s Social Security Number: Donor’s Name: (If different than taxpayer’s) Donor’s Relationship to Taxpayer: Act 668 of 2005 established a deduction of up to $10,000 for unreimbursed expenses related to the donation of an organ (part of a liver, pancreas, kidney, intestine, lung, or bone marrow) to another human being. The expenses must have been incurred by the taxpayer or one of his/her dependents, and the deduction must be claimed for the taxable year in which the transplantation of the organ occurred. Allowable expenses include travel, lodging, medical expenses, and lost wages that were related to the organ donation. An individual may claim the deduction only once in his/her lifetime. This deduction does not apply to organs harvested from a deceased donor. 1. Enter total medical expenses incurred in 2008 related to the donation of an organ (part of a liver, 00 pancreas, kidney, intestine, lung, or bone marrow) to another human being:..........................................1 00 2. Enter total travel expense incurred: .........................................................................................................2 00 3. Enter total lodging expense incurred:.......................................................................................................3 00 4. Enter total lost wages incurred: ................................................................................................................4 00 5. Total expenses: (Add lines 1 through 4) ...................................................................................................5 $10,000 00 6. Maximum allowable deduction: ................................................................................................................6 00 7. Deduction: (Enter the smaller of Lines 5 or 6 here and on Line 12, AR1000ADJ) ...................................7 PLEASE SIGN: Under penalties of perjury, I declare that the above information is true, correct and complete. Taxpayer Date AR1000-OD (Rev 8/4/08)