FORM AR-3Q-TEX

                                                  State of Arkansas

                 Annual Reconciliation of Texarkana Employee's Exempt Wages

Employer FEIN                          Account ID                           -WHW       Tax Year

Employer Name

Employer Address                                                   City          State                         Zip

Total number AR-TX forms issued for Texarkana, Arkansas residents                Exempt Wages       $
Total number AR-TX forms issued for Texarkana, Texas residents                   Exempt Wages       $

          I declare under penalties of perjury that this return has been examined by me and to the best of my knowledge 
          and belief is a true, direct, and complete return.

Signature                                                               Date     Phone

                 INSTRUCTIONS FOR EMPLOYER FOR FORMS AR-3Q-TEX AND AR-TX

FORM AR-3Q-TEX
          Enter the total amount of AR-TX forms and exempt wages for Texarkana, Arkansas and Texarkana, Texas 
          residents on the appropriate line above.

FORM AR-TX

          The employee's physical address must be entered, post office box or route numbers are not acceptable.

          Select either Texarkana, Arkansas or Texarkana, Texas resident and whether the employee is a complete year 
          resident of Texarkana.  Enter the exempt wages.

          Give the employee two copies.  Submit the State Copy of AR-TX with AR-3Q-TEX to Withholding Tax and retain 
          one copy for employer's file.

Due date for filing for AR-3Q-TEX and the State Copy of form AR-TX is February 28th of the following tax year.  Mail To:

                                                  Withholding Tax 
                                                  PO BOX 8055 
                                       Little Rock, Arkansas  72203-8055

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