Free Arizona 140Py Form Get Form Now

Free Arizona 140Py Form

The Arizona 140PY form is the official document used by part-year residents to file their personal income tax returns in Arizona. This form is essential for individuals who lived in the state for only part of the tax year, allowing them to report their income and calculate their tax obligations accurately. Completing the 140PY form ensures compliance with state tax laws while facilitating any potential refunds or payments owed to the Arizona Department of Revenue.

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Dos and Don'ts

When filling out the Arizona 140PY form, it's important to follow specific guidelines to ensure accuracy and compliance. Here are four key dos and don'ts to keep in mind:

  • Do check your personal information carefully. Ensure your name, Social Security number, and address are correct to avoid processing delays.
  • Do use black or blue ink only. This helps the scanning equipment read your form accurately.
  • Don't use tape or staples on the form. These can interfere with the processing of your return.
  • Don't forget to sign and date your return. An unsigned form will be considered incomplete and may delay your refund or processing.

Key takeaways

  • The Arizona 140PY form is specifically designed for part-year residents filing their personal income tax returns.

  • It is essential to indicate the tax year for which you are filing by specifying the beginning and ending dates in the designated fields.

  • Individuals should check the appropriate box if they are filing under an extension, ensuring compliance with filing deadlines.

  • Accurate entry of personal information, including names and Social Security numbers for both the taxpayer and spouse, is critical to avoid processing delays.

  • The form requires the declaration of residency status, which affects tax calculations and eligibility for certain deductions.

  • Taxpayers must calculate their Arizona taxable income by subtracting deductions and exemptions from their Arizona adjusted gross income.

  • It is necessary to include any applicable credits, such as the family income tax credit, to reduce the overall tax liability.

  • Taxpayers should ensure that the total payments and refundable credits are accurately calculated to determine any balance due or refund owed.

  • When mailing the completed form, it is important to send it to the correct address based on whether a payment is included or if expecting a refund.

Discover More on This Form

What is the Arizona 140PY form?

The Arizona 140PY form is a tax return specifically designed for individuals who are part-year residents of Arizona. This form allows taxpayers to report their income and calculate their tax liability for the portion of the year they lived in Arizona. It is used for both calendar and fiscal years.

Who should use the Arizona 140PY form?

Individuals who moved to or from Arizona during the tax year should use the Arizona 140PY form. This includes people who may have lived in another state for part of the year and earned income in Arizona during their residency. It is important to file this form if you qualify as a part-year resident.

What information is required to complete the Arizona 140PY form?

To complete the Arizona 140PY form, you will need several pieces of information, including:

  1. Your Social Security number and that of your spouse, if applicable.
  2. Your current home address.
  3. Your filing status (e.g., single, married filing jointly, married filing separately).
  4. Your federal adjusted gross income.
  5. Details about your Arizona income, including any additions or subtractions.
  6. Information about dependents and exemptions.

How do I determine my Arizona income?

Your Arizona income is calculated by taking your federal adjusted gross income and making necessary adjustments based on Arizona tax laws. This includes adding or subtracting specific amounts as outlined in the form instructions. It’s important to follow the guidance provided on the form to ensure accurate reporting.

What are the exemptions available on the Arizona 140PY form?

The Arizona 140PY form allows for several exemptions that can reduce your taxable income. These include:

  • Exemptions for age (65 or older).
  • Exemptions for blindness.
  • Exemptions for dependents.
  • Exemptions for qualifying parents and grandparents.

Each exemption has specific criteria and amounts, so it is essential to review the instructions carefully.

What should I do if I owe taxes or expect a refund?

If you owe taxes, you will need to calculate the amount due on the form and submit payment with your return. The form provides instructions on where to send your payment. If you expect a refund, you can choose to have it direct deposited into your bank account or receive a check by mail. Make sure to complete the appropriate sections of the form to indicate your preference.

Where can I find the instructions for completing the Arizona 140PY form?

The instructions for completing the Arizona 140PY form are included with the form itself. They provide detailed guidance on how to fill out each section, including what documentation you may need to support your claims. It is advisable to read through these instructions thoroughly before starting your tax return.

What happens if I file the Arizona 140PY form late?

If you file the Arizona 140PY form after the deadline, you may incur penalties and interest on any taxes owed. If you believe you will miss the deadline, you may consider filing for an extension. However, it is important to pay any estimated taxes due to avoid additional penalties.

Documents used along the form

The Arizona 140PY form is essential for part-year residents filing their personal income tax returns. Along with this form, there are several other documents that may be necessary to complete your tax filing accurately. Below is a list of commonly used forms and documents that often accompany the Arizona 140PY form.

  • Arizona Form 204: This form is used to apply for an extension of time to file your Arizona income tax return. If you need extra time beyond the regular deadline, submitting this form ensures you won’t incur penalties for late filing.
  • Arizona Form 301: This form is for claiming various tax credits. If you qualify for any credits, such as the family income tax credit or other refundable credits, you will need to complete this form and attach it to your return.
  • Arizona Form 308-I: This form is used to claim a credit for contributions made to qualifying charitable organizations. If you made donations and wish to receive a tax credit for them, this form is necessary.
  • Arizona Form 342: This form allows you to claim the credit for taxes paid to another state. If you paid taxes in another state while earning income, you can use this form to avoid double taxation.

Gathering these documents will help streamline the filing process and ensure you claim all eligible deductions and credits. If you have any questions about these forms or need assistance, it’s advisable to seek guidance to ensure accuracy in your tax return.

Document Sample

NO TAPE.

ARIZONA FORM

 

 

Part-Year Resident Personal Income Tax Return

 

 

 

 

FOR

 

 

 

140PY

 

 

 

 

 

 

 

 

 

 

 

 

 

 

CALENDAR YEAR

 

OR FISCAL YEAR BEGINNING

 

M

 

M

 

D

 

 

D

 

Y

 

Y

 

Y

 

Y

 

AND ENDING

 

M

 

M

 

D

 

D

 

Y

 

Y

 

Y

 

Y

 

.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

2012

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

82F

 

 

 

 

 

Check box 82F if filing under extension

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Your First Name and Middle Initial

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Last Name

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Enter

 

 

 

 

Your Social Security No.

 

 

 

1

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

your

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Spouse’s First Name and Middle Initial (if box 4 or 6 checked)

 

 

 

Last Name

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Spouse’s Social Security No.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

1

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

SSN(s)

.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Current Home Address - number and street, rural route

 

 

 

Apt. No.

Daytime Phone (with area code)

 

 

 

Home Phone (with area code)

 

 

 

2

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

94

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

City, Town or Post Office

 

State

Zip Code

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

3

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

4

 

 

 

Married filing joint return

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

REVENUE USE ONLY. DO NOT MARK IN THIS AREA.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

5

 

 

 

Head of household

NAME OF QUALIFYING CHILD OR DEPENDENT

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

6

 

 

 

Married filing separate return. Enter spouse’s name and Social Security No. above.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

7

 

 

 

Single

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

page 2; staplecorner.uppertoleft

 

EXEMPTIONSSTATUSFILING

 

 

 

 

 

 

 

Enter the number claimed. Do not put a check mark.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

88

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

8

 

 

 

 

Age 65 or over (you and/or spouse)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

9

 

 

 

 

Blind (you and/or spouse)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

10

 

 

 

 

Dependents. From page 2, line A2 – do not include self or spouse.

 

 

 

 

 

 

 

 

 

 

 

 

 

81

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

80

 

 

 

 

 

 

11

 

 

 

 

Qualifying parents and grandparents from page 2, line A5.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

12-13 Residency Status (check one):

12

 

 

Part-Year Resident Other than Active Military

13

 

 

 

 

 

 

 

Part-Year Resident Active Military

 

 

140PY

 

 

 

 

 

 

 

 

 

 

 

 

 

14

 

Federal adjusted gross income (from your federal return)

...............................................................

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

14

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

00

 

 

 

 

 

 

 

15

 

Arizona income (from page 2, line B19)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

15

 

 

 

 

00

Form

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

16

 

Additions to income (from page 2, line C24)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

16

 

 

 

 

00

 

17

 

Subtractions from income (from page 2, line D36)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

17

 

 

 

 

00

after

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

18

 

Arizona adjusted gross income: Add lines 15 and 16 then subtract line 17

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

18

 

 

 

 

00

documents

 

19

 

Deductions. Check box and enter amount. See instructions, page 16

19I

 

 

ITEMIZED 19S

 

 

 

STANDARD

 

19

 

 

 

 

00

 

20

 

Personal exemptions. See page 16 of the instructions

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

20

 

 

 

 

00

 

21

 

Arizona taxable income: Subtract lines 19 and 20 from line 18.

If less than zero, enter zero

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

21

 

 

 

 

00

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

00

other

 

22

 

Compute the tax using Tax Table X or Y

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

22

 

 

 

 

 

23

 

Tax from recapture of credits from Arizona Form 301, Part II, line 35

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

23

 

 

 

 

00

or

 

24

 

Subtotal of tax: Add lines 22 and 23

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

24

 

 

 

 

00

schedules

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

25

 

Family income tax credit from worksheet on pages 17 and 18 of the instructions

.............................................................

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

25

 

 

 

 

00

 

26

 

Credits from Arizona Form 301, Part II, line 68, or Forms 310, 321, 322 and 323, if Form 301 is not required

 

 

 

 

 

 

 

 

 

 

26

 

 

 

 

00

 

27

 

Credit type: Enter form number of each credit claimed

 

 

 

 

 

 

 

 

 

 

 

 

27

 

 

 

3

 

 

 

 

 

 

 

 

 

 

 

 

3

 

 

 

 

 

 

 

 

 

3

 

 

 

 

 

 

 

 

 

 

 

 

 

 

3

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

..............

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

AZ

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

28

 

Clean Elections Fund Tax Credit for donations made prior to August 2, 2012 (from worksheet on page 20 of the instructions)

 

28

 

 

 

 

00

and

 

 

 

 

 

 

 

 

29

 

Balance of tax: Subtract lines 25, 26 and 28 from line 24.

If the sum of lines 25, 26 and 28 is more than line 24, enter zero

 

 

 

 

 

 

 

 

 

 

29

 

 

 

 

00

federal

 

30

 

Arizona income tax withheld during 2012

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

30

 

 

 

 

00

 

31

 

Arizona estimated tax payments for 2012

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

31

 

 

 

 

00

required

 

32

 

2012 Arizona extension payment (Form 204)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

32

 

 

 

 

00

 

33

 

Increased Excise Tax Credit: From worksheet on page 20 of the instructions

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

33

 

 

 

 

00

 

34

 

Other refundable credits: Check the box(es) and enter the amount

 

 

341

 

Form 308-I

342

 

 

 

Form 342

 

34

 

 

 

 

00

any

 

 

 

 

 

 

 

 

 

 

 

 

 

 

35

 

Total payments/refundable credits: Add lines 30 through 34

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

35

 

 

 

 

00

Place

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

36

 

TAX DUE: If line 29 is larger than line 35, subtract line 35 from line 29, and enter amount of tax due. Skip lines 37, 38 and 39

 

 

 

 

 

 

 

 

 

 

36

 

 

 

 

00

 

37

 

OVERPAYMENT: If line 35 is larger than line 29, subtract line 29 from line 35, and enter amount of overpayment

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

37

 

 

 

 

00

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

38

 

Amount of line 37 to be applied to 2013 estimated tax

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

38

 

 

 

 

00

TAPE.

 

39

 

Balance of overpayment: Subtract line 38 from line 37

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

39

 

 

 

 

00

 

40 - 49 Voluntary Gifts to:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Aid to Education

 

 

 

 

 

 

40

 

 

 

 

 

 

 

 

 

 

 

 

 

00

Arizona Wildlife

 

 

 

 

 

 

 

 

 

 

 

 

 

 

41

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

00

 

 

 

 

 

 

 

NO

 

 

 

.................................

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Child Abuse Prevention

 

42

 

 

 

 

 

 

 

 

 

 

 

 

 

00

Domestic Violence Shelter

 

 

 

 

 

43

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

00

 

 

 

 

 

 

 

HERE.

 

 

 

I Didn’t Pay Enough Fund

 

44

 

 

 

 

 

 

 

 

 

 

 

 

 

00

National Guard Relief Fund

 

 

 

 

 

45

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

00

 

 

 

 

 

 

 

 

 

 

Neighbors Helping Neighbors

 

46

 

 

 

 

 

 

 

 

 

 

 

 

 

00

Special Olympics

 

 

 

 

 

 

 

 

 

 

 

47

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

00

 

 

 

 

 

 

 

 

 

 

 

Veterans’ Donations Fund

 

48

 

 

 

 

 

 

 

 

 

 

 

 

 

00

Political Gift

 

 

 

 

 

 

 

 

 

 

 

 

 

 

49

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

00

 

 

 

 

 

 

 

PAYMENT

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

50

 

Voluntary Political Gift (check only one):

501 Americans Elect

502

 

 

 

Democratic 503

 

Green 504 Libertarian

505

 

 

 

Republican

 

 

 

 

 

51

 

Estimated payment penalty and MSA withdrawal penalty

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

51

 

 

 

00

 

52

 

....Check applicable boxes 521

Annualized/Other

522

 

 

 

Farmer or Fisherman 523

 

 

 

Form 221 attached 524

 

MSA Penalty

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

STAPLE

 

53

 

Total of lines 40 through 49 and 51

....................................................................................................................................

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

53

 

 

 

00

 

54

 

REFUND: Subtract line 53 from line 39.

If less than zero, enter amount owed on line 55

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

54

 

 

 

00

 

 

 

 

Direct Deposit of Refund: Check box 54A if your deposit will be ultimately placed in a foreign account; see instructions

54A

 

 

 

 

 

 

 

 

 

 

 

 

 

ROUTING NUMBER

 

 

 

ACCOUNT NUMBER

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

C

 

 

Checking or

 

 

 

 

 

 

 

 

 

 

 

 

98

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

S

 

 

Savings

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

55

 

AMOUNT OWED: Add lines 36 and 53.

 

Make check payable to Arizona Department of Revenue; include SSN on payment

55

 

 

 

00

ADOR 10149 (12)

Your Name (as shown on page 1)

Your Social Security No.

 

 

A1

List children and other dependents. Do not list yourself or spouse. If more space is needed,

 

 

 

 

 

 

 

 

 

 

 

 

 

attach a separate sheet.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

NO. OF MONTHS LIVED

 

 

 

 

 

 

 

FIRST AND LAST NAME

 

 

 

 

 

 

 

 

 

 

 

SOCIAL SECURITY NO.

RELATIONSHIP

 

IN YOUR HOME IN 2012

 

 

 

 

 

DependentsA:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

b Enter dependents listed above who were not claimed on your federal return due to education credits:

 

 

 

 

 

 

 

A2

Enter total number of persons listed in A1 here and on the front of this form, box 10

 

TOTAL

 

A2

 

 

 

 

 

A3

a Enter the names of the dependents listed above who do not qualify as your dependent on your federal return:

 

 

 

 

 

 

PART

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

A4

List qualifying parents and grandparents. If more space is needed, attach a separate sheet.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

You cannot list the same person here and also on line A1. For information on who is a

 

 

 

 

 

 

 

 

 

 

 

 

qualifying parent or grandparent, see page 5 of the instructions.

 

 

 

 

 

 

 

 

NO. OF MONTHS LIVED

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

FIRST AND LAST NAME

 

 

 

 

 

 

 

 

 

 

 

SOCIAL SECURITY NO.

RELATIONSHIP

 

IN YOUR HOME IN 2012

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

A5

Enter total number of persons listed in A4 here and on the front of this form, box 11

 

TOTAL

 

A5

 

 

 

 

 

B6

Dates of Arizona residency: From

 

M

 

M

 

D

 

D

 

Y Y

 

Y Y

 

to

 

M M

 

D D

 

Y Y Y

 

Y

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

2012 FEDERAL

 

2012 ARIZONA

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Income

 

List other state(s) of residency:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Amount from Federal Return

 

Amount Only

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

B8

............................................................................................................................................Interest

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

B8

 

 

00

 

 

00

 

 

 

B7

Wages, salaries, tips, etc

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

B7

 

 

00

 

 

00

 

 

Total

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

B9

Dividends

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

B9

 

 

00

 

 

00

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

of

B10

Arizona income tax refunds

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

B10

 

 

00

 

 

00

 

 

B11

Alimony received

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

B11

 

 

00

 

 

00

 

 

Percent

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

B13

.....................................................................................Gains (or losses) from federal Schedule D

 

 

 

 

 

 

 

B13

 

 

00

 

 

00

 

 

 

B12

Business income (or loss) from federal Schedule C

 

 

 

 

 

 

 

B12

 

 

00

 

 

00

 

 

Arizona

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

B14

Rents, royalties, partnerships, estates, trusts, small business corporations from federal Schedule E.

B14

 

 

00

 

 

00

 

 

 

 

 

 

 

 

 

 

B15

Other income reported on your federal return

 

 

 

 

 

 

 

B15

 

 

00

 

 

00

 

 

B:

B16

Total income: Add lines B7 through B15

 

 

 

 

 

 

 

B16

 

 

00

 

 

00

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

00

 

 

00

 

 

PART

B17

Federal adjustments. Attach your own schedule

 

 

 

 

 

 

 

B17

 

 

 

 

 

 

B18

Federal adjusted gross income: Subtract line B17 from line B16 in the FEDERAL column

 

B18

 

 

00

 

 

 

 

 

 

B19

Arizona income: Subtract line B17 from line B16 in the ARIZONA column. Enter here and on the front of this form, line 15

 

B19

 

00

 

 

 

B20

Arizona percentage: Divide line B19 by line B18, and enter the result (not over 100%)

 

 

 

 

B20

%

 

PARTC: Additions

C21

I.R.C. §179 expense in excess of allowable amount. Also see the instructions for line D34

 

 

 

 

C21

 

00

 

C22

Total depreciation included in Arizona gross income

 

 

 

 

 

 

 

 

 

 

 

 

C22

 

00

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

C23

Other additions to income: See instructions and attach your own schedule

 

 

 

 

 

 

 

 

 

 

 

C23

 

00

 

 

 

C24

Total: Add lines C21 through C23.

 

Enter here and on the front of this form on line 16

..................................................................

 

 

 

 

 

 

 

 

 

 

C24

 

00

 

 

Income

D25

Exemption: Age 65 or over. Multiply the number in box 8, page 1, by $2,100

 

 

 

 

 

 

 

D25

 

 

00

 

 

 

 

 

D27

.........................................Exemption: Dependents. Multiply the number in box 10, page 1, by $2,300

 

 

 

 

 

 

 

D27

 

 

00

 

 

 

 

 

 

D26

Exemption: Blind. Multiply the number in box 9, page 1, by $1,500

 

 

 

 

 

 

 

D26

 

 

00

 

 

 

 

 

from

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

D28

Exemption: Qualifying parents and grandparents. Multiply the number in box 11, page 1, by $10,000 .

 

D28

 

 

00

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Subtractions

D29

Total exemptions: Add lines D25 through D28

 

 

 

 

 

 

 

D29

 

 

00

 

 

 

 

 

D30

Multiply line D29 by the percentage on line B20, and enter the result

 

 

 

 

 

 

 

 

 

 

 

 

D30

 

00

 

 

D31

Interest on U.S. obligations such as U.S. savings bonds and treasury bills included in the ARIZONA column

 

D31

 

00

 

 

D32

Arizona state lottery winnings included on line B15 in the ARIZONA column (up to $5,000 only)

 

 

 

 

D32

 

00

 

D:

D33

U.S. Social Security or Railroad Retirement Act benefits included in your ARIZONA income

 

 

 

 

D33

 

00

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

D34

Adjustment for I.R.C. §179 expense not allowed

 

 

 

 

 

 

 

 

 

 

 

 

D34

 

00

 

PART

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

D35

Other subtractions from income: See instructions and attach your own schedule

 

 

 

 

 

 

 

 

 

 

 

 

D35

 

00

 

 

D36

Total: Add lines D30 through D35.

 

Enter here and on the front of this form, line 17

 

 

 

 

 

 

 

 

 

 

 

D36

 

00

E37 Last name(s) used in prior years if different from name(s) used in current year:

HERE

 

I have read this return and any attachments with it. Under penalties of perjury, I declare that to the best of my knowledge and belief, they are

 

 

true, correct and complete. Declaration of preparer (other than taxpayer) is based on all information of which preparer has any knowledge.

 

 

 

 

SIGN

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

YOUR SIGNATURE

 

 

 

 

 

DATE

 

OCCUPATION

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

SPOUSE’S SIGNATURE

 

 

 

 

 

DATE

 

SPOUSE’S OCCUPATION

 

 

PLEASE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

PAID PREPARER’S SIGNATURE

 

DATE

 

FIRM’S NAME (PREPARER’S IF SELF-EMPLOYED)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(

)

 

 

 

PAID PREPARER’S TIN

 

PAID PREPARER’S ADDRESS

 

 

 

 

 

PAID PREPARER’S PHONE NO.

 

If you are sending a payment with this return, mail to Arizona Department of Revenue, PO Box 52016, Phoenix, AZ, 85072-2016.

If you are expecting a refund or owe no tax, or owe tax but are not sending a payment, mail to Arizona Department of Revenue, PO Box 52138, Phoenix, AZ, 85072-2138.

ADOR 10149 (12)

AZ Form 140PY (2012)

Page 2 of 2

Guidelines on How to Fill Out Arizona 140Py

Completing the Arizona 140Py form requires careful attention to detail. This form is essential for part-year residents to report their income and determine their tax obligations. Follow these steps to ensure accurate completion of the form.

  1. Start by indicating the calendar or fiscal year for which you are filing at the top of the form.
  2. If applicable, check the box for filing under an extension.
  3. Fill in your first name, middle initial, last name, and Social Security number.
  4. If you are married and filing jointly, enter your spouse's name and Social Security number.
  5. Provide your current home address, including the city, state, and zip code.
  6. Indicate your filing status by checking the appropriate box: married filing jointly, head of household, married filing separately, or single.
  7. List your exemptions, including age, blindness, and dependents, by entering the number claimed in the designated boxes.
  8. Select your residency status as either part-year resident other than active military or part-year resident active military.
  9. Report your federal adjusted gross income as shown on your federal return.
  10. Enter your Arizona income, additions to income, and subtractions from income as directed.
  11. Calculate your Arizona adjusted gross income by adding your Arizona income and additions, then subtracting the subtractions.
  12. Indicate whether you are taking itemized deductions or the standard deduction, and enter the amount.
  13. Calculate your Arizona taxable income by subtracting your deductions and personal exemptions from your adjusted gross income.
  14. Compute your tax using the provided tax tables and record the subtotal of tax.
  15. Claim any applicable credits and enter them in the designated lines.
  16. Determine your balance of tax due or any overpayment by following the instructions on the form.
  17. If applicable, provide details for voluntary gifts, penalties, and any other relevant information.
  18. Finally, sign and date the form, ensuring all information is complete and accurate.

Once you have completed the form, review it carefully for any errors. If you are expecting a refund or do not owe any tax, mail the form to the appropriate address for refunds. If you owe tax, include your payment and send it to the designated address for payments. Ensure that you keep a copy of the completed form for your records.

Common mistakes

Completing the Arizona 140PY form can be a straightforward process, but many individuals make common mistakes that can lead to delays or complications. One frequent error occurs when individuals fail to accurately report their residency dates. The form requires specific dates indicating the start and end of Arizona residency. Inaccurate dates can result in incorrect tax calculations and potential penalties.

Another mistake is related to the exemptions section. Some filers mistakenly check boxes instead of entering the correct number of exemptions. The instructions clearly state that individuals should enter the number of exemptions claimed without marking a check. This oversight can lead to discrepancies in tax calculations and may affect eligibility for certain deductions.

Additionally, many people overlook the importance of including all sources of income. The form requires a comprehensive listing of income from various sources, including wages, dividends, and business income. Failing to report all income can result in an underreporting of tax liability, which may trigger audits or penalties from the Arizona Department of Revenue.

Finally, individuals often forget to sign the form before submission. A missing signature can delay processing and may require additional correspondence with the tax authority. Ensuring that all required signatures are present is essential for a smooth filing process.