Form 140x - Individual Amended Income Tax Return

Individual Amended Income Tax Return

2001

ARIZONA FORM

140X

For calendar year

, or ﬁ scal year beginning

, and ending

YYYY

M M

D D

Y Y Y Y

M M

D D

Y Y Y Y

Your ﬁ rst name and initial

Last name

Your Social Security Number

If a joint return, spouse’s ﬁ rst name and initial

Last name

Spouse’s Social Security Number

Present home address - number and street, rural route, apt. no.

Daytime phone: (

)

IMPORTANT

You must enter your SSNs.

Home phone: (

)

City, town or post ofﬁ ce

State

Zip Code

FOR DOR USE ONLY

Original

This

Check box to indicate both ﬁ ling and residency status:

Return Return

4 Married ﬁ ling joint return .........................................................................

5 Head of household:

_____________

name of qualifying child or dependent

6 Married ﬁ ling separate return. Enter spouse’s Social Security Number

above and full name here.

________________________________

►

7 Single......................................................................................................

8 Resident..................................................................................................

9 Nonresident ............................................................................................

Original Form Filed: (Check only one)

10 Part-year resident ................................................................................... 10

1 Form 140.................................................................. 1

11 Part-year resident active military ............................................................ 11

2 Form 140A ............................................................... 2

12 Nonresident active military...................................................................... 12

3 Form 140EZ ............................................................. 3

13 Age 65 or over: Enter the number claimed. ........................................... 13

4 Form 140NR............................................................. 4

14 Blind: Enter the number claimed............................................................ 14

5 Form 140PY ............................................................. 5

If 140NR or 140PY, enter corrected percentage of

15 Dependents: Enter the number claimed. ............................................... 15

Arizona residency...............................

16 Qualifying parents or ancestors: Enter the number claimed.................. 16

IMPORTANT: You must enter an amount in columns (a), (b), and (c) for lines 17 through

ORIGINAL AMOUNT

AMOUNT TO BE ADDED

CORRECTED

REPORTED

OR SUBTRACTED

AMOUNT

24, lines 26, 30, 31, 34, and lines 36 through 39.

(a)

(b)

(c)

17. Federal adjusted gross income/Arizona gross income ....................................................

00 17

18. Additions to income .........................................................................................................

00 18

19. Subtotal: Add line 17 and line 18 ....................................................................................

00 19

20. Subtractions from income ................................................................................................

00 20

21. Arizona adjusted gross income. Subtract line 20 from line 19........................................

00 21

22. Deductions (itemized or standard)...................................................................................

00 22

23. Personal exemptions .......................................................................................................

00 23

24. Arizona taxable income. Subtract lines 22 and 23 from line 21......................................

00 24

25 Tax from tax rate table:

Table X or Y (140, 140NR or 140PY)

Optional Table (140, 140A or 140EZ).................................. 25

26. Tax from recapture of credits from Arizona Form 301, Part II ..........................................

00 26

27 Subtotal of tax. Add lines 25 and 26, column (c). ................................................................................................................................ 27

28. Clean Elections Fund Tax Reduction claimed on original return

(1998, 1999, 2000 or 2001)

29 Reduced tax. Subtract line 28 from line 27, column (c). ...................................................................................................................... 29

30. Family income tax credit .................................................................................................

00 30

31. Credits from Arizona Form 301 or Forms 310, 321, 322 or 323 ......................................

00 31

32 Credit type: Enter form number of each credit claimed:

33 Subtract lines 30 and 31 from line 29 ................................................................................................................................................... 33

34. Clean Elections Fund Tax Credit. See instructions.........................................................

00 34

35 Balance of tax. Subtract line 34 from line 33. If line 34 is more than line 33, enter zero. ................................................................... 35

36. Payments (withholding, estimated, or extension) ............................................................

00 36

37. Increased Excise Tax Credit ............................................................................................

00 37

38. Property Tax Credit ..........................................................................................................

00 38

39 Other refundable credits. Check box(es) and enter amount(s):

313

326

327

329

330

00 39

40. Payment with original return plus all payments after it was ﬁ led .......................................................................................................... 40

41 Total payments and refundable credits. Add lines 36 through 40, column (c). .................................................................................... 41

42 Overpayment from original return or as later adjusted. See instructions............................................................................................. 42

43 Balance of credits: Subtract line 42 from line 41 ................................................................................................................................. 43

44 REFUND/CREDIT DUE: If line 35 is less than line 43, subtract line 35 from line 43, and enter amount of refund/credit. .................. 44

45 Amount of line 44 to be applied to 2002 estimated tax. If zero, enter “0” ............................................................................................ 45

46 AMOUNT OWED: If line 35 is more than line 43, subtract line 43 from line 35, and enter the amount owed..................................... 46

47 Is this amended return the result of a net operating loss? If “yes”, check the box:

YES

DOR USE ONLY

ADOR 91-0018 (01) slw