Form A1-Qrt - Arizona Quarterly Withholding Tax Return (Page 2 of 2) in pdf

Form A1-Qrt - Arizona Quarterly Withholding Tax Return Page 2

Form A1-QRT Page 2

If this is an amended return, complete the following information:

1. Total liability for quarter from section Z on page 1 of the amended return.

2. Total liability for quarter (section Z) previously reported on Form A1-QRT.

3. If the amount on line 2 is greater than the amount on line 1, enter the difference here.

This is the amount of tax overpaid.

4. If the amount on line 1 is greater than the amount on line 2, enter the difference here.

This is the amount of tax underpaid.

NOTE: If this amended return is being filed for a quarter in a prior year, attach an amended Form A1-R and the state copies of

federal Forms W-2c for the prior year.

Explain why an amended return is being filed:

Reason for cancellation of employer's withholding account (check the applicable box):

Reorganization or change in business entity (example: from corporation to partnership)

2. Business sold

3. Business stopped paying wages and will not have any employees in the future

4. Business permanently closed

5. Business has only leased or temporary agency employees

6. Other (specify reason)

Under penalties of perjury, I declare that I have examined this return and to the best of my knowledge and belief, it is a true,

complete and correct return.

Please

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)

Sign Here

Signature

Date

Business telephone number

Paid

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)

Preparer's

Use Only

Preparer's signature

Date

Business telephone number

Firm's name (or preparer's, if self-employed)

Preparer's EIN, SSN or PTIN

Firm's address

ZIP code

ADOR 64-1061 (99)

Form A1-Qrt - Arizona Quarterly Withholding Tax Return Page 2