Form 140nr - Nonresident Personal Income Tax Return

1999

ARIZONA FORM

Nonresident Personal Income Tax Return

140NR

For the year January 1 - December 31, 1999, or other tax year beginning ____________________, 1999, and ending _________________, 2000.

Your first name and initial

Last name

Your social security number

If a joint return, spouse's first name and initial

Last name

Spouse's social security number

Present home address - number and street, rural route

Apt. No.

Daytime telephone

IMPORTANT!

You must enter

(

)

your SSN(s) above.

Home telephone

For DOR use only

City, town or post office

State

ZIP code

(

)

Married filing joint return

Head of household -

name of qualifying dependent

Married filing separate return. Enter spouse's social security number above

and full name here.

Single

Enter the number

Age 65 or over (you and/or spouse)

claimed. Do not put

4 month federal extension

Blind (you and/or spouse)

CHECK ONE if filing under a

a check mark.

6 month federal extension

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

federal extension:

Residency Status (check one) 11

Nonresident

Nonresident Active Military

Composite Return

14 Federal adjusted gross income (from your federal return) .........................................................................

15 Arizona income (from page 2, line B15) ..................................................................................................................................................

16 Additions to income (from page 2, line C19) ...........................................................................................................................................

17 Add lines 15, and 16 ...........................................................................................................................................................................................................

18 Subtractions from income (from page 2, line D30) ..................................................................................................................................

19 Elective subtraction of 1999 federal retirement contributions. See instructions ......................................................................................

20 Arizona adjusted gross income. Subtract lines 18 and 19 from line 17 ...................................................................................................

Deductions

See instructions page 11.

21 I

ITEMIZED

21 S

STANDARD ....

Check box and enter amount.

Personal exemptions. See page 11 of the instructions ...........................................................................................................................

Arizona taxable income. Subtract lines 21 and 22 from line 20 ...............................................................................................................

Compute the tax using Tax Rate Table X or Y ........................................................................................................................................

25 Tax from recapture of credits from Arizona Form 301, line 28 ................................................................................................................

26 Subtotal of tax. Add lines 24 and 25 .......................................................................................................................................................

Clean Elections Fund Tax Reduction. See instructions, page 12.

YOURSELF

SPOUSE

Tax reduction. Complete worksheet on page 13 of the instructions ......................................................................................................

Reduced tax. Subtract line 28 from line 26 ...........................................................................................................................................

30 Credits from Arizona Form 301, line 53 ..................................................................................................................................................

31 Credit type. Enter form number of each credit claimed ...............

32 Subtract line 30 from line 29. If line 30 is more than line 29, enter zero .................................................................................................

33 Clean Elections Fund Tax Credit. From worksheet on page 14 .............................................................................................................

34 Balance of tax. Subtract line 33 from line 32. If line 33 is more than line 32 enter zero .......................................................................

Arizona income tax withheld during 1999 ......................................................................................................................................... . .....

Arizona estimated tax payments for 1999 ...............................................................................................................................................

Amount paid with 1999 Arizona extension request (Form 204) ..............................................................................................................

Total payments. Add lines 35 through 37 ...............................................................................................................................................

39 TAX DUE. If line 34 is larger than line 38, enter amount of tax due. Skip lines 40, 41 and 42 ...............................................................

40 OVERPAYMENT. If line 38 is larger than line 34, enter amount of overpayment ..................................................................................

Amount of line 40 to be applied to 2000 estimated tax ...........................................................................................................................

42 Balance of overpayment. Subtract line 41 from line 40 ..........................................................................................................................

Voluntary gifts to:

Aid to Education Fund (Enter entire refund only)

Arizona Wildlife Fund

Citizens Clean Elections Fund

Child Abuse Prevention Fund

Domestic Violence Shelter Fund

Neighbors Helping Neighbors Fund

Special Olympics Fund

Political Gift

Check only one if making a political gift:

Democratic

Libertarian

Reform

Republican

Estimated payment penalty and interest ............................................................................................................................................... . .

Check applicable box(es).

Annualized/Other

Farmer or fisherman

Form 221 attached

54 MSA withdrawal penalty ..........................................................................................................................................................................

Total of lines 43, 44, 45, 46, 47, 48, 49, 50, 52 and 54 ...........................................................................................................................

REFUND. Subtract line 55 from line 42. If less than zero, enter amount owed on line 57 ......................................................................

Make Checks Payable To: Arizona Department of Revenue

57 AMOUNT OWED. Add lines 39 and 55. Include SSN on payment

ADOR 06-0080 (99)