Arizona Form 165 - Arizona Partnership Income Tax Return - 2003
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22003
ARIZONA FORM
Arizona Partnership Income Tax Return
165
CHECK ONE:
For taxable year beginning
and ending
Calendar year
Fiscal year
CHECK ONE:
Mail to: Arizona Department of Revenue, PO Box 29079, Phoenix AZ 85038-9079
Original
Amended
Federal employer ID number (FEIN)
Business telephone number
Name
Please
AZ withholding tax number
Number and street or PO Box
Type
Business activity code number
or
(from federal Form 1065)
AZ transaction privilege tax number
City, or town, state, and ZIP code
Print
FOR DOR USE ONLY
68
Check box if:
This is a fi rst return
Name change
Address change
A
DBA __________________________________________________________________
B
Will a composite return be fi led on Form 140NR?
Yes
No
C
Total number of nonresident individual partners _______________________________
D
Total number of resident individual partners __________________________________
81
66
E
Total number of entity partners (see instruction page 2) _________________________
CHECK BOX IF:
F
82
82
Federal extension used to fi le return.
F
Date business commenced
YES
NO
G Is this the partnership’s fi nal return? ...............................................................................................................................................................
H
Did you fi le 2001 and 2002 Arizona partnership returns? If no, state reason _________________________________________________
_____________________________________________________________________________________________________________
I
Have you fi led amended federal partnership returns for prior years? .............................................................................................................
If yes, list years _______________________________________________________________________________________________
J
Have you attached a copy of your federal Form 1065 and supporting schedules to this return, including Schedule(s) K-1? ........................
K
Has the Internal Revenue Service made any adjustments in any federal income tax return fi led by the partnership not previously
reported to the department? If yes, indicate year(s) _____________________________ , and submit under separate cover a copy of
the IRS report as fi nally determined................................................................................................................................................................
L
The partnership books are in care of:
located at:
____________________________________________________________________________________________________________________________________
1 Federal ordinary business and rental income - from Form 1065, Schedule K. See instructions...........................
1
00
Adjustment of
2 Additions to partnership income - from page 2, Schedule A, line A6.....................................................................
2
00
Partnership
3 Subtotal - add lines 1 and 2...................................................................................................................................
3
00
Income From
4 Subtractions from partnership income - from page 2, Schedule B, line B10 .........................................................
4
00
Federal to
5 Partnership income adjusted to Arizona basis - line 3 minus line 4.......................................................................
5
00
Arizona Basis
6 Net adjustment of partnership income from federal to Arizona basis - line 5 minus line 1 ....................................
6
00
Penalty
7 Penalty for late fi ling or incomplete fi ling ( $500.00 ).............................................................................................
7
00
Certifi cation
Penalty Code
I, the undersigned partner of the partnership for which this return is made, certify under penalty of perjury, that this return,
including the accompanying schedules and statements, has been examined by me and is to the best of my knowledge and
87
belief, a correct and complete return, made in good faith, for the taxable year stated pursuant to the income tax laws of the
State of Arizona.
Please
___________________________________________________________________________________________ ______________________________________
Partner’s signature
Date
Partner’s social security number or EIN
Sign Here
____________________________________________________________________________________________________________________________________________________
___________________________________________________________________________________________________________________________________
Paid
Preparer’s signature
Date
Preparer’s
Use Only
___________________________________________________________________________________________________________________________________
Firm’s name (or preparer’s, if self-employed)
Preparer’s TIN
___________________________________________________________________________________________________________________________________
Firm’s address
Zip code
Attach all schedules to this return including federal Form 1065 and federal Schedule(s) K-1
ADOR 91-0031 (03) (rev. 05/04)
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