Arizona Form 99t - Arizona Exempt Organization Business Income Tax Return - 2004 Page 2
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2AZ Form 99T (2004) Page 2
Schedule A - Apportionment Formula (Multistate Organizations Only)
See instruction pages 5 and 6
Limited to Unrelated Trade or Business Amounts
Column A
Column B
Column C
A1 Property Factor
Total
Total Within
Ratio Within
Value of real and tangible personal property (by averaging the value of
Within
and
Arizona
owned property at the beginning and end of the tax period; rented
Arizona
Without Arizona
A B
property at capitalized value)
Total owned and rented property .............................................................
A2 Payroll Factor
Total wages, salaries, commissions and other compensation of employees ..
A3 Sales Factor
a. Total sales and other gross receipts ........................................................
b. Double weight Arizona sales and gross receipts .....................................
X 2
c. Sales factor (for column A, multiply item a by item b; for column B,
enter amount from item a) .......................................................................
A4 Total ratio - add A1, A2 and A3(c), in column C....................................................................................................................................
A5 Average apportionment ratio - divide A4 by four (4). Enter the result in column C and on page 1, line 2..........................................
____________________________________________________________________________________________________________________________________________________
Certifi cation
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and
belief, it is a true, 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
___________________________________________________________________________________________________________________________________
Signature of offi cer
Date
Title
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
____________________________________________________________________________________________________________________________________________________
ADOR 91-0023 (04)
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