Arizona Form 140a - Resident Personal Income Tax Return (Short Form) - 2011 Page 11
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33Form 140A
You may lose the exemption if you do not furnish this information.
1.
The name of the qualifying parent or grandparent.
2. The SSN of the qualifying parent or grandparent.
Line A2 - Total Dependents
Enter the total number of persons listed on line(s) A1. Enter
3. The qualifying parent’s or grandparent’s relationship to
you, or your spouse if filing a joint return.
the same number on the front of the return in box 10.
4. The number of months the qualifying parent or
Lines A3a and A3b - Persons You did Not
grandparent lived in your home during 2011.
Take as Dependents on Your Federal Return
You may lose the exemption if you do not furnish this
On line A3a, enter the following.
information.
1. The names of any dependents age 65 or over listed on
Line A5 - Total Qualifying Parents and
line(s) A1 that you cannot take as a dependent on your
Grandparents
federal return.
Enter the total number of persons listed on line(s) A4. Enter
the same number on the front of the return in box 11.
2. The name of any stillborn child listed on line(s) A1, if
the stillborn child was named. If the stillborn child was
Line B6 - Last Name(s) Used in Prior Years
not named, enter “stillborn child” on line A3a. Also
Use line B6 if the last name that you are using on this
enter the date of birth resulting in the stillbirth.
return is not the same as the last name you used on returns
filed for the last 4 years. On line B6, enter any other last
On line A3b, enter the name of any student listed on line(s) A1,
name(s) that you used when filing your return during the
that you did not claim as an exemption on your federal return
last 4 years.
in order to allow that student to claim a federal education credit
on the student’s federal return.
Totaling Your Income
Line 11 Box - Qualifying Parents and
Line 12 - Federal Adjusted Gross Income
Grandparents
You must complete your federal return before you enter an
amount on line 12. You must complete a 2011 federal return
A qualifying parent or grandparent may be any one of the
to figure your federal adjusted gross income. You must
following.
complete a federal return even if you do not have to file a
x
Your parent or your grandparent, great grandparent,
federal return.
great great grandparent, etc.
Arizona uses federal adjusted gross income as a starting
x
If married filing a joint return, your spouse’s parent or
point to determine Arizona taxable income. Your federal
your spouse’s grandparent.
adjusted gross income is your Arizona gross income.
You may claim this exemption if all of the following apply.
NOTE: Be sure to use your federal adjusted gross income
1. The parent or grandparent lived in your principal
and not your federal taxable income.
residence for the entire taxable year.
Exemptions
2. You paid more than one-half of the support and
maintenance costs of the parent or grandparent during
Line 13 - Age 65 or Over
the taxable year.
Multiply the number you entered in box 8 by $2,100.
3. The parent or grandparent was 65 years old or older
during 2011.
Line 14 - Blind
4. The parent or grandparent required assistance with
Multiply the number you entered in box 9 by $1,500.
activities of daily living, like getting in and out of
bed or chairs, walking around, going outdoors,
Line 15 - Dependents
using the toilet, bathing, shaving, brushing teeth,
Multiply the number you entered in box 10 by $2,300.
combing hair, dressing, medicating or feeding.
Line
16
-
Qualifying
Parents
and
You must complete Part A, lines A4 and A5, on page 2 of
Grandparents
your return before you can total your exemptions for
qualifying parents and grandparents.
Multiply the number you entered in box 11 by $10,000.
NOTE: If a person who is a qualifying parent or
Figuring Your Tax
grandparent also qualifies as your dependent, you may
claim that person as a dependent on line A2, or you may
Line 19 - Standard Deduction
claim that person as a qualifying parent or grandparent on
line A5. You may not claim that same person on both line
Your standard
A2 and line A5. Do not list the same person on line A4 that
If your filing status is:
deduction is:
you listed on line A1.
x
Single
$4,703
x
Married filing separately
$4,703
Completing Line(s) A4
x
Married filing jointly
$9,406
x
Head of household
$9,406
Enter the following on line(s) A4.
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