Arizona Form 99t - Arizona Exempt Organization Business Income Tax Return

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ARIZONA FORM

2012

Arizona Exempt Organization Business Income Tax Return

99T

For the

calendar year 2012 or

ﬁ scal year beginning

and ending

M M D D Y Y Y Y

CHECK ONE:

Name

Employer identification number (EIN)

Please

Original

Amended

Type

Number and street or PO Box

Business telephone number

AZ transaction privilege tax number

(with area code)

City or town, state and ZIP code

CHECK BOX IF:

68 Check box if:

Return filed under extension.

This is a first return

Name change

Address change

REVENUE USE ONLY. DO NOT MARK IN THIS AREA.

M M D D Y Y Y Y

Date Arizona operations began:

Nature of unrelated trade or business activities:

Unrelated business activity codes:

Arizona apportionment: (check only one) Multistate organizations only.

AIR Carrier

STANDARD Sales Factor

ENHANCED Sales Factor

Did you file an Arizona Form 99?

Yes

Check federal form filed:

990-T

Other (specify)

Attach a copy of the organization’s federal return.

Arizona Unrelated Trade or Business Taxable Income Computation

1 Unrelated trade or business taxable income - from federal Form 990-T ........................................................................

•

2 Apportionment ratio. Multistate organizations only - see instructions ......................

3 Taxable income attributable to Arizona - line 1 multiplied by line 2 (or enter amount from line 1, if 100% Arizona) .......

Arizona Tax Liability Computation

4 Enter tax. Tax is 6.968 percent of line 3, or $50, whichever is greater ....................................................................

5 Clean Elections Fund Tax Credit. SEE INSTRUCTIONS BEFORE COMPLETING THIS LINE .....................................

6 Tax liability after Clean Elections Fund tax credit - subtract line 5 from line 4 ................................................................

Tax Payments

7 Extension payment made with Arizona Form 120EXT or online ........................................

8 Estimated tax payments ....................................................................................................

9 Payment made with original return plus all payments made after it was filed -

see instructions ..................................................................................................................

10 Subtotal payments - add lines 7 through 9 ........................................................................

11 Overpayments of tax from original return or later adjustments - see instructions ..............

12 Total Payments - subtract line 11 from line 10 ................................................................................................................

Computation of Total Due or Overpayment

13 Balance of tax due - If line 6 is larger than line 12, enter balance of tax due. Skip line 14 .............................................

14 Overpayment of tax - If line 12 is larger than line 6, enter overpayment of tax ..............................................................

15 Penalty and interest ........................................................................................................................................................

16 Estimated tax underpayment penalty. If Form 220 is attached, check box .....................................................16A

17 TOTAL AMOUNT DUE - Add lines 13, 15, and 16. If money is due, payment must accompany return ........................

18 OVERPAYMENT - see instructions ................................................................................................................................

19 Amount of line 18 to be applied to 2013 estimated tax ......................................................

20 Amount to be refunded - subtract line 19 from line 18 ....................................................................................................

Continued on page 2

ADOR 10419 (12)