Arizona Form 99t - Arizona Exempt Organization Business Income Tax Return Page 2
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1
2Name (as shown on page 1)
EIN
Schedule A - Apportionment Formula (Multistate Organizations Only)
Limited to Unrelated Trade or Business Amounts
See instructions, pages 5 through 7.
Column A
Column B
Column C
A1 Property Factor
Total Everywhere
Ratio Within
Total Within Arizona
Value of real and tangible personal property (by averaging the
Arizona
Round to the
Round to the
value of owned property at the beginning and end of the tax
A ÷ B
Nearest Dollar
Nearest Dollar
period; rented property at capitalized value)
•
Total owned and rented property ......................................................
A2 Payroll Factor
Wages, salaries, commissions and other compensation paid to
•
employees .........................................................................................
A3 Sales Factor
a
Total sales and other gross receipts ...........................................
X 2
OR
X 8
b
Weight AZ sales - (STANDARD uses X 2; ENHANCED uses X 8) ....
c
Sales factor (for column A - multiply item a by item b;
•
for column B - enter the amount from item a) .............................
•
A4 Total ratio - add A1, A2, and A3(c), in column C ..............................
A5 Average apportionment ratio - divide line A4, column C, by the denominator (STANDARD divides by four (4);
•
ENHANCED divides by ten (10)). Enter the result in column C, and on page 1, line 2 ..........................................................
Certification Under penalties of perjury, I declare that I have examined this return, including the 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
Sign
Officer’s Signature
Date
Title
Here
Paid
Preparer’s Signature
Date
Preparer’s PTIN
Preparer’s
Use Only
Firm’s Name (or Preparer’s Name, if self-employed)
Firm’s
EIN or
SSN
Firm’s Address
ZIP Code
Firm’s Telephone Number
Mail to: Arizona Department of Revenue, PO Box 52153, Phoenix AZ 85072-2153
Print
ADOR 10419 (12)
AZ Form 99T (2012)
Page 2 of 2
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