Arizona Form 334-E - Transferee Notice Of Transfer Of Motion Picture Credits
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1Transferee Notice of Transfer
ARIZONA FORM
334-E
of Motion Picture Credits
The transferee must submit this notice to the Department of Revenue within thirty days after the sale or transfer. The notice must be
accompanied by a processing fee of 1 percent of the transfer amount or $200, whichever is less. Notices that are not accompanied by the
fee will be rejected.
DO NOT MAIL COMPLETED FORM WITH TAX RETURN.
:
Arizona Department of Revenue
MAIL FORM SEPARATELY TO
REVENUE USE ONLY. DO NOT MARK IN THIS AREA.
Offi ce of Economic Research and Analysis
PO Box 25248
Phoenix, AZ 85002
POSTMARK DATE
$
00
Processing fee enclosed .........................................................
HOW TO COMPUTE PROCESSING FEE:
Multiply the amount of transfer by 1% (.01). Round dollar amounts to the nearest whole dollar.
If 50 cents or more, round up to the next dollar. If less than 50 cents, round down. If the result is less than $200, enter the amount. If the
amount is equal to or greater than $200, enter $200. Make checks payable to: Arizona Department of Revenue.
A. Transferee Information:
Name
TIN
Number and street or PO Box
City or town, state, and ZIP code
Authorized contact person
Telephone number
B. Motion Picture Production Company Information:
Name
TIN
Number and street or PO Box
City or town, state, and ZIP code
C. Credit Information:
Date of transfer
Amount of transfer
Credit postapproval number
$
00
M M D D Y Y Y Y
D. Transferor Information:
Name
TIN
Authorized contact person
Telephone number
$
.00
Effective as of the transfer date, the transferee has received a credit for motion picture production costs for
from
the transferor noted above.
Transferee Signature
Name
Title
Telephone number
ADOR 10717 (12)
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