Arizona Form 334-O - Transferor Notice Of Transfer Of Motion Picture Credits
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1
2Transferor Notice of Transfer
ARIZONA FORM
334-O
of Motion Picture Credits
The transferor must submit this notice to the Department of Revenue within thirty days after the sale or transfer. Each form must be for
a transfer of a single credit by a transferor to one or more transferees. If you have more than one credit you are transferring, complete a
separate Form 334-O for each credit.
DO NOT MAIL COMPLETED FORM WITH TAX RETURN.
:
Arizona Department of Revenue
MAIL FORM SEPARATELY TO
Offi ce of Economic Research and Analysis
PO Box 25248
Phoenix, AZ 85002
A. Transferor 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
Authorized contact person
Telephone number
C. Credit Information:
4
1
Credit postapproval number
Transfer credit balance
$
00
before transfer
2
Amount of transfer from
$
5
00
page 2, Part D, Line 5
Transfer credit remaining
$
00
after transfer
Date of transfer
3
M M D D Y Y Y Y
D. Transferee Information:
Enter the transferee information on page 2 of this form.
The transferor hereby represents that it has neither claimed for its own behalf nor conveyed to any other transferee the credit for motion
picture production costs transferred in this notice. Effective as of the date of transfer shown in this notice, the transferor agrees to transfer
the credit amount shown on line 2 above.
Transferor Signature
Taxpayer name
Title
Telephone number
Print Pg 1
ADOR 10718 (12)
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