Arizona Form 321 - Credit For Contributions To Charities That Provide Assistance To The Working Poor - 2012

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ARIZONA FORM

Credit for Contributions to Charities

321

2012

That Provide Assistance to the Working Poor

For the calendar year 2012, or

M M D D Y Y Y Y

ﬁ scal year beginning

and ending

Your Name as shown on Form 140, 140NR, 140PY or 140X

Your Social Security Number

Spouse’s Name as shown on Form 140, 140NR, 140PY or 140X (if joint return)

Spouse’s Social Security Number

1 Are you claiming itemized deductions on your 2012 Arizona income tax return? ......................................

Yes

If the answer to question 1 is “Yes”, continue to line 2a.

If “No”, STOP. You cannot claim a current year credit or carryover credit.

Part I

Current Year’s Credit

NOTE: If you made cash contributions to more than three qualifying charities, attach a separate schedule.

(a)

(b)

(c)

Name of Qualifying Charity

Location of Qualifying Charity

to which you made cash contributions

(city, state)

Cash Amount

.00

2d Total Cash Contributions: Add the amounts in column (c) of lines 2a, 2b, and 2c. Also, add any amount

.00

included on a separate schedule ..........................................................................................................................

.00

3 Single taxpayers or heads of household, enter $200. Married taxpayers, enter $400 ......................................

4 Current year’s credit: Enter the smaller of line 2d or line 3. In most cases, if you are married filing a

.00

separate return, enter one-half (½) of the smaller of line 2d or line 3. See instructions ....................................

Part II

Available Credit Carryover

(a)

(b)

(c)

(d)

Taxable Year