This page is NOT fillable.
Your Name (as shown on page 1)
Your Social Security Number
Schedule of Income Allocation
Complete this schedule only if you are an Arizona resident who is also considered to be a resident of another state under the laws of
that other state (dual resident); otherwise skip this schedule. See pages 2 and 8 of the instructions.
(a)
(b)
(c)
(d)
Amount entered
Amount entered in
in column (a)
column (c) that would be
Amount entered
reported on your
sourced to your statutory
Amount reported
in column (a)
2012 return filed
state of residence as
on your
reported on your
to your statutory
income of a nonresident
2012 federal return.
2012 Form 140.
state of residence.
of that state.
$
00 $
00 $
00 $
00
1
Wages, salaries, tips, etc. ..................
$
00 $
00 $
00 $
00
2
Interest...............................................
$
00 $
00 $
00 $
00
3
Dividends ...........................................
4
Business income or (loss) from
$
00 $
00 $
00 $
00
federal Schedule C ............................
5
Gains or (losses) from
$
00 $
00 $
00 $
00
federal Schedule D ............................
6
Rents, royalties, partnerships,
estates, trusts, small business
$
00 $
00 $
00 $
00
corporations from federal Schedule E
7
Other income reported on
$
00 $
00 $
00 $
00
your federal return .............................
$
00 $
00 $
00 $
00
8
Total Income: Add lines 1 through 7 .
Other federal adjustments: List on
lines 9a through 9c:
$
00 $
00 $
00 $
00
9a
$
00 $
00 $
00 $
00
9b
$
00 $
00 $
00 $
00
9c
9d Total adjustments: Add lines 9a
$
00 $
00 $
00 $
00
through 9c for each column ...............
10
Adjusted Gross Income: Subtract
$
00 $
00 $
00 $
00
line 9d from line 8 for each column....
ADOR 10136 (12)
AZ Form 309 (2012)
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