Arizona Form 141az - Arizona Fiduciary Income Tax Return - 2011 Page 4

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NAME OF ESTATE OR TRUST AS SHOWN ON PAGE 1
EMPLOYER IDENTIFICATION NUMBER
SCHEDULE C: Fiduciary Adjustment Allocation
The Arizona fiduciary adjustment is allocated among the beneficiaries and the fiduciary in proportion to their share of the federal
distributable net income.
(a)
(b)
(c)
Share of Federal
Beneficiary
Distributable Net Income
Percent
$
00
%
C1
C2
$
00
%
$
00
%
C3
C4
$
00
%
$
00
%
C5
$
00
%
C6
$
00
%
C7
$
00
%
C8
$
00
%
C9
$
00
%
C10
$
00
%
C11 Subtotal: If more than 10 beneficiaries, attach an additional schedule .............. C11
$
00
%
C12 Fiduciary ............................................................................................................. C12
C13 Total: Add lines C11 and C12. This should total the federal distributable
$
00
100 %
net income .......................................................................................................... C13
C14 Enter the fiduciary adjustment from Form 141AZ, Schedule B, line B10 here and also on
00
Form 141AZ Schedule K-1, line 1 or Form 141AZ Schedule K-1(NR), line 3 ........................................... C14
C15 Multiply the amount on line C14 by the percentage on line C11. Enter the result here and also on
00
Form 141AZ, page 1, line 9 ...................................................................................................................... C15
C16 Multiply the amount on line C14 by the percentage on line C12. Enter the result here and also on
00
Form 141AZ, page 1, line 10 .................................................................................................................... C16
SCHEDULE D: Federal Distributable Net Income From Arizona Sources
Complete Schedule D only if the estate or trust has nonresident beneficiaries. Use the information in Schedule D to complete
Form 141AZ, Schedule K-1(NR). Do not complete Schedule D if all of the beneficiaries are Arizona residents.
(a)
(b)
(c)
FEDERAL
ARIZONA
D1 Dividends .................................................................................................................
D1
00
00
00
00
D2 Interest .....................................................................................................................
D2
00
00
D3 Partnership/fiduciary income....................................................................................
D3
00
00
D4 Net rents and royalties .............................................................................................
D4
00
00
D5 Net profit (loss) business .........................................................................................
D5
00
00
D6 Other income ...........................................................................................................
D6
00
00
D7 Total: Add lines D1 through D6 ...............................................................................
D7
00
00
D8 Expenses .................................................................................................................
D8
D9 Federal distributable income: Subtract line D8 from line D7 and enter the
difference here. Also, enter the amount from column (c) on
00
00
Form 141AZ, Schedule K-1(NR), line 1 ...................................................................
D9
ADOR 10584 (11) Eff. 8/2/2012
AZ Form 141AZ (2011)
Page 3 of 4

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