Fillable Arizona Form 141az - Arizona Fiduciary Income Tax Return

Arizona Form 141az - Arizona Fiduciary Income Tax Return - 2011 Page 5

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NAME OF ESTATE OR TRUST AS SHOWN ON PAGE 1

EMPLOYER IDENTIFICATION NUMBER

SCHEDULE E: Questions

Check the box if this return is for a short taxable year ..........................................................................

YES

Have Arizona income tax returns been filed for the four (4) years preceding date of death? ...............

If “No”, please explain:

M M D D Y Y Y Y

Date of decedent’s death or date the trust was established .......................

YES

Was a fiduciary return filed the preceding year? ...................................................................................

CASH ACCRUAL

Check the box to indicate whether this return was prepared on a cash or accrual basis: ....................

YES

Has the federal government made an additional assessment on the income of this estate in the last

four (4) years? .......................................................................................................................................

If “Yes”, submit a detailed report with this return.

If return is for a trust, enter the name and address of the grantor:

I declare under the penalties of perjury that this return, including any accompanying schedules and statements, has been

examined by me, and to the best of my knowledge and belief is a true, correct and complete return.

SIGNATURE OF FIDUCIARY OR OFFICER REPRESENTING FIDUCIARY

DATE

SIGNATURE OF PERSON OTHER THAN TAXPAYER OR AGENT

DATE

ADDRESS OF FIDUCIARY OR OFFICER

NAME OF FIRM OR EMPLOYER, IF ANY

PAID PREPARER’S SIGNATURE

DATE