Arizona Form 141az (Schedule K-1(Nr)) - Nonresident Beneficiary'S Share Of Income And Share Of Fiduciary Adjustment - 2015

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FOR
Nonresident Beneficiary’s Share of Income
Arizona Form
CALENDAR YEAR
2015
141AZ Schedule K-1(NR)
and Share of Fiduciary Adjustment
For the calendar year 2015 or fiscal year beginning
M M D D
2 0 1 5 and ending
M M D D Y Y Y Y
.
Name of Estate or Trust
Estate or Trust Employer Identification Number (EIN)
Beneficiary’s Name
Fiduciary’s Name
Beneficiary’s I.D. Number
Fiduciary’s Address - number and street, or rural route
Beneficiary’s Address - number and street, or rural route
Fiduciary’s City, Town or Post Office
State
ZIP Code
Beneficiary’s City, Town or Post Office
State
ZIP Code
Fiduciary’s Phone Number – include area code
Beneficiary’s Daytime Phone Number – include area code
Part 1
Arizona Nonresident Beneficiary’s Share of Federal Distributable Income From Arizona Sources
1 Federal distributable net income from Arizona sources: Enter the amount from
00
Form 141AZ, Schedule D, line D9, column (c)................................................................................................. 1
2 Beneficiary’s share of the amount entered on line 1: Nonresident individual beneficiaries, also
00
enter this amount on Form 140NR, page 1, line 21, “ARIZONA” column ........................................................ 2
Part 2
Arizona Nonresident Beneficiary’s Share of Fiduciary Adjustment Related to Arizona Source Income
00
3 Net fiduciary adjustment to be allocated: Enter the amount from Form 141AZ, Schedule C, line C14 .......... 3
00
4 Amount on line 3 related to Arizona source income allocated to all nonresident beneficiaries ........................ 4
00
5 Beneficiary’s share of the amount entered on line 4 ........................................................................................ 5
• If the amount on line 5 is a positive number, enter this amount as an Other Addition to income on
AZ Form 140NR, page 1, line 30.
• If the amount on line 5 is a negative number, enter this amount as an Other Subtraction from income
on AZ Form 140NR, page 2, line 46.
Continued on page 2 
ADOR 10586 (15)

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