Arizona Form 165 (Schedule K-1) - Resident And Part-Year Resident Partner'S Share Of Adjustment To Partnership Income - 2015

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Resident and Part-Year Resident Partner’s
Arizona Form
2015
165 Schedule K-1
Share of Adjustment to Partnership Income
Corporate partners must use Form 165, Schedule K-1(NR).
For the
calendar year 2015 or
fiscal year beginning
M M D D
2 0 1 5 and ending
M M D D
2 0
Y Y
.
CHECK ONE:
Original
Amended
Partner’s Identifying Number
Partnership’s Employer Identification Number (EIN)
Partner’s Name
Partnership’s Name
Partner’s Address – number and street or rural route
Partnership’s Address – number and street or rural route
Partner’s City, Town or Post Office
State ZIP Code
Partnership’s City, Town or Post Office
State ZIP Code
Before Change or
Partner’s Percentage of:
Termination
End of Year
Profit sharing ...............................................
%
%
Loss sharing ................................................
%
%
Ownership of capital ....................................
%
%
Type of partner (individual, trust, or estate) .
Part I
Arizona Partnership Adjustment
00
1 Adjustment of partnership income from federal to Arizona basis from Form 165, page 1, line 6 ......... 1
2 Partner’s percentage of profit or loss (expressed as a decimal) ........................................................... 2
3 Partner’s distributive share of the adjustment of partnership income from federal to Arizona basis:
00
Multiply line 1 by line 2 .......................................................................................................................... 3
Part II
Net Capital Gain From Investment in a Qualified Small Business – Information Schedule
If the partner’s federal Schedule K-1 (Form 1065) does not include any net capital gain or loss from investment in a qualified small
business, the partnership is not required to complete Part II.
(a)
Pro Rata Share Items
Distributive Share Amount
4
Net capital gain (loss) from investment in a qualified
small business .........................................................
4
Part III
Net Long-Term Capital Gain Subtraction – Information Schedule
If the partner’s federal Schedule K-1 (Form 1065) does not include any net long-term capital gain or loss, the partnership is not required
to complete Part III.
(a)
(b)
(c)
Pro Rata Share Items
Distributive Share Amount
Net long-term capital gain
Net long-term capital gain
From Federal Form 1065, Schedule K-1
(loss) included in column (a)
(loss) included in column (a)
from assets acquired before
from assets acquired after
January 1, 2012
December 31, 2011
5
Net long-term capital gain (loss) ..............................
5
ADDITIONAL INFORMATION:
6
Net long-term capital gain (loss) from investment in
a qualified small business (amount already included
in line 5, column (c)) ................................................
6
ADOR 10344 (15)
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