Arizona Form 140py - Part-Year Resident Personal Income Tax Return - 2015
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Calculate
Arizona Form
FOR CALENDAR YEAR
Part-Year Resident Personal Income Tax Return
2015
140PY
Reset
Check box 82F
82F
if filing under extension
OR FISCAL YEAR BEGINNING
AND ENDING
.
66F
Your First Name and Middle Initial
Last Name
Your Social Security Number
Enter
1
your
Spouse’s First Name and Middle Initial (if box 4 or 6 checked)
Last Name
Spouse’s Social Security No.
SSN(s).
1
Current Home Address - number and street, rural route
Apt. No.
Daytime Phone (with area code)
2
94
City, Town or Post Office
State
ZIP Code
Last Names Used in Last Four Prior Year(s) (if different)
3
97
REVENUE USE ONLY. DO NOT MARK IN THIS AREA.
4
Married filing joint return
NOTE: Yellow fields are Read-Only.
88R
5
Head of household:
Enter name of qualifying child or dependent on next line:
You can not enter data in the yellow fields. They
calculate as you enter data in the white fields.
6
Married filing separate return:
Enter spouse’s name and Social Security Number above.
7
Single
If the field doesn't seem to calculate, continue
Enter the number claimed. Do not put a check mark.
filling in the white fields and the calculations will
PM
RCVD
8
Age 65 or over (you and/or spouse)
81P
80R
"catch up".
If completing lines 8
9
Blind (you and/or spouse)
through 11, also complete
Use GREEN buttons to move around the form.
10
Dependents:
Do not include self or spouse.
lines 48 through 53.
11
Qualifying parents and grandparents
12-13
Residency Status
: 12
Part-Year Resident Other than Active Military
13
Part-Year Resident Active Military
(check one)
(Box 10): Dependent Information: Children and other dependents. For more space, (check)
and complete page 3.
(a)
(b)
(c)
(d)
(e)
(f)
if this person
if you did not claim
NO. OF MONTHS
FIRST AND LAST NAME
SOCIAL SECURITY NO.
RELATIONSHIP
did not qualify as a
this person on your
LIVED IN YOUR
(Do not list yourself or spouse.)
dependent on your
federal return due to
Go to Extra DEPENDENTS: Page 3
HOME IN 2015
federal return
educational credits
10
a
10
b
(Box 11): Qualifying parents and grandparents. See instructions. For more space, (check)
and complete page 3.
(a)
(b)
(c)
(d)
(e)
(f)
FIRST AND LAST NAME
SOCIAL SECURITY NO.
RELATIONSHIP
NO. OF MONTHS
if
if
LIVED IN YOUR
(Do not list yourself or spouse.)
age 65 or over
died in 2015
HOME IN 2015
11
a
11
b
M M D D Y Y Y Y
M M D D Y Y Y Y
14
to
2015 FEDERAL
2015 ARIZONA
Dates of Arizona residency: From
Amount from Federal Return
Amount Only
List other state(s) of residency:
00
00
15 Wages, salaries, tips, etc. ................................................................................................... 15
00
00
16 Interest................................................................................................................................. 16
00
00
17 Dividends ............................................................................................................................. 17
00
00
18 Arizona income tax refunds ................................................................................................. 18
00
00
19 Alimony received ................................................................................................................. 19
00
00
20 Business income (or loss) from federal Schedule C............................................................ 20
00
00
21 Gains (or losses) from federal Schedule D.......................................................................... 21
00
00
22
22
Rents, royalties, partnerships, estates, trusts, small business corporations from federal Schedule E....
00
00
23 Other income reported on your federal return ..................................................................... 23
00
00
0
0
24 Total income:
.................................................................................... 24
Add lines 15 through 23
00
00
25 Other federal adjustments:
........................................................... 25
Include your own schedule
00
0
26 Federal adjusted gross income:
.............. 26
Subtract line 25 from line 24 in the FEDERAL column
00
0
27 Arizona gross income:
...................................................................... 27
Subtract line 25 from line 24 in the ARIZONA column
This box may be blank or may contain a printed barcode of data from your return
.
28 AZ income ratio:
.... 28
Divide line 27 by line 26
I M P O R T A N T - P l e a s e R e a d
00
29
29
Total depreciation included in Arizona gross income
- This form is provided in a fill-in-format.
00
30 Other additions to income .......................... 30
- When this form is printed using the PRINT button on the upper right corner of
00
31 Subtotal:
................ 31
Add lines 27, 29, and 30
this return, a two dimensional (2D) barcode is generated that includes the data
00
32
. 32
AZ sourced gain/loss
entered in this form.
00
33
. 33
Short-term gain/loss
- Using a 2D barcode vastly speeds up processing your return.
00
34
. 34
Long-term gain/loss
- Do NOT handwrite any data on the form other than your signature(s).
35
Net long-term gain
00
after Dec. 31, 2011 ..
35
- Use the PRINT button on this form to print your return.
00
0
36 Multiply line 35 by 25% (.25) ...................... 36
- Use the BLACK ink setting of your printer to print this return. Do not use the
00
37
.... 37
Net capital gain from qualified small business
color ink setting.
0
00
38 Subtract line 31 - (lines 36 + 37) ................ 38
AZ Form 140PY (2015)
v1c
Page 1 of 3
ADOR 10149 (15)
1250
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