Arizona Form 140a - Resident Personal Income Tax Return (Short Form)
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9Arizona Form
Resident Personal Income Tax Return (Short Form)
FOR CALENDAR YEAR
2015
140A
STOP! If your Arizona taxable income is $50,000 or more, you must use Arizona Form 140.
Reset
Print 140A Return
Calculate
Check box 82F if filing under extension
82F
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.
88
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
6
Married filing separate return:
Enter spouse’s name and Social Security Number above.
white fields.
7
Single
Enter the number claimed. Do not put a check mark.
If a field doesn't seem to calculate, continue
8
Age 65 or over (you and/or spouse)
filling in the white fields and the calculations
If completing lines 8
81 PM
80 RCVD
9
Blind (you and/or spouse)
will "catch up".
through 11, also complete
10
Dependents:
Do not include self or spouse.
lines 13 through 16.
Use GREEN buttons to move around the
11
Qualifying parents and grandparents
return.
(Box 10): Dependent Information: Children and other dependents. 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 this person
if you did not claim
LIVED IN YOUR
did not qualify as a
this person on your
(Do not list yourself or spouse.)
Go to Extra DEPENDENTS: Page 3
dependent on your
federal return due to
HOME IN 2015
federal return
educational credits
10
a
10
b
10
c
(Box 11): Qualifying parents and grandparents. See instructions. For more space, (check)
and complete page 3.
(a)
(b)
(c)
(d)
(e)
(f)
NO. OF MONTHS
FIRST AND LAST NAME
SOCIAL SECURITY NO.
RELATIONSHIP
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
11
c
00
12 Federal adjusted gross income (from your federal return) ................................................................................... 12
00
13 Age 65 or over:
.................................................................................................... 13
Multiply the number in box 8 by $2,100
Line 13 = Box 8 x $2,100
Line 14 = Box 9 x $1,500
00
14 Blind:
.................................................................................................................... 14
Multiply the number in box 9 by $1,500
Line 15 = Box 10 x $2,300
00
15 Dependents:
...................................................................................................... 15
Multiply the number in box 10 by $2,300
00
Line 16 = Box 11 x $10,000
16 Qualifying parents and grandparents:
.............................................................. 16
Multiply the number in box 11 by $10,000
0
00
17 Arizona adjusted gross income:
............................................................. 17
Subtract lines 13, 14, 15, and 16 from line 12
00
Select Standard Deduction
18 Standard deduction:
. ............... 18
If you checked filing status box 4 or 5, enter $10,173. If you checked box 6 or 7, enter $5,091
This box may be blank or may contain a printed barcode of data from your return
I M P O R T A N T - Please Read
.
00
19 Personal exemptions:
....... 19
See instructions
Select Personal Exemption
0
- This form is provided in a fill-in format.
00
20 AZ taxable income:
20
Line 17 - (lines 18 + 19)
Tax Table
00
21 Amount of tax from Optional Tax Tables .... 21
- When this form is printed using the PRINT button on the upper right
00
22 Family income tax credit ............................ 22
corner of this return, a two dimensional (2D) barcode is generated
00
that includes the data entered in the form.
23 Balance of tax:
23
Subtract line 22 from line 21
00
24 Arizona income tax withheld during 2015.. 24
- Using a 2D barcode vastly speeds up processing your return.
00
25 2015 Arizona extension payment .............. 25
00
- Do NOT handwrite any data on the form other than your signature(s).
26 Increased Excise Tax Credit ...................... 26
00
27 Property Tax Credit from Form 140PTC .... 27
- Use the PRINT button on this form to print this return.
0
00
28
. 28
Total payments/credits: Add lines 24 through 27
0
00
29 TAX DUE:
........ 29
Subtract line 28 from line 23
- Use the BLACK ink setting of your printer to print this return. Do not
use the color ink setting.
00
30 OVERPAYMENT:
. 30
Subtract line 23 from line 28
v1c
Continued on page 2
PLEASE BE SURE TO SIGN THE RETURN ON THE REVERSE SIDE OF THIS PAGE.
AZ Form 140A (2015)
Page 1 of 3
ADOR 10414 (15)
1250
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