Arizona Form 140ez - Resident Personal Income Tax Return (Ez Form) - 2014
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1Arizona Form
FOR CALENDAR YEAR
Resident Personal Income Tax Return (EZ Form)
2014
140EZ
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 is 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
REVENUE USE ONLY. DO NOT MARK IN THIS AREA.
88
Check box 82F if filing under extension
82F
STOP
You must use Arizona Form 140 if:
• Your Arizona taxable income on line 8 is $50,000 or more.
• You are claiming estimated payments.
• You are taking a subtraction for:
81 PM
80 RCVD
– active duty military pay
– wages earned on Indian reservation(s)
FILING STATUS: Check one box.
4
Married filing joint return
5
Single
00
6 Federal adjusted gross income from your federal return .......................................................................... 6
7 Standard deduction and personal exemption:
If you checked filing status box 4, enter $14,210; if you
00
............................................................................................................... 7
checked filing status box 5, enter $7,109
00
8 Arizona taxable income:
..................................................... 8
Subtract line 7 from line 6. If less than zero, enter zero
00
9 Amount of tax from Optional Tax Tables ................................................................................................... 9
00
10 Family income tax credit
............................................................ 10
(from worksheet see page 5 of instructions)
00
11 Balance of tax:
.................................................. 11
Subtract line 10 from line 9. If line 10 is more than line 9, enter zero
00
12 Arizona income tax withheld during 2014 ................................................................................................. 12
00
13 2014 Arizona extension payment (Form 204)........................................................................................... 13
00
14 Increased Excise Tax Credit
................................................. 14
(from worksheet see page 5 of the instructions)
00
15 Total payments/credits:
.......................................................................................... 15
Add lines 12 through 14
16 TAX DUE / AMOUNT OWED:
If line 11 is more than line 15, subtract line 15 from line 11. Skip line 17.
00
Make check payable to Arizona Department of Revenue; include SSN on payment ............................ 16
00
17 REFUND / OVERPAYMENT:
.......................................... 17
If line 15 is more than line 11, subtract line 11 from line 15
A
A
Direct Deposit of Refund: Check box
if your deposit will be ultimately placed in a foreign account; see instructions ..
17
17
ROUTING NUMBER
ACCOUNT NUMBER
C
Checking or
98
S
Savings
I have read this return and any documents with it. Under penalties of perjury, I declare that to the best of my knowledge and belief, they are
true, correct and complete. Declaration of preparer (other than taxpayer) is based on all information of which preparer has any knowledge.
YOUR SIGNATURE
DATE
OCCUPATION
SPOUSE’S SIGNATURE
DATE
SPOUSE’S OCCUPATION
PAID PREPARER’S SIGNATURE
DATE
FIRM’S NAME (PREPARER’S IF SELF-EMPLOYED)
PAID PREPARER’S STREET ADDRESS
PAID PREPARER’S TIN
(
)
PAID PREPARER’S CITY
STATE
ZIP CODE
PAID PREPARER’S PHONE NUMBER
• If you are sending a payment with this return, mail to:
Arizona Department of Revenue, PO Box 52016, Phoenix, AZ, 85072-2016.
Include the payment with Form 140EZ.
• If you are expecting a refund or owe no tax, or owe tax but are not sending a payment, mail to:
Arizona Department of Revenue, PO Box 52138, Phoenix, AZ, 85072-2138.
ADOR 10534 (14)
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