Arizona Form 202 - Personal Exemption Allocation Election - 2015 Page 2
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1
2Name of Spouse – claiming more than 1/2 of the total exemption as shown on page 1
Social Security Number
Name of Spouse – claiming less than 1/2 of the total exemption as shown on page 1
Social Security Number
For Full-Year Residents Only (Form 140 or 140A)
SPOUSE CLAIMING
SPOUSE CLAIMING
Part 3
Claiming at Least One Dependent
MORE THAN 1/2
LESS THAN 1/2
$
6,300.00 $
6,300.00
1 Total personal exemption allowed married taxpayers claiming at least one dependent ................. 1
2 Amount of personal exemption each spouse is claiming on his or her separate Arizona return.
Enter the result here. Also enter the result on Form 140, page 2, line 44, or Form 140A, page 1,
line 19. If one spouse is a nonresident or part-year resident, that spouse should
$
.00 $
.00
complete Part 4 below .................................................................................................................... 2
For Part-Year Residents (Form 140PY) or
SPOUSE CLAIMING
SPOUSE CLAIMING
Part 4
Nonresidents (Form 140NR) Claiming at Least One Dependent
MORE THAN 1/2
LESS THAN 1/2
1 Total personal exemption allowed (prior to prorating) married taxpayers claiming at least
$
6,300.00 $
6,300.00
one dependent................................................................................................................................ 1
2 Amount of personal exemption each spouse is claiming (prior to prorating) on his or her
separate Arizona return. If you are a part-year resident who is an active duty military member
who either began or gave up Arizona residency during 2015, skip lines 3 and 4, and
enter this amount on Form 140PY, page 2, line 56. If you are a nonresident who is an active
military member, skip lines 3 and 4, and enter this amount on Form 140NR, page 2, line 54.
$
.00 $
.00
All other taxpayers complete lines 3 and 4 ..................................................................................... 2
3 If you are a part-year resident, enter your Arizona income ratio from Form 140PY, page 1,
line 28. If you are a nonresident, enter your Arizona income ratio from Form 140NR,
page 1, line 27 ................................................................................................................................ 3
4 Multiply line 2 by the ratio on line 3. If you are a part-year resident, enter the result here
and on Form 140PY, page 2, line 56. If you are a nonresident, enter the result here and on
$
.00 $
.00
Form 140NR, page 2, line 54 ......................................................................................................... 4
We, the undersigned, agree to divide the personal exemption as shown in Part 1, Part 2, Part 3 or Part 4 of this
form. Both spouses must sign:
Signature of spouse claiming more than one-half (1/2) of total personal exemption
Date
Signature of spouse claiming less than one-half (1/2) of total personal exemption
Date
Print Form
ADOR 10167 (15)
AZ Form 202 (2015)
Page 2 of 2
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