Arizona Form 99 - Arizona Exempt Organization Annual Information Return

Arizona Form 99

If the organization files Form 99, attach a copy of the

applies to the NMMD, then an amended Arizona

appropriate federal return.

Form 120S or Arizona Form 165 must be filed and the

amended federal return should be attached to the Arizona

The department normally determines the timeliness of a

amended Form 120S or Form 165.

return by the postmark or other official mark of the U.S.

Postal Service stamped on the envelope in which the return is

Specific Instructions

mailed. Refer to Arizona General Tax Ruling GTR 93-1 for

further information. The department will also accept proof of

Type or print the required information in the name, address,

mailing from a private delivery service included in the

and information boxes at the top of page 1. Indicate whether

Internal Revenue Service list of designated private delivery

the taxable year is a calendar year or a fiscal year; if a fiscal

services. Contact the private delivery service for information

year, indicate the taxable year on the top of the return.

regarding how to obtain written proof of mailing.

Indicate whether this return is an original or an amended

Extension of Time to File a Return

return.

Enter the employer identification number (EIN) of the

The organization can apply for an Arizona extension by filing

organization, which is its taxpayer identification number

a completed Arizona Form 120EXT by the original due date

(TIN).

of the return. The organization can also use a valid federal

extension rather than applying for an Arizona extension.

All returns, statements, and other documents filed with the

department require a TIN. Taxpayers that fail to include their

NOTE for NMMDs: A NMMD cannot use the federal

TIN may be subject to a penalty. Paid tax return preparers

extension for filing its Arizona Form 99. The NMMD must

must include their TIN where requested. The TIN for a paid

request an Arizona extension on Arizona Form 120EXT.

tax return preparer is the individual's social security number

The department grants an Arizona extension for filing

or the employer identification number of the business. Paid

Form 99 for a period of six months. Arizona will accept the

tax return preparers that fail to include their TIN may be

federal extension for the same period of time as covered by

subject to a penalty.

the federal extension, except for NMMDs.

Organization that is exempt under A.R.S. § 43-1201(A) -

Because the first federal extension for organizations exempt

answer questions A, B and C. Skip questions D through H.

under A.R.S. § 43-1201(A) is an automatic three-month

Complete the rest of page 1 and pages 2 and 3.

extension instead of the automatic six-month Arizona

NMMD that is exempt under A.R.S. § 43-1201(B) - answer

extension, those organizations requiring a six-month

questions A and B. Skip question C. Check the box for

extension must be approved for a second three-month federal

question D and enter the registry identification number of the

extension, which is not automatic, or file an Arizona

dispensary. Check one box for question E. If the dispensary is

Form 120EXT by the original due date.

an LLC, check one box for question F. If the dispensary is a

Penalty

flow through entity (LLC, S corporation or partnership) be

sure to attach a schedule that lists ownership information

This form is an information return. The penalty for failing to file,

including name, address, TIN and ownership percentage at

filing late (including extensions) or filing an incomplete

the end of the tax year. Check a box for question G and attach

information return is $100 for each month, or fraction of a month,

a copy of the dispensary’s federal return, unless question H

that the failure continues, up to a maximum penalty of $500.

applies to the dispensary. If the NMMD is organized or taxed

Filing Amended Returns

as a partnership or an S corporation, and the federal return is

attached to the Form 165 or Form 120S filed by the NMMD,

File amended returns within four years of the filing of the

check the box for question H and do not attach a copy of the

original return. However, do not file an amended return until

federal return to this Form 99. Complete the rest of page 1,

the original return has been processed.

and pages 2 and 3, as instructed below.



Organization that filed a copy of its federal return of

Lines 1 through 12 -

organization exempt from income tax - file a copy of the

amended federal return of organization exempt from

Include in this section all sources of income received during

income tax.

the year.



Organization that filed Form 99 - attach a statement to

Lines 13 through 20 -

the amended return that explains why the organization

Include in this section all administrative expenses.

amended its Arizona return. If the organization amended

its federal return, attach a copy of the amended federal

Schedule A and Line 21 -

return with all schedules applicable to the amended

Include in Schedule A on page 2 all disbursements made

Arizona return.

from current income for exempt purposes. Enter the total of



NMMD that filed Form 99 - attach a statement to the

lines A1 through A5 on line A6 and on page 1, line 21.

amended return that explains why the dispensary

amended its Arizona return. If the dispensary amended

Schedule B and Line 22 -

its federal return, attach a copy of the amended federal

Include in Schedule B on page 2 all disbursements from

return with all schedules applicable to the amended

principal for exempt purposes. Enter the total of lines B1

Arizona return, unless question H applies. If question H

through B5 on line B6 and on page 1, line 22.

Arizona Form 99 - Arizona Exempt Organization Annual Information Return - 2013 Page 2

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