Arizona Form 140x - Individual Amended Income Tax Return - 2013

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FOR

CALENDAR YEAR

Arizona Form 140X

Individual Amended Income Tax Return

2013

. 66

M M D D Y Y Y Y

OR FISCAL YEAR BEGINNING

AND ENDING

Your First Name and Middle Initial

Last Name

Your Social Security No.

Enter

your

Spouse’s First Name and Middle Initial (if box 4 or 6 checked)

Last Name

Spouse’s Social Security No.

SSN(s).

Current Home Address - number and street, rural route

Apt. No.

Daytime Phone (with area code)

City, Town or Post Office

State

ZIP Code

Last Names Used in Prior Year(s)

REVENUE USE ONLY. DO NOT MARK IN THIS AREA.

Check a box to indicate both filing and residency status:



Married filing joint return



Head of household –

Enter name of qualifying child or dependent on next line:



Married filing separate return:

Enter spouse’s name and Social Security No. above.



Single



Resident



Nonresident

81 PM

80 RCVD



Nonresident active military



Part-year resident



Part-year resident active military

13 Exemption – Age 65 or over:

15 Exemption – Dependents:

Enter number claimed ►

Enter number claimed ........................................ ►

14 Exemption – Blind:

.................

16 Exemption – Qualifying parents or grandparents:

Enter number claimed

►

Enter number claimed ►

17 Federal adjusted gross income (from your federal return) ............................................................................................. 17

18 Nonresidents and part-year residents only: Enter Arizona gross income here .............................................................. 18

18a Arizona Residency: If you checked box 9, 10, 11 or 12 above, divide line 18 by line 17 .....

Do not type decimal

19 Additions to income ........................................................................................................................................................ 19

20 Subtotal: Residents: Add line 17 and line 19. Nonresidents and part-year residents: Add lines 18 and 19 ............... 20

21 Subtractions from income ............................................................................................................................................... 21

22 Net capital gain or (loss) .................................................................................................

Net long-term capital gain subtraction from assets acquired after December 31, 2011 ................................................. 22

23 Arizona adjusted gross income: Subtract lines 21 and 22 from line 20, and enter the difference ............................ 23



24 Deductions .........................................................................................................

ITEMIZED

STANDARD 24

25 Personal exemptions ...................................................................................................................................................... 25

26 Arizona taxable income: Subtract lines 24 and 25 from line 23 .................................................................................. 26



27 Tax from tax table:

Table X or Y (140, 140NR or 140PY)

Optional Table (140, 140A or 140EZ) ................... 27

28 Tax from recapture of credits from Arizona Form 301, Part II, line 36 ............................................................................ 28

29 Subtotal of tax: Add lines 27 and 28 .............................................................................................................................. 29

30 Family income tax credit (Arizona residents only) .......................................................................................................... 30

31 Credits from Arizona Form 301, Part II, line 69; or Forms 310, 321, 322 or 323 ............................................................ 31

32 Credit type: Enter form number of each credit claimed ....... 32

33 Balance of tax: Subtract lines 30 and 31 from line 29. If less than zero, enter “zero” ................................................ 33

34 Payments (withholding, estimated, or extension) ........................................................................................................... 34

35 Increased Excise Tax Credit (Arizona residents only) .................................................................................................... 35

36 Property Tax Credit (Arizona residents only) .................................................................................................................. 36



37 Other refundable credits:

350 37

308-I

342

349

Check the box(es); enter the amount

38 Payment with original return plus all payments after it was filed .................................................................................... 38

39 Total payments and refundable credits: Add lines 34 through 38 ............................................................................. 39

40 Overpayment from original return or as later adjusted. See instructions ....................................................................... 40

41 Balance of credits: Subtract line 40 from line 39 ........................................................................................................... 41

42 OVERPAYMENT: If line 33 is less than line 41, subtract line 33 from line 41 ............................................................... 42

43 Amount of line 42 to be applied to 2014 estimated tax. If zero, enter “0” ...................................................................... 43

44 REFUND: Subtract line 43 from line 42. If less than zero, enter amount owed on line 45 .......................................... 44



Direct Deposit of Refund: Check box

if your deposit will be ultimately placed in a foreign account; see instructions.

ROUTING NUMBER

ACCOUNT NUMBER



Checking or



Savings

45 AMOUNT OWED: If line 33 is more than line 41, subtract line 41 from line 33, and enter the amount owed.

Make check payable to Arizona Department of Revenue; include SSN on payment................................................... . 45