Resident Personal Income Tax Booklet (Arizona Form 140) - 2013 Page 11
ADVERTISEMENT
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56Arizona Form 140
amount of MSA funds used within one year of the date of
Part B: Additions to Income
death, to pay the decedent's qualified medical expenses. You
can reduce the fair market value by only those expenses paid
Line B6 - Non-Arizona Municipal Interest
from the MSA. If you pay additional medical expenses for
Enter the amount of interest income from non-Arizona
the decedent from the MSA after you file, you may file an
municipal bonds that you did not include as income on your
amended return to further reduce the fair market value of the
federal return.
MSA.
You may exclude any expenses incurred to purchase or carry the
3 - Decedent's Final Return and No Named MSA
obligation. Reduce the interest income by the amount of those
Beneficiary
expenses that you could not deduct on your federal return.
You must make an entry here if all of the following apply.
If you received tax exempt interest from municipal bonds,
1. The account holder died during the year.
attach a schedule listing the payors and the amount received
from each payor. You may also want to attach supporting
2. There is no named MSA beneficiary.
documents for amounts received from Arizona municipal
3. This is the decedent's final return.
bonds that are exempt from Arizona income tax. These may
4. The value of the MSA did not have to be included on the
be items such as bank statements, brokerage statements, etc.
decedent's final federal income tax return.
Line B7 - Ordinary Income Portion of Lump-
In this case, the MSA ceased to be an MSA. Enter the fair
market value of the MSA as of the date of death. This rule
Sum Distributions Excluded on Your Federal
applies in all cases in which there is no named beneficiary,
Return
even if the surviving spouse ultimately obtains the right to
Use line B7 if you use federal averaging for lump-sum
the MSA assets.
distributions from your pension or profit-sharing plan.
The following are not withdrawals. Do not enter any of the
Arizona law does not provide for averaging. Enter the
following:
amount of the distribution that you treated as ordinary
x
Amounts from the MSA used to pay qualified
income on your federal return. If you choose to treat the
medical expenses.
capital gain portion of the distribution as ordinary income,
x
A qualified return of excess contributions.
you must also include that amount.
x
A qualified rollover.
For more information, see the department’s Income Tax
x
The fair market value of an MSA received by a surviving
Ruling ITR 93-5.
spouse who was the deceased account holder's named
Line B8 - Total Federal Depreciation
beneficiary.
For more information about the above items, see the
Enter the total amount of depreciation deducted on the
department's brochure, Pub 542.
federal return. If you make an entry here, you should also take
a subtraction on line C22. To figure how much you should
Line B10 - Reserved
subtract, see the instructions for line C22.
This line has been reserved for future use. Do not enter any
Line B9 - Medical Savings Account (MSA)
amount on line B10.
Distributions
Line B11 - Other Additions to Income
For information on Arizona's MSA provisions, see the
Use line B11 if any of the special circumstances below apply.
department's brochure, Pub 542, Medical Savings Accounts.
Attach your own schedule to the back of your return
You must add amounts received from an MSA here if any of
explaining any amounts entered here.
the following apply.
You may either add or subtract items B through D below on
1 - You Withdrew Funds From Your MSA for Other
line B11 or C29, respectively, depending on your situation.
Than Qualified Expenses
A. Pensions (First Payment Received Prior to 1979)
You must make an entry here if all of the following apply.
Prior to 1979, Arizona treated pension income differently
1. You withdrew money from your MSA during 2013.
than the IRS. For federal purposes, you could have excluded
2. You did not use the amount withdrawn to pay qualified
a portion of the cost of the pension from the pension
medical expenses.
payment included on your federal return.
For Arizona
3. You did not have to include the withdrawal as income on
purposes, the payments were excluded from Arizona gross
your federal income tax return.
income until you recovered the cost. After recovering the
Enter the amount withdrawn.
cost, you must include the rest of the payments in Arizona
2 - Deceased Account Holder Where the Named
gross income.
Beneficiary is Not the Decedent's Surviving Spouse
If you received the first payment prior to December 31,
You must make an entry here if all of the following apply.
1978, you may have to make an addition to income.
1. The account holder died during the year.
Complete the following worksheet to figure your addition.
2. You are the named beneficiary of the decedent's MSA.
The addition is equal to the total payments received during
the taxable year that are more than the cost.
3. You are not the decedent's surviving spouse.
4. You did not have to include the value of the MSA as
Complete the worksheet only if both of the following apply.
income on your federal income tax return.
1. Arizona taxed your pension for years before 1979.
In this case, the MSA ceased to be an MSA. Enter the fair
2. You reported that pension on your federal return using
market value of the MSA as of the date of death, less the
the percentage exclusion method.
7
ADVERTISEMENT
0 votes
Related Articles
Related forms
Related Categories
Parent category: Financial