Resident Personal Income Tax Booklet (Arizona Form 140) - 2013 Page 42
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56Arizona Form 140
Line 47 - Veterans’ Donations Fund
If the above applies, check Box 2 on line 51 and do not
complete Form 221.
You may give some or all of your refund to the Veterans’
An individual who fails to make the required estimated
Donations Fund. You may also give more than your entire
payments is subject to penalty on any estimated tax payment
refund. If you send in additional money with your return,
that is late or underpaid.
include that amount on line 54. Enter the amount you want
Complete and attach Form 221, Underpayment of Estimated
to donate on line 47.
Tax by Individuals, to determine if any penalty is due. Enter
Gifts go to the Veterans’ Donations Fund, which may be
the total penalty from Form 221.
used for veterans in Arizona.
MSA Withdrawal Penalty
Line 48 - I Didn’t Pay Enough Fund
You must pay a withdrawal penalty if you made an MSA
You may give some or all of your refund to the I Didn’t Pay
withdrawal during 2013 and all of the following apply.
Enough Fund. You may also give more than your entire
1. You used the amount withdrawn for purposes other than
refund. If you send in additional money with your return,
to pay for qualified medical expenses.
include that amount on line 54. Enter the amount you want
2. You made the withdrawal on a day other than the last
to donate on line 48.
business day of the year.
Gifts that you make to the I Didn’t Pay Enough Fund will aid
3. The withdrawal is not subject to the federal withdrawal
the state by going to the Arizona general fund.
penalty.
Line 49 - Political Party
The penalty is equal to 10% (.10) of the withdrawal. The
withdrawal penalty is not subject to abatement. You must
Check the box for the political party to which you wish to
remit this penalty with your income tax return filed for the
give. Select only one party. If you do not select a political
year in which you made the withdrawal.
party, the department will return the amount on line 43.
Multiply the amount of your withdrawal subject to penalty
Line 50 –
by 10% (.10). Enter the result.
x
Estimated Payment Penalty
The following withdrawals are not subject to the penalty.
x
MSA Withdrawal Penalty
1.
Any withdrawal subject to the federal withdrawal penalty.
x
AZ
Long-Term
Health
Care
Savings
Account
2. Withdrawals made from your MSA on the last business
(AZLTHSA) Withdrawal Penalty
day of the tax year.
Estimated Payment Penalty
3. Any withdrawal made by an account holder who is at
NOTE:
Do not complete Form 221, Underpayment of
least age 59 1/2 when he or she makes the withdrawal.
Estimated Tax by Individuals, if the amount on Form 140,
NOTE: The following are not withdrawals. Do not enter a
page 1, line 28, is more than the amount on Form 140, page 1,
penalty for any of the following.
line 27. If the amount on Form 140, page 1, line 28, is more
x
Amounts from the MSA used to pay qualified medical
than the amount on Form 140, page 1, line 27, skip line 50,
expenses
unless you must report an MSA penalty and/or a Long-Term
x
A qualified return of excess contributions
Health Care Savings Account penalty.
x
A qualified rollover
x
The fair market value of an MSA received by a surviving
You must have made Arizona estimated income tax
spouse who was the deceased account holder's named
payments during 2013 if:
beneficiary
Your filing status is:
AND
AND
For more information about the above items, see the
Your Arizona
Your
Arizona
department's Pub 542, Medical Savings Accounts.
gross
income
gross income for
for 2012 was
2013 was greater
AZ Long-Term Health Care Savings Account
greater than:
than:
(AZLTHSA) Withdrawal Penalty
Married Filing Joint
$150,000
$150,000
You must pay a withdrawal penalty if you made a long-term
Single
$75,000
$75,000
health care savings account withdrawal during 2013 from a
Head of Household
$75,000
$75,000
long-term health care savings account, established under
Married Filing
Arizona law, for purposes other than to pay for qualified
Separate
$75,000
$75,000
long-term health care expenses.
Long-term health care
expense means any expense you paid for long-term health
If you report as a farmer or fisherman for federal purposes,
care costs, including the following:
you were not required to make estimated payments during
x
expenses for skilled nursing care
2013 if the following apply.
x
expenses for home health care
1. You are a calendar year filer. You file your Arizona
x
personal care or supportive services due to the loss of
return by March 1, 2014. You pay in full the amount
some capacity for self-care based on a chronic illness or
stated on your return as owed.
condition
2. You are a fiscal year filer. You file your Arizona return
The penalty is equal to 10% (.10) of the withdrawal. You
by the first day of the third month after the end of your
must remit this penalty with your income tax return filed for
fiscal year. You pay in full the amount stated on your
the year in which you made the withdrawal.
return as owed.
23
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