Arizona Form 140ptc - Property Tax Refund (Credit) Claim - 2012 Page 5
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8Arizona Form 140PTC
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1. You were renting a home.
Anyone who lives in the same dwelling unit as you is a member
of your household. Enter the total for each line in column 4.
2. You were renting an apartment.
3. You were renting a mobile home lot.
You must figure the income for each household member.
Household income is the total of each household member's
4. You were a nursing home resident.
income. Enter your income in column 1. If your spouse
Line 5 -
lived with you, enter your spouse's income in column 2. If
you lived with another person, enter that person's income in
Check "Yes" if you were a resident of Arizona for the whole
column 3. If you lived with more than one other person, fill
year, (from January 1, 2012, to December 31, 2012.) To
out a separate schedule for each other person.
qualify for the property tax credit, you must have lived in
Arizona for the whole year.
In the proper column list all income, except as noted below.
Line 6 -
Do not include income from the following.
Social security benefits
Check "Yes" if one of the following applies.
Railroad Retirement benefits
1. You paid property taxes on your main home in Arizona
Workers' Compensation "Loss of Time" insurance
during 2012.
payments
2. You paid rent on your main home in Arizona for all of
2012.
Arizona unemployment insurance payments
3. You paid both rent and property taxes on your main
Veteran's disability pensions
home in Arizona for all of 2012.
Welfare payments, surplus food, or other relief provided
4. You were a resident of a nursing home in Arizona. That
by a governmental agency
nursing home was subject to and paid property taxes.
Gifts from non-governmental sources
You used your social security or other personal funds to
Form 140PTC refunds received last year
pay the nursing home.
Line A -
5. You were a shareholder of a cooperative corporation in
Enter the salaries, wages, tips, etc., received by each
Arizona. The unit that you lived in was your main home
member of the household in 2012.
during 2012.
6. You were a member of a condominium association in
Line B -
Arizona. Your unit was your main home during 2012.
Enter all dividend and interest income. Enter all amounts
Line 7 -
received by each member of the household in 2012. You
must include interest income that Arizona does not tax.
Check "Yes" if this is the only PTC being claimed in your
Interest income that you must enter here includes the
household.
following.
NOTE: Arizona law allows only one 140PTC claimant per
Interest income from federal obligations
household per year. If someone else in your household has
Interest income from Arizona municipalities
already filed a 140PTC claim for 2012, do not file this
Line C -
claim. If you have already filed a claim for 2012, do not file
another Form 140PTC for 2012, unless you are amending
Enter all of the business and farm income. Enter all business
your original claim for 2012.
and farm income for each member of the household.
To qualify for the tax credit, your answers to questions 5
Line D -
through 7 must be "Yes."
For each member of the household combine gains and losses
Line 8 -
from the sale or exchange of property. If the result is a gain,
enter the gain. If the result is a loss, enter only up to a
Check "Yes" if you were 65 or older on December 31, 2012.
maximum of ($1,500).
(You must enter your date of birth in the space provided on
When figuring household income, the maximum net loss of
line 3 - Box 79.)
$1,500 is applicable to each household member who had
Line 9 -
capital gains and losses during the year when the net result
for that person resulted in a loss.
Check "Yes" if you received Title 16 SSI payments in 2012.
Line E -
NOTE: This is not the normal social security disability.
This is for people with limited incomes who are either blind,
Enter the income that each member of the household
disabled, or over age 65.
received from pensions and annuities in 2012. You should
not include income from the following:
To qualify for the tax credit you must have answered "Yes"
Social security benefits
to either question 8 or 9.
Railroad Retirement benefits
Income
Veteran's disability pensions
You must include income from all other pensions and
Turn the form over and complete the "Schedule of
annuities. Pension income that you must enter here includes
Household Income" under Part I.
the following.
You must list all income that you, your spouse, and any other
All retirement payments from the federal government,
member of your household received or earned in 2012.
except those listed above
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