Arizona Form 141az Schedule K-1(Nr) - Nonresident Beneficiary'S Share Of Income And Share Of Fiduciary Adjustment - 2012

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ARIZONA FORM
141AZ
Nonresident Beneficiary’s
2012
Share of Income and
Schedule K-1(NR)
Share of Fiduciary Adjustment
For calendar year 2012, or
fiscal year beginning
M M D D Y Y Y Y
and ending
M M D D Y Y Y Y
.
Name of Estate or Trust
Estate or Trust Employer Identification Number (EIN)
Beneficiary’s Name
Fiduciary’s Name
Beneficiary’s I.D. Number
Fiduciary’s Address - number and street, or rural route
Beneficiary’s Address - number and street, or rural route
Fiduciary’s City, Town or Post Office
State Zip Code
Beneficiary’s City, Town or Post Office
State Zip Code
Fiduciary’s Phone Number – include area code
Beneficiary’s Daytime Phone Number – include area code
Part I Arizona Nonresident Beneficiary’s Share of
Federal Distributable Income From Arizona Sources
1 Federal distributable net income from Arizona sources: Enter the amount from
00
Form 141AZ, Schedule D, line D9, column (c) .....................................................................................
1
2 Beneficiary’s share of the amount entered on line 1: Nonresident individual beneficiaries, also
00
enter this amount on Form 140NR, page 2, line B11, “ARIZONA” column ..........................................
2
Part II Arizona Nonresident Beneficiary’s Share of
Fiduciary Adjustment Related to Arizona Source Income
3 Net fiduciary adjustment to be allocated: Enter the amount from Form 141AZ,
00
Schedule C, line C14 ............................................................................................................................
3
00
4 Amount on line 3 related to Arizona source income allocated to all nonresident beneficiaries ............
4
00
5 Beneficiary’s share of the amount entered on line 4 ............................................................................
5
• If the amount on line 5 is a positive number, enter this amount as an other addition to income on
Arizona Form 140NR, page 2, line C20.
• If the amount on line 5 is a negative number, enter this amount as an other subtraction from income
on Arizona Form 140NR, page 2, line D31.
Print Form
ADOR 10586 (12)

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