Arizona Form 141az Es - Estate Or Trust Estimated Income Tax Payment - 2012
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1FOR
ARIZONA FORM
CALENDAR YEAR
141AZ ES
2012
Estate or Trust Estimated Income Tax Payment
DO NOT USE THIS FORM TO MAKE DELINQUENT INCOME TAX PAYMENTS.
Use this form only for voluntary estimated payments for an estate or trust.
M M D D 2 0 Y Y
This estimated payment is for tax year ending December 31, 2012, or for tax year ending:
Print Name of Estate or Trust
Employer Identification Number (required)
1
Print Name and Title of Fiduciary
2
Address of Fiduciary - number and street, or rural route
REVENUE USE ONLY. DO NOT MARK IN THIS AREA.
3
City, Town or Post Office
State
Zip Code
4
Daytime Phone Number of Fiduciary/Representative – include area code
88
81
80
Check box 1 if you are a first time Arizona income tax return filer .....
1
1
The enclosed amount is payment for quarter number .......................
2
Payment: You must round your estimated payment to a whole dollar (no cents). Enter the
3
00
$
amount of payment enclosed ..........................................................................................................
IMPORTANT
To ensure proper application of this payment, be sure that you:
Complete this form in its entirety.
Make your check payable to Arizona Department of Revenue.
Write your EIN on your payment.
Attach your payment to the upper left corner of this page.
Mail to Arizona Department of Revenue, PO Box 29085,
Phoenix, AZ 85038-9085.
Be sure to review your estimated income and adjust your payments as necessary during
the year. Payments for calendar year filers are due April 17, 2012; June 15, 2012;
September 17, 2012; and January 15, 2013.
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ADOR 11135 (11)
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