Arizona Form 141az - Arizona Fiduciary Income Tax Return - 2012

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FOR
ARIZONA FORM
CALENDAR YEAR
141AZ
2012
Arizona Fiduciary Income Tax Return
. 66
M M D D Y Y Y Y
M M D D Y Y Y Y
OR FISCAL YEAR BEGINNING
AND ENDING
Check box 82E if filing under extension
Click on box 82E if filing under extension.
82E
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
Click one box to select an option:
Check
box:
ONLY ONE
5a
5c
Resident Estate
Resident Trust
81
80
5b
5d
Nonresident Estate
Nonresident Trust
Click applicables boxes to select:
Check applicable box(es):
6
Amended Return
Decedent’s Estate
Simple Trust
1
Final Return
Bankruptcy Estate
Complex Trust
2
Initial Return
Grantor Trust
Charitable Remainder Trust
7 Federal taxable income: Resident estates or trusts, enter federal taxable income from federal Form 1041.
00
Nonresident estates or trusts, enter the amount from Arizona Form 141AZ, Schedule A, line A6 .................................
7
8 Net fiduciary adjustment: Enter the amount from Form 141AZ, Schedule B, line B10.
00
If a negative number, enter that number in brackets ............................................................
8
9 Net fiduciary adjustment allocated to beneficiaries: Enter the amount from Form 141AZ,
00
Schedule C, line C15 ............................................................................................................
9
10 Net fiduciary adjustment allocated to fiduciary: Enter the amount from Form 141AZ,
00
Schedule C, line C16 ......................................................................................................................................................
10
11 Subtotal: If the amount on line 10 is a positive number, add the amount on line 10 to line 7. If the amount
00
on line 10 is a negative number, subtract the amount on line 10 from line 7..................................................................
11
00
12 Electing Small Business Trust (ESBT) income: Attach federal computation .................................................................
12
00
13 Add line 11 and line 12. Enter the result ........................................................................................................................
13
00
14 Income of a trust established as a Medical Savings Account .........................................................................................
14
00
15 Arizona taxable income: Subtract line 14 from line 13 ...............................................................................................
15
00
16 Tax on amount on line 15. See Tax Table on page 12 of the instructions .....................................................................
16
00
17 Credit for taxes paid to other states or countries. See instructions ...............................................................................
17
00
18 Subtract line 17 from line 16. If line 17 is more than line 16, enter zero. .......................................................................
18
19 Clean Elections Fund Tax Credit for donations made prior to August 2, 2012, from worksheet
00
on page 9 of the instructions ..........................................................................................................................................
19
00
20 Balance of tax: Subtract line 19 from line 18. If line 19 is more than line 18, enter zero ............................................
20
00
21 Arizona estimated tax payments ..........................................................................................
21
00
22 Payment with extension ........................................................................................................
22
00
23 Arizona income tax withheld. See instructions ....................................................................
23
00
24 Payment with original return (if amending) plus all payments after return was filed .............
24
00
25 Total payments: Add lines 21 through 24 ............................................................................
25
00
26 Refund from original return (if amending) .............................................................................
26
00
27 Balance of payments: Subtract line 26 from line 25 ......................................................................................................
27
28 BALANCE DUE: Subtract line 27 from line 20. Make check payable to Arizona Department
00
of Revenue; write your EIN on payment, and attach to lower left corner of this page .................................................
28
00
29 REFUND DUE: Subtract line 20 from line 27 ................................................................................................................
29
00
30 Amount of line 29 to be applied to your 2013 estimated tax ...........................................................................................
30
00
31 Balance of refund/overpayment: Subtract line 30 from line 29 ..................................................................................
31
ADOR 10584 (12)

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