Arizona Schedule A(Pyn) - Itemized Deductions For Part-Year Residents - 2012 Page 2
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1
2Your Name (as shown on page 1)
Your Social Security No.
Part II: Portion of Itemized Deductions Allowable for the Part of the Year
While a Nonresident
Adjustment to Medical and Dental Expenses
00
24 Medical and dental expenses .........................................................................................
24
25 Amount of MSA distributions used to pay qualified medical expenses included
00
on line 24 ........................................................................................................................
25
00
26 Medical expenses allowed to be taken as a federal itemized deduction ........................
26
00
27 Add lines 25 and 26, and enter the total .........................................................................
27
28 If line 24 is the same as or more than line 27, subtract line 27 from line 24.
00
Otherwise, go to line 29 .........................................................................................................................................
28
00
29 If line 27 is more than line 24, subtract line 24 from line 27 ...................................................................................
29
Adjustment to Interest Deduction
30 If you received a federal credit for interest paid on mortgage credit certificates (from federal
Form 8396), enter the amount of mortgage interest you paid for 2012 that is equal to the
amount of your 2012 federal credit ........................................................................................................................
30
00
Adjustment to Gambling Losses
00
31 Wagering losses allowed as a federal itemized deduction .............................................
31
00
32 Total gambling winnings included in your federal adjusted gross income ......................
32
00
33 Arizona lottery subtraction from Form 140PY, page 2, line D32 .....................................
33
00
34 Maximum allowable gambling loss deduction: Subtract line 33 from line 32 .................
34
00
35 If line 34 is less than line 31, subtract line 34 from line 31; otherwise enter “zero” ...............................................
35
Adjustment to Charitable Contributions
00
36 Amount of charitable contributions for which you are taking a credit under Arizona law .......................................
36
Adjusted Itemized Deductions
00
37 Add the amounts on lines 28 and 30 ..............................................................................
37
00
38 Add lines 29, 35 and 36 ..................................................................................................
38
00
39 Total itemized deductions allowed to be taken on federal return ....................................
39
40 Enter the amount from line 37 above ..............................................................................
40
00
41 Add the amount on lines 39 and 40 ................................................................................
41
00
00
42 Enter the amount from line 38 above ..............................................................................
42
00
43 Subtract line 42 from line 41 ...........................................................................................
43
00
44 Enter the amount on line 23 here ...................................................................................
44
45 Subtract line 44 from line 43 ...........................................................................................
45
00
46 Arizona percentage from line 4 of the worksheet on page 3 of the
%
Schedule A(PYN) instructions .........................................................................................
46
00
47 Multiply the percentage on line 46 by the amount on line 45 ..........................................
47
00
48 Add lines 44 and 47. Enter the total here and on Form 140PY, page 1, line 19 ...................................................
48
Print Form
ADOR 10176 (12)
AZ Schedule A(PYN) (2012)
Page 2 of 2
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