Arizona Form 140nr - Nonresident Personal Income Tax Return - 2012

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ARIZONA FORM

FOR

Nonresident Personal Income Tax Return

140NR

CALENDAR YEAR

Calculate

2012

OR FISCAL YEAR BEGINNING

AND ENDING

Reset

Check box 82F if filing under extension

82F

Your First Name and Middle Initial

Last Name

Your Social Security No.

Enter

your

Spouse’s First Name and Middle Initial (if box 4 or 6 checked)

Last Name

Spouse’s Social Security No.

SSN(s).

Current Home Address - number and street, rural route

Apt. No.

Daytime Phone (with area code)

Home Phone (with area code)

City, Town or Post Office

State Zip Code

NOTE: Yellow fields are Read-Only.

REVENUE USE ONLY. DO NOT MARK IN THIS AREA.

You can not enter data in the yellow fields.

Married filing joint return

They calculate as you enter data in the white

NAME OF QUALIFYING CHILD OR DEPENDENT

Head of household ..........

fields.

Married filing separate return. Enter spouse’s name and Social Security No. above.

If the field doesn't seem to calculate, continue

Single

filling in the white fields and the calculations

Enter the number claimed. Do not put a check mark.

will "catch up".

Age 65 or over (you and/or spouse)

Blind (you and/or spouse)

Use GREEN buttons to move around the form.

Dependents

Dependents. From page 2, line A2 – Do not include self or spouse.

…

11-13

Residency Status (check one): 11

Nonresident 12

Nonresident Active Military 13

Composite Return

This box may be blank or may contain a printed barcode of data from your return.

14 Federal AGI ........ 14

I M P O R T A N T - P l e a s e R e a d

Income

15 Arizona income

......... 15

(from page 2, line B16)

Additions

- This form is provided in a fill-in-format.

16 Additions to income

.. 16

(from page 2, line C21)

Subtractions

17 Subtractions

............. 17

(from page 2, line D32)

- When this form is printed using the PRINT button on the upper right

18 Arizona AGI:

.......... 18

Lines (15 + 16) - line 17

corner of this return, a two dimensional (2D) barcode is generated that

…

ITEMIZED

STANDARD ..... 19

includes the data entered in this form.

Select Personal Exemptions

20 Personal exemptions ................................. 20

- Using a 2D barcode vastly speeds up processing your return.

21 AZ taxable income:

. 21

Line 18 - lines (19 + 20)

X&Y Tax Table

22 Compute tax using Tax Table X or Y .......... 22

- Do NOT handwrite any data on the form other than your signature(s).

23 Tax from recapture of credits ..................... 23

- Use the PRINT button on this form to print your return.

24 Subtotal of tax:

............. 24

Add lines 22 and 23

25 Credits

...... 25

(Forms 301, or 321, 322, and 323)

- Use the BLACK ink setting of your printer to print this return. Do not use

the color ink setting.

26 Cr Type

27 Clean Elections Fund Tax Cr

(prior 8/2/2012)

28 Balance of tax:

.....................

Subtract lines 25 and 27 from line 24. If the sum of lines 25 and 27 is more than line 24, enter zero

29 Arizona income tax withheld during 2012 ..........................................................................................................................

30 Arizona estimated tax payments for 2012 .........................................................................................................................

31 2012 Arizona extension payment (Form 204) ....................................................................................................................

…

32 Other refundable credits: Check the box(es) and enter the amount .........................

Form 308-I

Form 342 32

33 Total payments/refundable credits:

............................................................................................

Add lines 29 through 32

No Withholding? Click this button

34 TAX DUE:

..........

If line 28 is larger than line 33, subtract line 33 from line 28, and enter amount of tax due. Skip lines 35, 36 and 37

..........................

35 OVERPAYMENT:

If line 33 is larger than line 28, subtract line 28 from line 33, and enter amount of overpayment

36 Amount of line 35 to be applied to 2013 estimated tax ......................................................................................................

37 Balance of overpayment:

..........................................................................................................

Subtract line 36 from line 35

38 - 47 Voluntary Gifts to:

Aid to Education .................................

Arizona Wildlife ...................................

Child Abuse Prevention ......................

Domestic Violence Shelter .................

I Didn’t Pay Enough Fund...................

National Guard Relief Fund ................

Neighbors Helping Neighbors.............

Special Olympics ................................

Veterans’ Donations Fund ..................

Political Gift.........................................

…

48 Voluntary Political gift

(check only one):

Americans Elect

Democratic

Green

Libertarian

Republican

49 Estimated payment penalty and MSA withdrawal penalty .................................................................................................

…

50 Check applicable boxes ....

Annualized/Other

Farmer or Fisherman

Form 221 attached

MSA Penalty

51 Total of lines 38 through 47 and 49 ...................................................................................................................................

52 REFUND:

.............................................................

Subtract line 51 from line 37. If less than zero, enter amount owed on line 53

…

Direct Deposit of Refund: Check box

if your deposit will be ultimately placed in a foreign account; see instructions. ......

…

ROUTING NUMBER

ACCOUNT NUMBER

Checking or

…

Savings