Arizona Form 122 - Authorization And Consent Of Subsidiary Corporation To Be Included In A Consolidated Income Tax Return

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ARIZONA FORM
Authorization and Consent of Subsidiary Corporation
122
to be Included in a Consolidated Income Tax Return
M M D D Y Y Y Y
M M D D Y Y Y Y
For the calendar year 2012 or fi scal year beginning
and ending
.
Attach to your return.
( Please type or print. )
For the fi rst taxable year a consolidated return is fi led, this form must be completed by each subsidiary, and attached to the return.
Name
Employer identifi cation number
Number and street or PO Box
City or town, state, and ZIP code
Name of common parent corporation
Employer identifi cation number
The subsidiary corporation named above authorizes its common parent corporation to include it in a consolidated return for the taxable year indicated.
The authorization also applies to each succeeding taxable year, unless the department consents to a change of fi ling method.
Signature
Under penalties of perjury, I declare that the subsidiary named above has authorized me to sign this form on its behalf, that I have examined this form
and the information contained herein, and to the best of my knowledge and belief, it is correct and complete.
Signature of corporate offi cer
Title
Date
Name of corporate offi cer (print or type)
Telephone number
Print
How to Make an Election to File an Arizona
Purpose of Form
Consolidated Return
The common parent of an affi liated group that fi les a federal
•
Complete a separate Form 122 for each subsidiary included
consolidated return may elect to fi le an Arizona consolidated
in the federal affi liated group for the taxable year for which the
return. The election by the common parent is effective only if
election is made. The Form 122 for each subsidiary must be
it is accompanied by written consents to the election signed by
signed by a current offi cer of that subsidiary.
each of the members of the affi liated group. This form is used
by each of the subsidiary corporations included in the affi liated
•
File all of the completed Form(s) 122 (for each subsidiary
group to consent to the election made by the common parent.
included in the federal affi liated group) AND the tax return by the
The consent form must be signed by a current offi cer of each
due date, including extensions, for fi ling the original return.
subsidiary in the affi liated group.
NOTE: Refer to ARS § 43-947 and Form 120 instructions for
further information regarding the election to fi le an Arizona
consolidated return.
Elections for Taxable Years Beginning From and
After December 31, 1993
The election must be made by the common parent on or before
the due date, including any extensions, for fi ling the original
return (Form 120). The completed Form(s) 122 must be attached
to Form 120 fi led with the department for the fi rst taxable year a
consolidated return is fi led. The consent form must be signed by
a current offi cer of each subsidiary in the affi liated group.
ADOR 10147 (12)

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