Arizona Form 120x - Arizona Amended Corporation Income Tax Return - 2012 Page 2

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Name (as shown on page 1)

EIN

Schedule C - Apportionment Formula (Multistate Corporations Only)

See instructions, pages 5 and 6.

NOTE: Qualifying air carriers must use Schedule ACA

Property Factor

Column A

Column B

Column C

Value of real and tangible personal property (by averaging the

Total Everywhere

Ratio Within

Total Within Arizona

value of owned property at the beginning and end of the tax

Arizona

Round to the

period; rented property at capitalized value)

A ÷ B

Nearest Dollar

a Owned property (at original cost):

Inventories .....................................................................................

Depreciable assets - (do not include Construction in Progress) ....

Land ...............................................................................................

Other assets - (describe)

(

)

(

)

Less: Nonbusiness property (if included in above totals) ..............

Total of section a ............................................................................

b Rented property (capitalize at 8 times net rental paid) ..................

•

c Total owned and rented property (section a total plus section b) ..

Payroll Factor

Total wages, salaries, commissions and other compensation

•

paid to employees (per federal Form 1120 or payroll reports) .......

Sales Factor

a Sales delivered or shipped to Arizona purchasers ........................

b Other gross receipts ......................................................................

c Total sales and other gross receipts ..............................................

X 2

X 8

d Weight AZ sales - (STANDARD uses X 2; ENHANCED uses X 8) .

e Sales factor (for column A - multiply item c by item d;

•

for column B - enter the amount from item c) ...............................

•

Total ratio - add C1(c), C2, and C3(e), in column C ............................................................................................................

Average apportionment ratio - divide line C4, column C, by the denominator (STANDARD divides by four (4);

•

ENHANCED divides by ten (10)). Enter the result in column C, and on page 1, line 9(c) ...................................................

Schedule D - Schedule of Payments (List payment date and amount).

M M D D Y Y Y Y

Payment with original return ...............................................................................................

M M D D Y Y Y Y

Payment after original return filed .......................................................................................

M M D D Y Y Y Y

Payment after original return filed .......................................................................................

M M D D Y Y Y Y

Total - add lines D1, D2 and D3 ..........................................................................................

Schedule E - Explanation of Changes (See instructions, page 6).

Certification The following certification must be signed by one or more of the following officers (president, treasurer, or any other principal officer).

Under penalties of perjury, I(we), the undersigned officer(s) authorized to sign this return, declare that I(we) have examined this return,

including the accompanying schedules and statements, and to the best of my(our) knowledge and belief, it is a true, correct and

complete return, made in good faith, for the taxable year stated pursuant to the income tax laws of the State of Arizona.

Please

Officer’s Signature

Date

Title

Sign

Here

Officer’s Signature

Date

Title