Form 140 - Resident Personal Income Tax Return - 2013

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FOR

CALENDAR YEAR

Arizona Form 140

Resident Personal Income Tax Return

2013

Calculate

Reset

. 66

OR FISCAL YEAR BEGINNING

AND ENDING

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)

City, Town or Post Office

State

ZIP Code

Last Names Used in Prior Year(s)

REVENUE USE ONLY. DO NOT MARK IN THIS AREA.

Married filing joint return

NOTE:

Yellow fields are

Read-Only.

Head of household –

Enter name of qualifying child or dependent on next line:

You can not enter data in the

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

yellow fields.

They calculate

as you enter data in the white

Single

fields.

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

Age 65 or over (you and/or spouse)

If the field doesn't seem to

81 PM

80 RCVD

Blind (you and/or spouse)

Dependents and Qualifying Parents

calculate, continue filling in

Dependents.

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

the white fields and the

Use GREEN buttons to move around

calculations will "catch up".

Qualifying parents and grandparents.

the form.

From page 2, line A5.

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

I M P O R T A N T - Please Read

Additions

Federal adjusted gross income .............................

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

Additions to income (from page 2, line B12) ..........

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

Subtotal: Add lines 12 and 13, and enter the total

right

Subtractions

Subtractions (from page 2, line C17 or line C30) ..

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

generated that

Gain/Loss:

Subtr.

includes the data entered in the form.

Arizona AGI: Line 14 - (lines 15 + 16) .................

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

Sch A

............ 18

ITEMIZED

STANDARD

- Do NOT handwrite any data on the form other than your signature

(s).

Select Personal Exemption

Personal exemptions. ..........................................

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

Arizona taxable income: Line 17 - (lines 18 + 19)

Opt Tax Table

- Use the BLACK ink setting of your printer to print this return.

Compute tax: use line 20 & proper Tax Table ........

X&Y Tax Table

Do not use

............................. 22

the color ink setting.

Tax from recapture of credits

.................. 23

Subtotal of tax: Add lines 21 and 22

24 Family income tax credit

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

(from worksheet in the instructions)

25 Credits from Arizona Form 301, Part II, line 69, or Forms 310, 321, 322, and 323 if Form 301 is not required ............. 25

................. 26

Credit 301

26 Credit type:

Enter form number of each credit claimed

27 Balance of tax:

.................. 27

Subtract lines 24 and 25 from line 23. If the sum of lines 24 and 25 is more than line 23, enter zero

28 Arizona income tax withheld during 2013 ....................................................................................................................... 28

29 Arizona estimated tax payments for 2013 ...................................................................................................................... 29

30 2013 Arizona extension payment (Form 204) ................................................................................................................. 30

31 Increased Excise Tax Credit

................................................................. 31

(from Form 140PTC or worksheet - see instructions)

32 Property Tax Credit from Form 140PTC ......................................................................................................................... 32

33 Other refundable credits:

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

308-I

342

349

350 33

Check the box(es); enter the amount

34 Total payments/refundable credits:

......................................................................................... 34

Add lines 28 through 33

35 TAX DUE:

........ 35

If line 27 is larger than line 34, subtract line 34 from line 27 and enter amount of tax due. Skip lines 36, 37 and 38

36 OVERPAYMENT:

........................ 36

If line 34 is larger than line 27, subtract line 27 from line 34 and enter amount of overpayment

37 Amount of line 36 to be applied to 2014 estimated tax ................................................................................................... 37

38 Balance of overpayment:

....................................................................................................... 38

Subtract line 37 from line 36

39 - 48 Voluntary Gifts to:

Solutions Teams Assigned to Schools ....

Arizona Wildlife .........

Child Abuse Prevention .......

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

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

National Guard Relief Fund .

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

Special Olympics ......

Veterans’ Donations Fund ...

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

49 Voluntary Political Gift

(check only one):

Americans Elect

Democratic

Green

Libertarian

Republican

50 Estimated payment penalty; MSA penalty; and AZ Long-Term Health Care Savings Account (AZLTHSA) penalty ....... 50

Annualized/Other

Farmer or Fisherman

Form 221 attached

MSA Penalty

AZLTHSA Penalty

52 Total of lines 39 through 48 and 50 ................................................................................................................................ 52

53 REFUND:

.......................................................... 53

Subtract line 52 from line 38. If less than zero, enter amount owed on line 54

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

54 AMOUNT OWED:

Add lines 35 and 52. Make check payable to Arizona Department of Revenue; include SSN on payment.

ADOR 10413 (13)