Form 140ptc - Property Tax Refund (Credit) Claim - 2013

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Property Tax Refund (Credit) Claim

FOR

Arizona Form 140PTC

CALENDAR YEAR

2013

You must file this form, or Form 204, by April 15, 2014.

Reset

View 140PTC Instructions

Print Return

Check box 82F if filing under extension

Check box 95 if amended for year 2013

82F

Your First Name and Middle Initial

Last Name

Your Social Security No.

Enter

your

If a joint claim, Spouse’s First Name and Middle Initial

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

REVENUE USE ONLY. DO NOT MARK IN THIS AREA.

-As a service to you, this form, along with

other forms available on our website, are

provided in a fill-in format.

Just type in

Your Date of Birth

your data prior to printing the form.

-When this form is printed, a two dimensional

(2D) barcode is generated that includes the

QUALIFICATIONS FOR CREDIT

(Check the boxes that apply):

data entered on the form. Using a 2D barcode

vastly speeds up processing your form.

4 On December 31, 2013, were you renting or did you own? If you own a

Rent Own

mobile home but rent the space, check “Rent” .................................................. 4

-Do NOT handwrite any other data on the form

other than your signature.

81 PM

80 RCVD

5 Were you an Arizona resident for all of 2013?

Yes

If “No”, STOP. You do not qualify ..................................................................... 5

-Use the PRINT button at the top of the form to

print the form once filled.

6 Did you pay property taxes on your home, pay rent, or pay a combination of

-A high quality printer is necessary to print

both in 2013? See instructions for qualifications.

usable copies of the forms. Any laser, ink-jet,

If “No”, STOP. You do not qualify ..................................................................... 6

or bubble-jet printer in good working order

should be fine.

7 Is this the only Property Tax Refund being claimed in your household?

-Use the BLACK ink setting of your printer to

If “No”, STOP. You do not qualify ..................................................................... 7

print the form.

8 Were you age 65 or older in 2013? Enter your birth date in box 79 above ...... 8

Use GREEN buttons to move around the

-Do NOT use the color setting.

9 Did you receive Title 16, SSI payments in 2013? If “Yes”, attach proof.

return.

If you answered “No” to both 8 and 9, STOP. You do not qualify. ..................... 9

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

Go to Income: Page 2 Part I

INCOME

10 Income: from page 2, Part I, line J, column 4 .... 10

YELLOW fields are Read-Only.

You can not enter

CREDIT

data in yellow fields.

11a If you lived alone, enter credit from Schedule I, and

These fields are calculated as you fill in the

check the box ...................... 11a

Schedule I

form.

11b If you didn’t live alone, enter credit from Schedule II,

and check the box ..............11b

Schedule II 11

12 If owned your property, enter property

taxes paid during 2013. Attach proof .............. 12

13 If you rented, enter taxes from Form 201 ........... 13

14 2013 property taxes paid: lines 12 + 13 ............. 14

15 Tax Credit: the smaller of line 11 or line 14 ...... 15

16 If you have been claimed as a dependent on anyone else’s tax return, complete the following:

Name Of Taxpayer Who Claimed You

Social Security No.

Address:

If you are not claimed as a dependent on anyone else’s tax return, turn the form over and complete Part II.

Go to Page 2 Part II

If someone else claims you as a dependent, skip lines 17 and 18, and complete line 19.

17 Credit for increased excise taxes from Form 140PTC, page 2, Part II, line 6 .................................................................. 17

18 Enter the number from page 2, Part II, line 2, here .............................................................................................. 18

19 Total Credit: Add lines 15 and 17, and enter the total. See page 5 of the instructions if you have to file

Arizona Form 140 or Form 140A ........................................................................................................................................ 19

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

If this is your first claim for 2013, STOP HERE AND GO TO THE SIGNATURE BOX ON PAGE 2. If

this is an amended claim, complete lines 20 through 22, and check the box at the top of the form.

AMENDED

20 Enter the amount from line 5 of the worksheet on page 6 of the instructions..................................................................... 20

21 Additional refund: If line 19 is larger than line 20, subtract line 20 from line 19 ................................................................ 21

22 Amount to pay: If line 19 is less than line 20, subtract line 19 from line 20. Make check payable to

Arizona Department of Revenue; include SSN on payment; attach payment where indicated at left ............................. 22

Continued on page 2

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ADOR 10567 (13)