Form 140py - Part-Year Resident Personal Income Tax Return - 2013

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FOR

Arizona Form 140PY

Part-Year Resident Personal Income Tax Return

CALENDAR YEAR

2013

Calculate

. 66

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)

City, Town or Post Office

State

ZIP Code

Last Names Used in Prior Year(s)

REVENUE USE ONLY. DO NOT MARK IN THIS AREA.

NOTE:

Yellow fields are Read-Only.

Married filing joint return

Head of household –

Enter name of qualifying child or dependent on next line:

You can not enter data in the yellow

fields.

They calculate as you enter

Married filing separate return.

Enter spouse’s name and Social Security No. above.

data in the white fields.

Single

If the field doesn't seem to

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

calculate, continue filling in the

81 PM

80 RCVD

Age 65 or over (you and/or spouse)

white fields and the calculations

Dependents

Blind (you and/or spouse)

will "catch up".

Use GREEN buttons to move around the

form.

Dependents. From page 2, line A2 –

do not include self or spouse.

Qualifying parents and grandparents

from page 2, line A5.

12-13 Residency Status

: 12

Part-Year Resident Other than Active Military

Part-Year Resident Active Military

(check one)

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

Income

14 Federal AGI ..... 14

P l e a s e

R e a d

15 Arizona income

...........15

(from page 2, line B19)

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

Additions

16 Additions to income

....16

(from page 2, line C24)

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

17 Subtotal: Add lines 15 and 16 .....................17

upper right corner of this return, a two dimensional (2D)

barcode is generated that includes the data entered in this

Subtractions

18 Subtractions

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

(from page 2, line D36)

form.

AZ Gain/Loss

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

20 Arizona AGI:

...........20

Lines 17 - lines (18 + 19)

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

ITEMIZED

STANDARD ........21

signature(s).

Select Personal Exemptions

22 Personal exemptions. ................................22

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

23 AZ taxable income:

......23

Line 20 - lines (21+22)

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

X&Y Tax Table

24 Compute the tax using Tax Table X or Y ......24

return.

Do not use the color ink setting.

25 Tax from recapture of credits .......................25

26 Subtotal of tax:

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

Add lines 24 and 25

27 Family income tax credit from worksheet in the instructions .......................................................................................... 27

28 Credits from Arizona Form 301, Part II, line 69, or Forms 310, 321, 322 and 323, if Form 301 is not required ............. 28

................. 29

29 Credit type:

Enter form number of each credit claimed

30 Balance of tax:

.................. 30

Subtract lines 27 and 28 from line 26. If the sum of lines 27 and 28 is more than line 26, enter zero

31 Arizona income tax withheld during 2013 ....................................................................................................................... 31

32 Arizona estimated tax payments for 2013 ...................................................................................................................... 32

33 2013 Arizona extension payment (Form 204) ................................................................................................................. 33

34 Increased Excise Tax Credit:

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

From worksheet in the instructions

35 Other refundable credits:

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

308-I

342

349

350 35

Check the box(es); enter the amount

36 Total payments/refundable credits:

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

Add lines 31 through 35

37 TAX DUE:

....... 37

If line 30 is larger than line 36, subtract line 36 from line 30, and enter amount of tax due. Skip lines 38, 39 and 40

38 OVERPAYMENT:

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

If line 36 is larger than line 30, subtract line 30 from line 36, and enter amount of overpayment

39 Amount of line 38 to be applied to 2014 estimated tax ................................................................................................... 39

40 Balance of overpayment:

....................................................................................................... 40

Subtract line 39 from line 38

41 - 50 Voluntary Gifts to:

Solutions Teams Assigned To Schools ..

Arizona Wildlife .........

Child Abuse Prevention .......

Politcal Gift ...............

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

National Guard Relief Fund .

Special Olympics ......

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

Veterans’ Donations Fund ...

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

51 Voluntary Political Gift

(check only one):

Americans Elect

Democratic

Green

Libertarian

Republican

52 Estimated payment penalty; MSA pentalty, and AZ Long-Term Health Care Savings Account (AZLTHSA) penalty ...... 52

Annualized/Other

Farmer or Fisherman

Form 221 attached

MSA Penalty

AZLTHSA Penalty

54 Total of lines 41 through 50 and 52 ................................................................................................................................ 54

55 REFUND:

.......................................................... 55

Subtract line 54 from line 40. If less than zero, enter amount owed on line 56

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

56 AMOUNT OWED:

.... 56

Add lines 37 and 54.