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

ARIZONA FORM

Part-Year Resident Personal Income Tax Return

1999

140PY

Or fiscal tax year beginning ____________, 1999, and ending _________, 2000.

Your first name and initial

Last name

Your social security number

If a joint return, spouse's first name and initial

Last name

Spouse's social security number

Present home address - number and street, rural route

Apt. No.

Daytime telephone

IMPORTANT!

You must enter

(

)

your SSN(s) above.

Home telephone

City, town or post office

State

ZIP code

For DOR use only

(

)

Married filing joint return

Head of household -

name of qualifying dependent :

Married filing separate return. Enter spouse's social security number above

and full name here.

Single

Age 65 or over (you and/or spouse)

Enter the number

Blind (you and/or spouse)

claimed. Do not put

4 month federal extension

CHECK ONE if filing under a

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

a check mark.

federal extension:

6 month federal extension

Qualifying parents and ancestors. From page 2, line A5.

( Check one )

Residency Status

Part-year resident other than active military

Part-year resident active military

14 Federal adjusted gross income (from your federal return) .........................................................................

15 Arizona income (from page 2, line B21) ..................................................................................................................................................

16 Additions to income (from page 2, line C25) ...........................................................................................................................................

17 Add lines 15 and 16 .................................................................................................................................................................................

18 Elective subtraction of 1999 federal retirement contributions. See instructions ......................................................................................

19 Subtractions from income (from page 2, line D37) ..................................................................................................................................

20 Arizona adjusted gross income. Subtract lines 18 and 19 from line 17 ...................................................................................................

See instructions, page 13.

21 S

STANDARD ....

21 Deductions.

Check box and enter amount.

21 I

ITEMIZED

22 Personal exemptions. See page 14 of the instructions ............................................................................................................................

Arizona taxable income. Subtract lines 21 and 22 from line 20 ...............................................................................................................

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

25 Tax from recapture of credits from Arizona Form 301, line 28 ................................................................................................................

26 Subtotal of tax. Add lines 24 and 25 ........................................................................................................................................................

YOURSELF

SPOUSE

27 Clean Elections Fund Tax Reduction. See instructions, page 15.

Tax reduction. Complete worksheet on page 15 of the instructions .......................................................................................................

Reduced tax. Subtract line 28 from line 26 .............................................................................................................................................

30 Family income tax credit from worksheet on page 16 of the instructions ................................................................................................

31 Credits from Arizona Form 301, line 53 ...................................................................................................................................................

32 Credit type. Enter form number of each credit claimed ...............

33 Subtract lines 30 and 31 from line 29. If the sum of lines 30 and 31 is more than line 29, enter zero ....................................................

34 Clean Elections Fund Tax Credit. From worksheet on page 18 ..............................................................................................................

35 Balance of tax. Subtract line 34 from line 33. If line 34 is more than line 33, enter zero. ........................................................................

36 Arizona income tax withheld during 1999 ................................................................................................................................................

Arizona estimated tax payments for 1999 ...............................................................................................................................................

Amount paid with 1999 Arizona extension request (Form 204) ..............................................................................................................

Total payments. Add lines 36, 37 and 38 ................................................................................................................................................

40 TAX DUE. If line 35 is larger than line 39, enter amount of tax due. Skip lines 41, 42 and 43 ...............................................................

41 OVERPAYMENT. If line 39 is larger than line 35, enter amount of overpayment ...................................................................................

Amount of line 41 to be applied to 2000 estimated tax ...........................................................................................................................

43 Balance of overpayment. Subtract line 42 from line 41 ...........................................................................................................................

Voluntary gifts to:

Aid to Education Fund (Enter entire refund only)

Arizona Wildlife Fund

Citizens Clean Elections Fund

Child Abuse Prevention Fund

Domestic Violence Shelter Fund

Neighbors Helping Neighbors Fund

Political Gift

Special Olympics Fund

52 Check only one if making a political gift:

Democratic

Libertarian

Reform

Republican

53 Estimated payment penalty and interest .................................................................................................................................................

Check applicable box(es).

Annualized/Other

Farmer or fisherman

Form 221 attached

55 MSA withdrawal penalty ..........................................................................................................................................................................

Total of lines 44, 45, 46, 47, 48, 49, 50, 51, 53 and 55 ...........................................................................................................................

57 REFUND. Subtract line 56 from line 43. If less than zero, enter amount owed on line 58 ......................................................................

Make Checks Payable To: Arizona Department of Revenue

58 AMOUNT OWED. Add lines 40 and 56. Include SSN on payment

ADOR 06-0069 (99)