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

2000

Part-Year Resident Personal Income Tax Return

ARIZONA FORM

140PY

Or fiscal tax year beginning ____________, 2000, and ending _________, 2001.

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.

City, town or post office

State

ZIP code

Home telephone

For DOR use only

(

)

Married filing joint return

Head of household - name of qualifying child or 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

4 month federal extension

CHECK ONE if filing under a

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

put a check mark.

federal extension:

6 month federal extension

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

Part-year resident other than active military

Part-year resident active military

Residency Status

( Check one )

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 2000 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 ...................................................................................................

21 Deductions.

See instructions, page 13.

21 I

ITEMIZED

21 S

STANDARD ....

Check box and enter amount.

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

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

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

25 Tax from recapture of credits from Arizona Form 301, line 30 .................................................................................................................

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

YOURSELF

SPOUSE

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

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

29 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 56 ...................................................................................................................................................

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 2000 .................................................................................................................................................

37 Arizona estimated tax payments for 2000 ................................................................................................................................................

38 Amount paid with 2000 Arizona extension request (Form 204) ...............................................................................................................

39 Other refundable credits check box(es) and enter amount(s). ...............

313

326

327

40 Total payments/refundable credits. Add lines 36, 37, 38 and 39 .............................................................................................................

41 TAX DUE. If line 35 is larger than line 40, subtract line 40 from line 35 and enter amount of tax due. Skip lines 42, 43 and 44 ............

42 OVERPAYMENT. If line 40 is larger than line 35, subtract line 35 from line 40 and enter amount of overpayment ...............................

43 Amount of line 42 to be applied to 2001 estimated tax ............................................................................................................................

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

Voluntary gifts to:

Aid to Education Fund (Enter entire refund only)

Arizona Wildlife Fund

Child Abuse Prevention Fund

Citizens Clean Elections Fund

Domestic Violence Shelter Fund

Neighbors Helping Neighbors Fund

Special Olympics Fund

Political Gift

Check only one if making a political gift:

Democratic

Green

Libertarian

Natural Law

Reform

Republican

54 Estimated payment penalty and interest and MSA withdrawal penalty ....................................................................................................

Check applicable box(es).

Annualized/Other

Farmer or fisherman

Form 221 attached

MSA penalty

56 Total of lines 45, 46, 47, 48, 49, 50, 51, 52 and 54 ..................................................................................................................................

57 REFUND. Subtract line 56 from line 44. If less than zero, enter amount owed on line 58 .......................................................................

Make Checks Payable To: Arizona Department of Revenue

58 AMOUNT OWED. Add lines 41 and 56. Include SSN on payment

ADOR 06-0069 (00)