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ARIZONA FORM

Authorization and Consent of Subsidiary Corporation

122

to be Included in a Consolidated Income Tax Return

YYYY

For taxable year beginning ______/______/________, and ending ______/______/________

Attach to your return

( Please type or print )

For the ﬁ rst taxable year a consolidated return is ﬁ led, this form must be completed by each subsidiary, and attached to the return.

Name

Employer identiﬁ cation number

Number and street or PO Box

City or town, state, and ZIP code

Name of common parent corporation

Employer identiﬁ cation number

The subsidiary corporation named above authorizes its common parent corporation to include it in a consolidated return for the taxable year indicated.

The authorization also applies to each succeeding taxable year, unless the department consents to a change of ﬁ ling method.

Signature

Under penalties of perjury, I declare that the subsidiary named above has authorized me to sign this form on its behalf, that I have examined this

form and the information contained herein, and to the best of my knowledge and belief, it is correct and complete.

Signature of corporate ofﬁ cer

Title

Date

Name of corporate ofﬁ cer (print or type)

Telephone number

Purpose of Form

How to Make an Election to File an Arizona

Consolidated Return

The common parent of an afﬁ liated group that ﬁ les a federal

•

consolidated return may elect to ﬁ le an Arizona consolidated return.

Complete a separate Form 122 for each subsidiary included in

The election by the common parent is effective only if it is accompanied

the federal afﬁ liated group for the taxable year for which

by written consents to the election signed by each of the members

the election is made. The Form 122 for each subsidiary

of the afﬁ liated group. This form is used by each of the subsidiary

must be signed by a current ofﬁ cer of that subsidiary.

corporations included in the afﬁ liated group to consent to the election

•

made by the common parent. The consent form must be signed by a

File all of the completed Forms 122 (for each subsidiary included

in the federal afﬁ liated group) AND the tax return by the due

current ofﬁ cer of each subsidiary in the afﬁ liated group.

date, including extensions, for ﬁ ling the original return.

NOTE: Refer to ARS § 43-947 and the Form 120 instructions for further

information regarding the election to ﬁ le an Arizona consolidated return.

Elections for Taxable Years Beginning From and After

December 31, 1993

The election must be made by the common parent on or before

the due date, including any extensions, for ﬁ ling the original return

(Form 120). The completed Forms 122 must be attached to the

Form 120 ﬁ led with the department for the ﬁ rst taxable year a

consolidated return is ﬁ led. The consent form must be signed

by a current ofﬁ cer of each subsidiary in the afﬁ liated group.

ADOR 91-0067 (04)

Arizona Form 122 - Authorization And Consent Of Subsidiary Corporation To Be Included In A Consolidated Income Tax Return

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