ARIZONA FORM
Authorization and Consent of Subsidiary Corporation
122
to be Included in a Consolidated Income Tax Return
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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
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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
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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)