Arizona Form 140py - Part-Year Resident Personal Income Tax Return - 2004

Download a blank fillable Arizona Form 140py - Part-Year Resident Personal Income Tax Return - 2004 in PDF format just by clicking the "DOWNLOAD PDF" button.

Open the file in any PDF-viewing software. Adobe Reader or any alternative for Windows or MacOS are required to access and complete fillable content.

Complete Arizona Form 140py - Part-Year Resident Personal Income Tax Return - 2004 with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.

Some fillable PDF-files have the option of saving the completed form that contains your own data for later use or sending it out straight away.

DUALTT-XBEB-RDTD-VGLK-IMWV

Press here to PRINT this Form

Reset

ARIZONA FORM

Part-Year Resident Personal Income Tax Return

2004

140PY

Or ﬁ scal year beginning

and ending

M M D D

YOUR FIRST NAME AND INITIAL

LAST NAME

YOUR SOCIAL SECURITY NO.

IF A JOINT RETURN, SPOUSE’S FIRST NAME AND INITIAL

LAST NAME

SPOUSE’S SOCIAL SECURITY NO.

PRESENT HOME ADDRESS - NUMBER AND STREET, RURAL ROUTE

APT. NO.

DAYTIME PHONE:

IMPORTANT

You must enter your SSNs.

HOME PHONE:

CITY, TOWN OR POST OFFICE

STATE

ZIP CODE

FOR DOR USE ONLY

A T T E N T I O N

Married ﬁ ling joint return

You are NOT able to use this form if you are

Head of household - name of qualifying child or dependent:

claiming exemption(s) for Qualifying Parents.

Married ﬁ ling separate return. Enter spouse’s Social Security Number above

Click here to go to a fillable form. The form is

and full name here.

►

not barcoded.

Single

Age 65 or over (you and/or spouse)

Enter the

number

Blind (you and/or spouse)

claimed.

CHECK ONE if ﬁ ling under an extension:

Do not put

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

4 month extension

82D

a check

CLICK HERE IF YOU HAVE THIS EXEMPTION

mark.

Qualifying parents\ancestor

6 month extension

82F

12-13 Residency Status (check one): 12

Part-Year Resident Other than Active Military

Part-Year Resident Active Military

THIS BOX MAY BE BLANK OR MAY CONTAIN A PRINTED BARCODE OF DATA

Federal adjusted gross income...

Arizona income (

).................................

-As a service to you, this form, along with other forms available on our

from page 2, line B19

website, are provided in a fill-in format. Just type in your data prior to

Additions to income (

).......................

from page 2, line C24

printing the form.

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

-When this form is printed, a two dimensional (2D) barcode is generated

(This line not used.)

that includes the data entered on the form. Using a 2D barcode vastly

1 .......... 19

Subtractions from income (

)

from page 2, line D34a

speeds up processing your form.

Arizona AGI. Subtract line 19 from line 17..............................

-Do NOT handwrite any other data on the form other than your signature(s)

STANDARD .......

Deductions.

ITEMIZED

and date(s).

Personal exemptions. ..............................................................

-Use the PRINT button at the top of the form to print the form once filled.

Arizona taxable income. Line 20 minues lines 21 & 22...........

-A high quality printer is necessary to print usable copies of the forms. Any

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

Compute the tax using Tax Rate Table X or Y

laser, ink-jet, or bubble-jet printer in good working order should be fine.

. ............................................. 25

Tax from recapture of credits

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

-Use the BLACK ink setting of your printer to print the form. Do not use the

color setting.

27-28

.. 28

Clean Elections Fund.

YOURSELF

SPOUSE

29 Reduced tax. Subtract line 28 from line 26.......................................................................................................................................... 29

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

31 Credits from Arizona Form 301, line 58, or Forms 310, 321, 322 and 323 if Form 301 is not required................................................ 31

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

33 Clean Elections Fund Tax Credit. From worksheet on page 18 of the instructions.............................................................................. 33

34 Balance of tax. Subtract lines 30, 31 and 33 from line 29. If the sum of lines 30, 31 and 33 is more than line 29, enter zero........... 34

35 Arizona income tax withheld during 2004 ............................................................................................................................................. 35

36 Arizona estimated tax payments for 2004............................................................................................................................................. 36

37 Amount paid with 2004 Arizona extension request (Form 204) ............................................................................................................ 37

38 Increased Excise Tax Credit. From worksheet on page 18 of the instructions .................................................................................... 38

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

329

330................................................................... 39

40 Total payments/refundable credits. Add lines 35 through 39. .............................................................................................................. 40

41 TAX DUE. If line 34 is larger than line 40, subtract line 40 from line 34, and enter amount of tax due. Skip lines 42, 43 and 44. ..... 41

42 OVERPAYMENT. If line 40 is larger than line 34, subtract line 34 from line 40, and enter amount of overpayment........................... 42

43 Amount of line 42 to be applied to 2005 estimated tax ......................................................................................................................... 43

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

45 - 52 Voluntary Gifts to:

Aid to Education

Arizona Wildlife

Citizens Clean Elections

(entire refund only)

Child Abuse Prevention

Domestic Violence Shelter

Neighbors Helping

Neighbors

Political Gift

Special Olympics

53 Check only one if making a political gift:

Democratic

Libertarian

Republican

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

55 Check applicable boxes:

Annualized/Other

Farmer or Fisherman

Form 221 attached

MSA Penalty

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

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

Direct Deposit of Refund: See instructions.

ROUTING NUMBER

ACCOUNT NUMBER

Checking or

Savings

58 AMOUNT OWED. Add lines 41 and 56. Make check payable to Arizona Department of Revenue; include SSN on payment.

ADOR 91-0069 (04)

e-ﬁ le

Fast • Safe • Secure