Application For Individual Income Tax Penalty Amnesty
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1Application for Individual Income Tax Penalty Amnesty
How Will I Know If The Department Grants My
Phone Numbers
Amnesty Request?
If you need help, please call one of the help numbers listed below.
The department will notify you by mail within 30 days of
Phoenix
(602) 255-3381
receiving your application if you are granted amnesty. If you
From area codes 520 & 928 toll-free
(800) 352-4090
have not received notification within 30 days, contact one of
the numbers listed at the beginning of these instructions.
Hearing impaired TDD user
Phoenix
(602) 542-4021
Line-by-Line Instructions
From area codes 520 & 928 toll-free
(800) 397-0256
NOTE: Make sure that you write your social security
Who Can Use This Form?
number on the appropriate line.
You may use this form to request tax penalty amnesty if you have
Type or print your name in black or blue ink. Include your
an unpaid individual income tax liability for taxable years 2000 or
first name, middle initial, and last name. Enter your SSN in
prior if the liability was established as of November 21, 2001.
the space provided. If a joint application, also enter your
What is Tax Penalty Amnesty?
spouse’s name and SSN. If you are filing a joint application,
enter your SSNs in the same order as your names.
Tax penalty amnesty is the abatement or waiver of penalties.
If the department grants you amnesty, the department will:
Print or type your address. Include your present number and
street or rural route. Include your apartment number if you
1.
Abate any penalties that have been previously assessed or
live in an apartment. Include your mobile home lot number if
imposed on the amounts unpaid as of November 21, 2001 and
you live in a mobile home. Use your current home address.
remaining unpaid as of the date of the amnesty application.
Identification Numbers for Paid Preparers
2.
Waive any penalties that would otherwise be owing for
the taxable year for amounts unpaid as of November 21,
If you pay someone else to prepare your application, that person
2001 and remaining unpaid as of the date of the amnesty
must also include an identification number where requested.
application.
A paid preparer may use any of the following.
How Can I Apply For Tax Penalty Amnesty?
•
his or her SSN
To apply for tax penalty amnesty, complete the Application
•
his or her PTIN
for Individual Income Tax Penalty Amnesty and remit the
•
the federal employer identification number for the business
total tax and interest due for all years for which you are
Lines 1 through 6-
requesting amnesty with the amnesty application.
If you are requesting amnesty for all eligible tax years, check
When Can I File a Tax Penalty Amnesty
the box and enter the total tax and interest due for all years
Application?
on line 6. In this case skip lines 1 through 5.
You may apply for amnesty beginning on January 1, 2002,
If you are requesting amnesty for specific tax years,
through February 28, 2002. Amnesty cannot be granted if
complete lines 1 through 5. In column (a) of lines 1 through
the application is filed after February 28, 2002.
5, enter the taxable years for which you are requesting
Where Should I File my Amnesty Application?
amnesty. If you are requesting amnesty for more than 5
taxable years, complete an additional schedule. In column
Complete the Application for Individual Income Tax Penalty
(b) of lines 1 through 5, enter the total amount of tax and
Amnesty and mail to:
interest due for each year that you are requesting amnesty.
Arizona Department of Revenue
Add the amounts in column (b) of lines 1 through 5 and enter
P O Box 52153
the total on line 6. If you have completed an additional
Phoenix, AZ 85072-2153
schedule, include the total tax and interest from your
Do I Waive Any Rights if I am Granted Amnesty?
additional schedule with the total entered on line 6. This is
the amount that you must remit with the amnesty application.
Yes. If the department grants you amnesty, you waive any
right to refund or credit for the total amount of the tax
Make your check payable to Arizona Department of
liability for each taxable year included in the application. If
Revenue. Write your social security number on the front of
the department grants you amnesty, that will also terminate
your check or money order. Enclose your check or money
any appeal of an audit determination or refund denial. If you
order with your application. The department will apply your
have proceedings before the State Board of Tax Appeals
payment to your account regardless of whether the
(BOTA) or any court, BOTA or the court will dismiss each
action or proceeding before that body on receiving a
department grants you amnesty.
certification from the department that amnesty has been
The department cannot accept checks or money orders in
granted for the taxable year.
foreign currency. You must make payment in U.S. dollars.
The department may audit taxpayers for amnesty years,
Sign Your Application
subject to the statute of limitations and depending upon
whether a previous audit has already been done. You may
You must sign your application. If married filing a joint
contest any deficiency that is determined by audit, but you
application, both you and your spouse must sign.
will not receive any credit or refund for an amount that
would reduce the tax liability for any period below the
amount covered by amnesty.
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