ARIZONA FORM
TRANSACTION PRIVILEGE TAX
FOR
CALENDAR YEAR
51T
20YY
ELECTION FOR ACCOUNTING
AND REPORTING EXPENSES CREDIT
Mail to: Arizona Department of Revenue, 1600 W Monroe, Phoenix AZ 85007-2650
For assistance call: (602) 255-2060 or 1-800-843-7196 (statewide only); TDD (602) 542-4021 or 1-800-397-0256 (statewide only).
Reporting Entity Name
Employer identifi cation number
C/O
Business telephone number
Social Security Number
Mailing address
City or town, state, and ZIP code
Country
Postmark
Entity Type:
Check here if this is a change in election.
Check one
F= Consolidated
C= Combined
S= Separate Corporation
E= Estate
Change is to be effective beginning
.
H= Subchapter S
P= Partnership
I= Sole Proprietor
T= Trust
Month & Year
A business entity which fi les a single Arizona income tax return that includes income from more than one transaction privilege tax license should fi le this election
form with the Department of Revenue if it is expected that the credit for accounting and reporting expenses for all transaction privilege tax licenses will meet or
exceed the maximum $10,000 amount for the calendar year. This election form should indicate how the credit will be allocated among the licensees.
List all Arizona transaction privilege tax licenses that will be part of this group subject to the election.
Please use whole dollar amounts in each election; if none, please enter zero.
Entity
Transaction Privilege Tax Licensee
Employer Identifi cation
Arizona Transaction
Election Amount
Number
Privilege Tax Number
Type
A/D/C
$
00
1
$
00
2
$
00
3
$
00
4
$
00
5
$
00
6
$
00
7
$
00
8
$
00
9
$
00
10
$
00
11
$
00
12
$
00
13
$
00
14
Please
Sign here
Taxpayer’s Signature
Date
Taxpayer’s Title
Phone Number
ADOR 10150 (12)
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