Arizona Form 320 - Credit For Employment Of Tanf Recipients - 2012 Page 3
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4Your Name (as shown on page 1)
Your Social Security or Employer Identification Number
Column (b): Type SSN digits only.
Form 320-1 (2012)
Qualifying Employees
Columns (d) and (e): Click on the
Column (c): Type MMDDYYYY digits only;
down arrow and select "No" or "Yes"
use leading zeros.
(a)
(b)
(c)
(d)
(e)
Was this employee an
Was this employee
Social Security
Arizona resident on
receiving TANF benefits
Employee’s Name
Number
Date of Hire
date of hire?
on date of hire?
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If you have more than 25 qualifying employees, complete additional schedules.
ADOR 10579 (12)
Print 320-1
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Parent category: Financial