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Arizona PACT Act Statement
Extracted from PDF file 2023-arizona-form-11134.pdf, last modified October 2009PACT Act Statement
Arizona Department of Revenue • Tobacco Tax PACT Act Statement (15 U.S.C. 376(a)(1)) Federal law requires filing of this form by any person who intends to sell, transport, or ship cigarettes or smoking tobacco into Arizona (or who advertises or offers to do so) from outside the state, from Indian country, or from within Arizona if passing through points outside the state or in Indian country. This form must be filed before any such sale or transfer. The Arizona Department of Revenue will not consider this statement properly filed unless all of the requested information is accurately and completely provided. SELLER’S INFORMATION Name of Seller Trade Name (if applicable) Principle Place of Business - Address Phone Number (with area code) City State Address of any other place of business Phone Number (with area code) City State Seller’s Email Address Web Site Address Zip Code Zip Code AUTHORIZED AGENT’S INFORMATION (must meet requirements for statutory agents found in A.R.S. Title 10 or 29) Name of Authorized Agent Address Phone Number (with area code) City State Zip Code PLEASE SIGN HERE AZ Under penalties of perjury, I/we declare that to the best of my/our knowledge and belief, the information in this statement is true, correct and complete. Ä Ä PRINT YOUR NAME TITLE YOUR SIGNATURE DATE Please mail to: Arizona Department of Revenue, Tobacco Tax, 1600 West Monroe, Phoenix, AZ 85007 ADOR 11134 (7/10) Print Page Reset Agent
PACT Act Statement
More about the Arizona Form 11134 Individual Income Tax TY 2023
Arizona residents who qualify, complete this form to request to have no Arizona income tax withheld from their wages.
We last updated the PACT Act Statement in February 2024, so this is the latest version of Form 11134, fully updated for tax year 2023. You can download or print current or past-year PDFs of Form 11134 directly from TaxFormFinder. You can print other Arizona tax forms here.
Other Arizona Individual Income Tax Forms:
TaxFormFinder has an additional 95 Arizona income tax forms that you may need, plus all federal income tax forms.
| Form Code | Form Name |
|---|---|
| Form 140 | Resident Personal Income Tax Return |
| Form 140 Instructions | Income Tax Instruction Packet |
| Form 140A | Resident Personal Income Tax (Short) Package |
| Form 204 | Application for Filing Extension |
| Form 321 | Credit for Contributions to Qualifying Charitable Organizations |
View all 96 Arizona Income Tax Forms
Form Sources:
Arizona usually releases forms for the current tax year between January and April. We last updated Arizona Form 11134 from the Department of Revenue in February 2024.
About the Individual Income Tax
The IRS and most states collect a personal income tax, which is paid throughout the year via tax withholding or estimated income tax payments.
Most taxpayers are required to file a yearly income tax return in April to both the Internal Revenue Service and their state's revenue department, which will result in either a tax refund of excess withheld income or a tax payment if the withholding does not cover the taxpayer's entire liability. Every taxpayer's situation is different - please consult a CPA or licensed tax preparer to ensure that you are filing the correct tax forms!
Historical Past-Year Versions of Arizona Form 11134
We have a total of two past-year versions of Form 11134 in the TaxFormFinder archives, including for the previous tax year. Download past year versions of this tax form as PDFs here:
2023 Form 11134
PACT Act Statement
2022 Form 11134
PACT Act Statement
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