Arizona Property Tax Refund (Credit) Claim Package

Property Tax Refund (Credit) Claim Package
Arizona Form 140PTC
DO NOT STAPLE ANY ITEMS TO THE CLAIM.

Arizona Form

140PTC

FOR CALENDAR YEAR

Property Tax Refund (Credit) Claim

2023

You must file this form or Arizona Form 204 by April 15, 2024.
Check box 95 if amending claim for tax year 2023
Check box 82F if filing under extension
95

1
1
2
3
79

82F
Your First Name and Middle Initial

Last Name

Spouse’s First Name and Middle Initial (if a joint claim)

Last Name

Current Home Address - number and street, rural route
City, Town or Post Office

Enter
your
SSN(s).
Apt. No.

State

ZIP Code

Your Social Security Number
Spouse’s Social Security No.

Daytime Phone (with area code)
94
REVENUE USE ONLY. DO NOT MARK IN THIS AREA.

88

Your Date of Birth (required)

MM D D Y Y Y Y
	QUALIFICATIONS FOR CREDIT (Check the boxes that apply):
	 4	 On December 31, 2023, were you renting or did you own? If you own a
mobile home but rent the space, check “Rent”....................................................	
	 5	 Were you an Arizona resident for all of 2023?
If “No”, STOP. You do not qualify........................................................................	
	 6	 Did you pay property taxes on your home, pay rent, or pay a combination of
both in 2023? See instructions for qualifications.
If “No”, STOP. You do not qualify........................................................................	
	 7	 Is this the only Property Tax Refund being claimed in your household?
If “No”, STOP. You do not qualify........................................................................	
	 8	 Were you age 65 or older in 2023? Enter your birth date in box 79 above.....	
	 9	 Did you receive Title 16, SSI payments in 2023? If “Yes”, include proof.
If you answered “No” to both 8 and 9, STOP. You do not qualify.........................	

	INCOME

	Rent	 Own
4	
	

 

	Yes	 No
5	
	

 

6

		 

7
8

		 
		 

9

		 

81 PM

	10	 Total Household Income: Enter the amount from page 2, Part 1, line J, column 4......................................................... 	10
	CREDIT
	11	 a	 If you lived alone, enter the amount of credit from page 2, Part 1, Schedule 1, and
check the box............................................................................................................................... 11a  Schedule 1
	b	 If you lived with your spouse or one or more other persons, enter the amount of
credit from page 2, Part 1, Schedule 2, and check the box.........................................................11b  Schedule 2	 11
	12	 If you owned your property, enter property taxes actually paid during 2023. Include proof of
property taxes paid during 2023................................................................................................................................... 	12
	13	 If you rented, enter property taxes paid by your landlord on your portion of rents. Include Form 201............................ 	13
	14	 Total property taxes paid in 2023. Add lines 12 and 13................................................................................................... 	14
	15	 Amount of Property Tax Credit: Enter the smaller of line 11 or line 14........................................................................ 	15
	16	 If you have been claimed as a dependent on anyone else’s tax return, complete the following:
Name Of Taxpayer Who Claimed You
Social Security Number

80 RCVD

00

00
00
00
00
00

Address:
		If you are not claimed as a dependent on anyone else’s tax return, turn the form over and complete Part 2.
If someone else claims you as a dependent, skip lines 17 and 18, and complete line 19.
	17	
	18	
	19	
	
	

Credit for increased excise taxes from Form 140PTC, page 2, Part 2, line 6............................................................... 	17
Enter the number from page 2, Part 2, line 2, here.......................................................................................	 18
Total Credit: Add lines 15 and 17, and enter the total. See the instructions if you have to file
Arizona Form 140 or Form 140A..................................................................................................................................... 	19
Direct Deposit of Refund: Check box 19A if your deposit will be ultimately placed in a foreign account; see instructions.	 19A
ROUTING NUMBER	

00
00

ACCOUNT NUMBER

C		Checking or
98 S		Savings
If this is your first claim for 2023, STOP HERE AND GO TO THE SIGNATURE BOX ON PAGE 2. If
this is an amended claim, complete lines 20 through 22, and check box 95 at the top of the form.
	AMENDED

	20	 Enter the amount from line 5 of the worksheet on page 6 of the instructions.................................................................. 	20
	21	 Additional refund: If line 19 is larger than line 20, subtract line 20 from line 19.............................................................. 	21
	22	 Amount to pay: If line 19 is less than line 20, subtract line 19 from line 20. Make check payable to
Arizona Department of Revenue; write your SSN on payment, and include your payment with Form 140PTC.............. 	22
ADOR 10567 (23)

00
00
00

Continued on page 2 

Your Name (as shown on page 1)

Part 1

Your Social Security Number
(1)
YOU

Schedule of Household Income

(2)
YOUR SPOUSE

(3)
OTHER PERSONS

(4)
TOTAL (1+2+3)

	A	
	B	
	C	
	D	
	E	

Salaries, wages, tips, etc., received in 2023.............................................	 A
Dividend and interest income received in 2023........................................	 B
Business and farm income........................................................................	 C
Gain or loss from sale or exchange of property........................................	 D
Pension and annuity income. Include Arizona state and local
retirement benefits, civil service, and military retirement. Do
not include social security or railroad retirement benefits.........................	 E
	F	 Rent and royalty income...........................................................................	 F
	G	 S corporation, partnership, estate, and trust income................................	 G
	H	Alimony.....................................................................................................	 H
	I	 Other Income: Specify source on separate sheet....................................	 I
	J	 Total household income: Add lines A through I in column (4). Enter here and on the front of this form, line 10............................	 J

Use the amount on line J, column 4, to compute your credit from the proper schedule below.
2023 Schedule 1
2023 Schedule 2

Household
Income
$	
0 - 1,750
1,751 - 1,850
1,851 - 1,950
1,951 - 2,050
2,051 - 2,150

If you live alone, use this Schedule.

Tax
Credit
$502
479
457
435
412

2,151 - 2,250
2,251 - 2,350
2,351 - 2,450
2,451 - 2,550
2,551 - 2,650
2,651 - 2,750

Part 2

390
368
345
323
301
279

Household
Income
$	 2,751 - 2,850
2,851 - 2,950
2,951 - 3,050
3,051 - 3,150
3,151 - 3,250
3,251 - 3,350
3,351 - 3,450
3,451 - 3,550
3,551 - 3,650
3,651 - 3,750
3,751 and up

If you live with your spouse or another person, use this Schedule.

Tax
Credit
$256
234
212
189
167

Household
Income
$	
0 - 2,500
2,501 - 2,650
2,651 - 2,800
2,801 - 2,950
2,951 - 3,100

145
123
100
78
56
0

Tax
Credit
$502
479
457
435
412

3,101 - 3,250
3,251 - 3,400
3,401 - 3,550
3,551 - 3,700
3,701 - 3,850
3,851 - 4,000

Household
Income
$	 4,001 - 4,150
4,151 - 4,300
4,301 - 4,450
4,451 - 4,600
4,601 - 4,750

390
368
345
323
301
279

Enter the amount of credit on the front of this form, line 11.
Credit for Increased Excise Taxes

4,751 - 4,900
4,901 - 5,050
5,051 - 5,200
5,201 - 5,350
5,351 - 5,500
5,501 and up

Tax
Credit
$256
234
212
189
167
145
123
100
78
56
0

Do not complete Part 2 if you completed line 16 on page 1 of Form 140PTC. Do not complete Part 2 if you were sentenced for at least 60 days of 2023
to a county, state, or federal prison. Note: If you are filing a joint Property Tax Credit claim with your spouse, and you are also claiming the Excise Tax
Credit on Form 140PTC, you cannot claim the Excise Tax Credit for your spouse if your spouse was sentenced for at least 60 days during 2023 to a county,
state or federal prison.
	1

List dependents. See the instructions.

(a)
FIRST AND LAST NAME

(b)
SOCIAL SECURITY NO.

(Do not list yourself or spouse.)

(d)

NO. OF MONTHS LIVED
IN YOUR HOME IN 2023

1a
1b
1c
Enter total number of dependents listed on lines 1a through 1c. Also, enter this amount on Form 140PTC, page 1, line 18....... 	 2
If you are married filing a joint claim, enter the number “2” here. Otherwise, enter the number “1”................................................ 	 3
Add the amount on line 2 and line 3, and enter the total................................................................................................................... 	 4
00
Multiply the amount on line 4 by $25, and enter the result................................................................................................................ 	 5
00
Enter the smaller of line 5 or $100. Also, enter this amount on Form 140PTC, page 1, line 17..................................................... 	 6
Under penalties of perjury, I declare that I have read this return and any documents with it, and to the best of my knowledge and belief, they are
true, correct and complete. Declaration of preparer (other than taxpayer) is based on all information of which preparer has any knowledge.

PLEASE SIGN HERE

	2
	3
	4
	5
	6

(c)
RELATIONSHIP

	YOUR SIGNATURE			 	DATE		

	 	

	SPOUSE’S SIGNATURE			 	DATE		

	 	

	

	 	

OCCUPATION

SPOUSE’S OCCUPATION

	 	

PAID PREPARER’S SIGNATURE		 DATE		 FIRM’S NAME (PREPARER’S IF SELF-EMPLOYED)

	

	 	

PAID PREPARER’S STREET ADDRESS				 PAID PREPARER’S TIN

	

PAID PREPARER’S CITY	

	ADOR 10567 (23)

STATE	

	

	

ZIP CODE		 PAID PREPARER’S PHONE NUMBER

Mail to Arizona Department of Revenue, PO Box 52138, Phoenix, AZ 85072-2138
AZ Form 140PTC (2023

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