Arizona Part-Year Resident Personal Income Tax Package

Part-Year Resident Personal Income Tax Package
Arizona Form 140PY
	
	

140PY

Check box 82F
if filing under extension

82F

Spouse’s First Name and Middle Initial (if box 4 or 6 checked)

Last Name

AND ENDING

Current Home Address - number and street, rural route

Apt. No.

2023

MM D D Y Y Y Y

Enter
your
SSN(s).

1

.

66F

Your Social Security Number
Spouse’s Social Security No.

Daytime Phone (with area code)

2

94
City, Town or Post Office

State

ZIP Code

Last Names Used in Last Four Prior Year(s) (if different)

97

3
4	
5	

	
	

6	
7	

	
	

Exemptions 8, 9, and 11a - Dependents 10a and 10b



Married filing joint return 4a
Injured Spouse Protection of Joint Overpayment
Head of household: Enter name of qualifying child or dependent on next line:

REVENUE USE ONLY. DO NOT MARK IN THIS AREA.
88R

Married filing separate return: Enter spouse’s name and Social Security Number above.
Single
	Enter the number claimed. Do not put a check mark.

8	
9	
10a	

Age 65 or over (you and/or spouse) If completing lines 8, 9, and 11a, also complete lines 46,
47, and 49. For lines 10a and 10b, also complete line 59.
Blind (you and/or spouse)
Dependents: Under age of 17.
10b
Dependents: Age 17 and over.

11a	
	 12-13	

Qualifying parents and grandparents
Residency Status (check one): 12  Part-Year Resident Other than Active Military

81P

PM

80R

13  Part-Year Resident Active Military

(a)
FIRST AND LAST NAME

(Do not list yourself or spouse.)

10c
10d
	

(b)
SOCIAL SECURITY
NUMBER

(c)
(d)
(e)
Age
RELATIONSHIP NO. OF MONTHS Dependent
included in:
LIVED IN YOUR
HOME IN 2023

  
  




(Box 11a): Qualifying parents and grandparents. See instructions. For more space, check the box  and complete page 4, Part 2.
(a)
FIRST AND LAST NAME

(Do not list yourself or spouse.)

11b
11c
	14 Dates of Arizona residency: From
	15
	16
	17
	18
	19
	20
	21
	22
	23
	24
	25
	26
	27
28
29
	30
	31
	32
	33
	34
	35
36
	37
	38
	 39

(f)

 if you did not claim

this person on your
1
2
federal return due to
(Box 10a) (Box 10b) educational credits

MM D D Y Y Y Y

(b)
SOCIAL SECURITY
NUMBER

to

(c)
(d)
RELATIONSHIP NO. OF MONTHS

MM D D Y Y Y Y

LIVED IN YOUR
HOME IN 2023

(e)

Wages, salaries, tips, etc. ....................................................................................................
Interest.................................................................................................................................
Dividends..............................................................................................................................
Arizona income tax refunds..................................................................................................
Business income (or loss) from federal Schedule C............................................................
Gains (or losses) from federal Schedule D. See instructions for ARIZONA column...................

(f)

IF AGE 65 OR

 IF DIED IN







2023 FEDERAL

OVER

Amount from Federal Return

15
00
16
00
17
00
18
00
19
00
20
00
Rents, royalties, partnerships, estates, trusts, small business corporations from federal Schedule E.... 21
00
Other income reported on your federal return: Include your own schedule............................... 22
00
Total income: Add lines 15 through 22..................................................................................... 23
00
Other federal adjustments: Include your own schedule............................................................ 24
00
Federal adjusted gross income: Subtract line 24 from line 23 in the FEDERAL column............... 25
00
Arizona gross income: Subtract line 24 from line 23 in the ARIZONA column....................................................................... 26
Arizona income ratio: Divide line 26 by line 25 and enter the result (not over 1.000)......................................................... 27
Small Business income: 28S
check the box if you are filing Form 140PY-SBI and enter the amount from Form 140PY-SBI, line 10................ 28
Modified Arizona gross income. Subtract line 28 from line 26.................................................................................... 29
Total depreciation included in Arizona gross income................................................................................................... 30
Other Additions to Income. Complete Other Additions to Arizona Gross Income schedule on page 5...................... 31
Subtotal: Add lines 29, 30 and 31.................................................................................................................................. 32
Total Arizona net capital gain or (loss). Enter amount from line 20, Arizona column.................... 33
00
Total Arizona net short-term capital gain or (loss) included on line 33................................. 34
00
Total Arizona net long-term capital gain or (loss) included on line 33.................................. 35
00
Net long-term capital gain from assets acquired after December 31, 2011. See instructions. 36
00
Multiply line 36 by 25% (.25) and enter the result....................................................................................................... 37
Net capital gain derived from investment in qualified small business......................................................................... 38
Subtract lines 37 and 38 from line 32. Enter the difference........................................................................................ 39
ADOR 10149 (23)	
AZ Form 140PY (2023)

Arizona Income

RCVD

(Box 10a and 10b): Dependent Information. See instructions. For more space, check the box  and complete page 4, Part 1.

	

List other state(s) of residency:

Additions

Place any required federal and AZ schedules or other documents after Form 140PY. 

MM D D 2 0 2 3

1

Subtractions – cont. on page 2

	

OR FISCAL YEAR BEGINNING

Last Name

	
	
	
	

FOR CALENDAR YEAR

Part-Year Resident Personal Income Tax Return

Your First Name and Middle Initial

FILING STATUS

DO NOT STAPLE ANY ITEMS TO THE RETURN.
	
	

Arizona Form

2023

2023 ARIZONA
Amount Only

00
00
00
00
00
00
00
00
00
00
00
00
00
00
00
00

00
00
00

Page 1 of 6

Your Name (as shown on page 1)

Exemptions

Subtractions
cont. from page 1

	
	
	
	
	
	
	
	
	
	
	
	
	

Recalculated Arizona depreciation.................................................................................................................................. 40

40
41
42
43
44
45
46
47
48
49
50
51
52

Contributions to: 41a 529 College Savings Plans
00 41b 529A (ABLE accounts)
00 add 41a and 41b... 41c
Interest on U.S. obligations such as U.S. savings bonds and treasury bills.................................................................... 42
U.S. Social Security or Railroad Retirement Act benefits included in your Arizona income............................................ 43
Other Subtractions from Income. Complete Other Subtractions from Arizona Gross Income schedule on page 6....... 44
Subtract lines 40 through 44 from line 39. Enter the difference..................................................................................... 45
Age 65 or over: Multiply the number in box 8 by $2,100...................................................................... 	 46
00
Blind: Multiply the number in box 9 by $1,500..................................................................................... 	 47
00
Multiply the number in box 48E by $2,300............ 	 48
Other Exemptions. See instructions.....48E
00
Qualifying parents and grandparents: Multiply the number in box 11a by $10,000............................... 	 49
00
Add lines 46 through 49. Enter the total....................................................................................... 	 50
00
Multiply line 50 by the Arizona income ratio on line 27.................................................................................................... 51
Arizona adjusted gross income: Subtract line 51 from line 45. If less than zero, enter “0”.................................................. 52

Deductions: Check box and enter amount. See instructions........................53I ITEMIZED 53S STANDARD 53
If you checked box 53S and claim charitable contributions check 54C Complete page 3. See instructions........................ 54
Arizona taxable income: Subtract lines 53 and 54 from line 52. If less than zero, enter “0”...................................................... 55
Tax: Multiply line 55 by 2.5% (.025). Enter the result.................................................................................................... 56
Tax from recapture of credits from Arizona Form 301, Part 2, line 31............................................................................. 57

Balance of Tax

53
54
	55
	56
	57

	58 Subtotal of tax: Add lines 56 and 57. Enter the total............................................................................................................ 58
	59 Dependent Tax Credit. See instructions............................................................................................................................ 59
	60 Family income tax credit (from the worksheet - see instructions)........................................................................................... 60
	61 Nonrefundable credits from Arizona Form 301, Part 2, line 62....................................................................................... 61
	62 Balance of tax: Subtract lines 59, 60 and 61 from line 58. If the sum of lines 59, 60 and 61 is more than line 58, enter “0”........... 62
	63 2023 AZ income tax withheld.......................................................................................................................................... 63
	64 2023 AZ estimated tax payments...64a
00 Claim of Right.64b
00 Add 64a and 64b.. 64c
	65 2023 AZ extension payment (Form 204)......................................................................................................................... 65
	66 Increased Excise Tax Credit (from the worksheet - see instructions)..................................................................................... 66
	67 Other refundable credits: Check the box(es) and enter the total amount..........................671308-I 672334 673349 67
	68 Total payments and refundable credits: Add lines 63 through 67. Enter the total............................................................ 68
	69 TAX DUE: If line 62 is larger than line 68, subtract line 68 from line 62. Enter amount of tax due. Skip lines 70, 71 and 72............. 69
	70 OVERPAYMENT: If line 68 is larger than line 62, subtract line 62 from line 68. Enter amount of overpayment............................. 70
	71 Amount of line 70 to be applied to 2024 estimated tax................................................................................................... 71
	72 Balance of overpayment: Subtract line 71 from line 70. Enter the difference......................................................................... 72
Solutions Teams
	 73 - 83 Voluntary Gifts to:
00 Arizona Wildlife................ 74
00
Assigned to Schools............ 73
Child Abuse Prevention............ 75
00 Domestic Violence Services.76
00 Political Gift..................... 77
00
Neighbors Helping Neighbors.. 78
00 Special Olympics................. 79
00 Veterans’ Donations Fund.80
00
State Parks
I Didn’t Pay Enough Fund........ 81
00 Sustainable
00 Spay/Neuter of Animals... 83
00
and Road Fund.................... 82

00
00
00
00
00
00

00
00
00
00
00
00
00
00
00
00
00
00
00
00
00
00
00
00
00
00
00
00

Voluntary Gifts

Tax Due or
Overpayment

Refundable Credits

Total Payments and

Your Social Security Number

Penalty

	84 Political Party (if amount is entered on line 77- check only one): 841Democratic 842Libertarian 843Republican
	 85 Estimated payment penalty............................................................................................................................................. 85

Refund or
Amount Owed

	86 861Annualized/Other 862Farmer or Fisherman 863Form 221 included
	87 Add lines 73 through 83 and 85; enter the total.............................................................................................................. 87
	88 REFUND: Subtract line 87 from line 72. If less than zero, enter amount owed on line 89........................................................... 88
Direct Deposit of Refund: Check box 88A if your deposit will be ultimately placed in a foreign account; see instructions.	 88A
	

C		Checking or
98 S		Savings

ROUTING NUMBER	

PLEASE SIGN HERE

	89 AMOUNT OWED: Add lines 69 and 87.

00
00
00

ACCOUNT NUMBER

Make check payable to Arizona Department of Revenue; write your SSN on payment. 89

00

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.

	

	 	

	 	

	

	 	

	 	

YOUR SIGNATURE		
SPOUSE’S SIGNATURE		

	

PAID PREPARER’S SIGNATURE		

	

	 	

DATE		

DATE		
DATE		

	 	

OCCUPATION
SPOUSE’S OCCUPATION

FIRM’S NAME (PREPARER’S IF SELF-EMPLOYED)

	 	

PAID PREPARER’S STREET ADDRESS				 PAID PREPARER’S TIN

	

PAID PREPARER’S CITY	

STATE	

	 	

ZIP CODE		 PAID PREPARER’S PHONE NUMBER

If you are sending a payment with this return, mail to Arizona Department of Revenue, PO Box 52016, Phoenix, AZ 85072-2016. Include your payment with return
If you are expecting a refund or owe no tax, or owe tax but are not sending a payment, mail to Arizona Department of Revenue, PO Box 52138, Phoenix, AZ 85072-2138.
ADOR 10149 (23)	
AZ Form 140PY (2023)
Page 2 of 6

Print Form

Your Name (as shown on page 1)

Your Social Security Number

2023 Form 140PY - Standard Deduction Increase
for Charitable Contributions
You must complete this worksheet if you are taking an increased standard deduction for
charitable contributions. Include the completed worksheet with your tax return, when filed.
If you do not include the completed worksheet, your standard deduction will not be increased.
Taxpayers electing to take the Standard Deduction may increase the standard deduction amount by 31% (.31) of the total
amount of the taxpayer’s charitable deductions that would have been allowed if the taxpayer elected to claim itemized
deductions on the Arizona tax return.
Charitable contributions (lines 1C, 2C, and 3C) are those gifts allowed on federal Form 1040 Schedule A (Gifts to Charity) that
you would have claimed had you elected to take itemized deductions on your federal return.
NOTE 1: As a part-year resident filing Arizona Form 140PY, you may only include those charitable contributions that are
incurred and paid while an Arizona resident plus the amount of such gifts from Arizona sources incurred and paid during the
part of the year while an Arizona nonresident.
NOTE 2: You must reduce your contribution amount by the total charitable contributions you made during January 1, 2023
through December 31, 2023 for which you are claiming an Arizona tax credit under Arizona law for the current tax year return
or claimed on the prior tax year return. Enter this amount on line 5C.
NOTE 3: If you itemized deductions on your federal return (1040 Schedule A) and were required to adjust the amount of
your allowable contributions on your federal 1040 Schedule A for the amount claimed as a tax credit on your Arizona income
tax return, include the amount of the federal contribution adjustment to line 1C and enter the amount of the Arizona tax credit
on line 5C.

Complete the worksheet to determine your allowable increased standard deduction for charitable contributions.
1C 2023 Gifts by cash or check......................................................................................

1C

00

2C 2023 Other than by cash or check..........................................................................

2C

00

3C Carryover from prior year........................................................................................

3C

00

4C Add lines 1C through 3C and enter the total...........................................................

4C

00

5C

00

6C

00

7C

00

5C Total charitable contributions made in 2023 for which you are claiming a credit

under Arizona law for the current (2023) or prior (2022) tax year...........................

6C Subtract line 5C from line 4C and enter the difference. If less than zero, enter

“0”............................................................................................................................

7C Multiply line 6C by 31% (.31) and enter the result.................................................

•	
•	
•	

Enter the amount shown on line 7C on page 2, line 54.
Be sure to check box 53S for Standard Deduction on line 53.
Check box 54C for charitable contributions on line 54. If you do not check this box, you may be denied the increased
standard deduction.

ADOR 10149 (23)	

AZ Form 140PY (2023)

Page 3 of 6

Your Name (as shown on page 1)

Your Social Security Number

2023 Form 140PY Dependent and Other Exemption Information

•	

Include page 4 with your return if:
•	 You are listing additional dependents (for box 10a and 10b) from page 1.
You are listing additional qualifying parents and grandparents (for box 11a) from page 1.
•	 You are claiming Other Exemptions on page 2, line 48.

Part 1: Dependents (Box 10a and 10b) continued from page 1

Information used to compute your allowable Dependent Tax Credit on page 2, line 59.
NOTE: If you have more than three qualifying dependents, you must complete Part 1 and the worksheet in the instructions to
compute your Dependent Tax Credit on line 59.
(a)
FIRST AND LAST NAME

(Do not list yourself or spouse.)

(b)
SOCIAL SECURITY
NUMBER

(c)
RELATIONSHIP

(d)

(e)

Dependent Age

NO. OF MONTHS
LIVED IN YOUR
HOME IN 2023

included in:

1

2

(Box 10a)

(Box 10b)

  
  
  
  
  
  
  
  
  
  
  

10e
10f
10g
10h
10i
10j
10k
10l
10m
10n
10o

(f)

IF YOU DID NOT

CLAIM THIS PERSON
ON YOUR FEDERAL
RETURN DUE TO
EDUCATIONAL
CREDITS













Part 2: Qualifying parents and grandparents (Box 11a) continued from page 1

Additional qualifying parents and grandparents information used to compute your allowable exemption on page 2, line 49.
(a)

(b)

(c)

(d)

FIRST AND LAST NAME

SOCIAL SECURITY

RELATIONSHIP

NO. OF MONTHS
LIVED IN YOUR
HOME IN 2023

(Do not list yourself or spouse.)

NUMBER

(e)

11d
11e
11f
11g
11h
11i

(f)

 IF AGE 65 OR

 IF DIED IN















OVER

2023

Part 3: Other Exemptions
Information used to compute your allowable Other Exemptions on page 2, line 48.
(c)

(a)

(b)

FIRST AND LAST NAME

SOCIAL SECURITY

(Do not list yourself or spouse.)

NUMBER

AGE 65 OR OVER
(see instructions)
C1

C2

  
  
  
  
  
  
  
  
  
  

1
2
3
4
5
6
7
8
9
10

(d)

STILLBORN
CHILD IN 2023












Enter the total number of individuals listed in Part 3 in box 48E on page 2, line 48.
ADOR 10149 (23)	

AZ Form 140PY (2023)

Page 4 of 6

Your Name (as shown on page 1)

Your Social Security Number

2023 Form 140PY - Other Additions to Arizona Gross Income
Complete and include this schedule with your tax return only if you are making any adjustments increasing your Arizona Gross
Income.
Note: If you are making any adjustments reducing your Arizona Gross Income complete page 6.
Other Additions to Arizona Gross Income - Line 31 (see instructions for more information)
A Non-Arizona Municipal Interest.....................................................................................................................

A

00

B

Ordinary Income Portion of Lump-Sum Distributions Excluded on Your Federal Return…..........................

B

00

C

Fiduciary Adjustment from Arizona Form 141AZ Schedule K-1 and/or Schedule K-1(NR)......…….............

C

00

D

Partnership Income Adjustment...............…………………............................................................................

D

00

E Items Previously Deducted for Arizona Purposes…………………………………….......................................

E

00

F Claim of Right Adjustment for Amounts Repaid in 2023...............................................................................

F

00

G(a) Claim of Right Adjustment for Amounts Repaid in Prior Years.....................................................................

G(a)

00

G(b) Adjustment for Net Operating Loss due to Claim of Right...........................................................................

G(b)

00

H(a)

Adjusted Basis computed under IRC for property for which a credit was claimed on Form 338 and that
is sold or otherwise disposed of during the taxable year exceeds the adjusted basis of the property.
See instructions. in Property for Which You Have Claimed a Credit for Investment in Qualified Small
Businesses (Form 338) that was sold or otherwise disposed of during the tax year. See instructions.......

H(a)

00

H(b)

Adjusted basis under IRC for Agricultural Pollution Control Equipment for which a credit was claimed
(Form 325) before taxable year 2023 that was sold or otherwise disposed of during the tax year exceeds
the adjusted basis of the porperty. See instructions...................................................................................

H(b)

00

H(c)

Adjusted basis under IRC for Pollution Control Equipment for which a credit was claimed (Form 315)
before taxable year 2023 that was sold or otherwise disposed of during the tax year exceeds the adjusted
basis of the porperty. See instructions.......................................................................................................

H(c)

00

H(d)

Addition Due to Claiming the Agricultural Water Conservation System (Credit 312). See instructions.......

H(d)

00

H(e)

Addition to S Corporation Income Due to Claiming the Pass-Through Credit for Agricultural Water
Conservation System (Credit 312). See instructions.................................................................................

H(e)

00

I Nonqualified Withdrawals from 529 College Savings Plans.......................................................................

I

00

Sole Proprietorship Loss of an Arizona Nonprofit Medical Marijuana Dispensary Included in
Federal Adjusted Gross Income. Sole Proprietorship loss of an Arizona dual licensee that has not elected to
operate on a for-profit basis must also add back the portion of their loss that is from the medical marijuana
portion of the business that is included in their federal adjusted gross income................................................

J

00

Americans with Disabilities Act - Access Expenditures………………………………......................................

K

00

L Amortization or Depreciation for Child Care Facility Before 1990…………………………............................

L

00

M Net capital loss derived from exchange of legal tender. See instructions....................................................................

M

00

N

J

K

Entity-Level Income Tax Payment. See instructions....................................................................................

N

00

O Motion Picture Production Costs. See instructions.....................................................................................

O

00

P Other Adjustments Related to Tax Credits. See instructions.......................................................................

    P

00

Q Other Adjustments. See instructions....……………………………................................................................

    Q

00

R

    R

00

Total Other Additions: Add all amounts and enter the total here and on line 31............................................

ADOR 10413 (23)	

AZ Form 140PY (2023)

Page 5 of 6

Your Name (as shown on page 1)

Your Social Security Number

2023 Form 140PY - Other Subtractions from Arizona Gross Income
Complete and include this schedule with your tax return only if you are making any adjustments decreasing your Arizona Gross
Income.
Note: If you are making any adjustments increasing your Arizona Gross Income complete page 5.
Other Subtractions from Arizona Gross Income - Line 44 (see instructions for more information)
A

Exclusion for U.S. Government, Arizona State, or Local Government Pensions (up to $2,500 per taxpayer)...........

A

00

B

Exclusion for Benefits, Annuities, and Pensions Received as Retired or Retainer Pay of the Uniformed
Service of the United States. You may subtract 100% of the amount received................................................

B

00

C

Agricultural Crops Given to Arizona Charitable Organizations………………………………………………..........

C

00

D

Certain Wages of American Indians..........................................…………………………......................................

D

00

E

Pay Received for Active Service as a Member of the Reserves, National Guard, or the U.S. Armed Forces...

E

00

F

Federally Taxable Arizona Municipal Interest as Evidenced by Bonds.................................…………………....

F

00

G

Adoption Expense.........................……………………………………………………………………….....................

G

00

H

Qualified Wood Stove, Wood Fireplace, or Gas Fired Fireplace........................................................................

H

00

I

Claim of Right Adjustment for Amounts Repaid in Prior Tax Years....................................................................

I

00

J

Certain Expenses Not Allowed for Federal Purposes....……………………………….........................................

J

00

K

Qualified State Tuition Program Distributions..................................................................……………………......

K

00

L

Installment Sale Income From Another State Taxed by the Other State in a Prior Taxable Year.......................

L

00

M

Basis Adjustment for Property Sold or Otherwise Disposed of During the Taxable Year...................................

M

00

N

Fiduciary Adjustment from Arizona Form 141AZ Schedule K-1 and/or Schedule K-1(NR)......................................

N

00

O

Partnership Income Adjustment.................................................................................................................................

O

00

P

Net Operating Loss Adjustment.................................................................................................................................

P

00

Q

Sole Proprietorship Income of an Arizona Nonprofit Medical Marijuana Dispensary Included in Federal Adjusted
Gross Income. In addition, Sole Proprietorship income of an Arizona dual licensee that has not elected to
operate on a for-profit basis may subtract the portion of their federal taxable income that is from the medical
marijuana portion of the business. A dual licensee that elects to operate on a for-profit basis does not qualify for
a subtraction for the medical marijuana portion of their business.....................................................................

Q

00

R

Long-Term Care Insurance Premiums.......................................................................................................................

R

00

S

Americans with Disabilities Act - Access Expenditures.............................................................................................

S

00

T Exploration Expenses Deferred before January 1, 1990…………………………...............................................

 T

00

Sole Proprietorship of an Arizona Marijuana Establishment, Marijuana Testing Facilities and dual licensees
that operate on a for-profit basis: enter the total amount of ordinary and necessary expenses related to the
sales of recreational use products reported on Schedule DFE (line 16). An LLC that has elected to be treated
as a disregarded entity for federal purposes, and also elected to operate on a for-profit basis may subtract the
total amount of ordinary and necessary expenses related to the sales of recreational use products reported
on Schedule DFE (line 16).................................................................................................................................

U

00

V S Corporation shareholders of an Arizona Marijuana Establishment, Marijuana Testing Facilities and
dual licensees that operate on a for-profit basis: enter the amount of your pro-rata share of ordinary and
necessary expenses related to the sales of recreational use products as shown on your Form
120S Schedule K-1, line 7....................................................................................................................................

V

00

W

W

00

U

Net capital gain derived from exchange of legal tender: See instructions................................................................................

X(a)

Value of Virtual Currency and Non-Fungible Tokens Received at the Time of the Airdrop. See instructions..

X(a)

00

X(b)

Gas Fees Not Included in Virtual Currency or Non-Fungible Token Basis. See instructions............................

X(b)

00

Y Other Adjustments - see instructions..................................................................................................................

Y 

00

Z Total Other Subtractions: Add all amounts and enter the total here and on line 44...............................................
AZ Form 140PY (2023)

 Z

ADOR 10413 (23)	

00
Page 6 of 6