Arizona Arizona Annual Payment Withholding Tax Return

Arizona Annual Payment Withholding Tax Return
Arizona Form A1-APR
Arizona Form

A1-APR

2023

Arizona Annual Payment Withholding Tax Return

DO NOT FILE MORE THAN ONE ORIGINAL FORM A1-APR PER EIN PER YEAR.
Form A1-APR is due on or before January 31, 2024.
If you file Form A1-QRT, do not file this form.

Taxpayer Information (Refer to the instructions before completing Part 1.)
Part 1
Business Name (As listed on the Arizona Joint Tax Application - Form JT-1)

Employer Identification Number (EIN)

Number and street or PO Box
City or town, state and ZIP Code

REVENUE USE ONLY. DO NOT MARK IN THIS AREA.

88

Business telephone number (with area code)
Check box if:
A Amended Return    B

Address Change

C Final Return (CANCEL ACCOUNT)

If this is your final return, the department will cancel your withholding account. Enter the date final
wages were paid and complete Part 6.............................................. 	 M M D D Y Y Y Y

81 PM

66 RCVD

D		Check this box if this return is an early-filed return for calendar year 2024 due to an
account cancellation during calendar year 2024.
E	 	Check this box if this cancellation was due to a merger or acquisition and the
surviving employer is filing Forms W-2.

Part 2

Arizona Withholding Tax Liability

Part 3

Tax Payments (See instructions.)

	1	Total Annual Withholding Tax Liability from all sources: Enter the total amount withheld during the
calendar year.............................................................................................................................................	 1
	2	Withholding tax payments previously made for 2023................................................................................	2
	 3	 Amount of tax paid when filing extension request.....................................................................................	3
	4	 Total payments...........................................................................................................................................	4
	 5	 Balance of tax due:  If line 1 is larger than line 4, subtract line 4 from line 1. Enter the difference.
This is the balance of tax due. Skip line 6. Non-EFT payment must accompany return...........................	 5
	 6	 Overpayment of tax:  If line 4 is larger than line 1, subtract line 1 from line 4. Enter the difference. This
is the overpayment of tax...........................................................................................................................	6

Part 4

Federal Form Transmittal Information

	7	 Total amount of Arizona income tax withheld as shown on federal Forms W-2, W-2c, W-2G, and
1099 for 2023.............................................................................................................................................	 7
	8	 Total Arizona wages paid to employees for 2023......................................................................................	 8
	9	 Total number of employees paid Arizona wages for 2023.........................................................................	9
	10	 Total number of federal Forms W-2, W-2c, W-2G, and 1099 submitted to the department.......................	10
	

Instructions:	 If line 1 does not equal line 7, you have misreported your annual tax withholdings OR
you have misreported your employee wage withholdings.
Declaration

Under penalties of perjury, I declare that I have examined this return and to the best of my knowledge and belief, it is a true, complete
and correct return.

Please
Sign
Here

TAXPAYER’S SIGNATURE

DATE

BUSINESS PHONE NUMBER

Paid

PAID PREPARER’S SIGNATURE

DATE

PAID PREPARER’S TIN

Preparer’s
Use
Only

FIRM’S NAME (OR PAID PREPARER’S NAME, IF SELF-EMPLOYED)

FIRM’S EIN

FIRM’S STREET ADDRESS

FIRM’S PHONE NUMBER.

CITY
ADOR 10939 (23)

STATE

ZIP CODE

Name (as shown on page 1)

Part 5

EIN

Amended Form A1-APR

If you checked the box “Amended Return” in Part 1, explain why an amended Form A1-APR is being filed:

Part 6

Final Form A1-APR

If you checked the box “Final Return” in Part 1, check the box that indicates why this is a final return:
	11	
	 Reorganization or change in business entity (example:  from corporation to partnership).
	12	
	 Business sold.
	13	 	 Business stopped paying wages and will not have any employees in the future.
	14	
	 Business permanently closed.
	15	
	 Business has only leased or temporary agency employees.
	16	
	 Other (specify reason):  
17	
	
	 Check this box if records will be kept at a location different from the address shown in Part 1.
	
	
	

Name:
Number and Street:
City:

	

State:

	

18	
	
	 Check this box if there is a successor employer.
	
	
	

Name:
Number and Street:
City:

ZIP Code:

	
	

State:

	

EIN:
ZIP Code:

Payment and Submission of Form A1-APR
Part 7
	 Taxpayers with a 2023 tax liability of more than $500 must pay that tax liability by EFT. See instructions.
	 Taxpayers with a 2023 tax liability of $500 or less may pay that liability by EFT or by check. See instructions.
	 This form must be e-filed unless the taxpayer has a waiver or is exempt from e-filing. See instructions.

	
ADOR
10939 (23)

AZ Form A1-APR (2023)

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