Arizona Credit for Increased Excise Taxes

Credit for Increased Excise Taxes
Arizona Form 140ET
DO NOT STAPLE ANY ITEMS TO THE CLAIM.

Arizona Form

140ET

Check box 82F if filing under extension

82F

FOR CALENDAR YEAR

Credit for Increased Excise Taxes
95

Your First Name and Middle Initial

Last Name

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

Last Name

2023

Check box 95 if amending credit for tax year 2023
Enter
your
SSN(s).

1
1
Current Home Address - number and street, rural route

Your Social Security Number
	
Spouse’s Social Security No.

	
Daytime Phone (with area code)

Apt. No.

94

2
City, Town or Post Office

State

ZIP Code

REVENUE USE ONLY. DO NOT MARK IN THIS AREA.

88

3

FILING STATUS (check the appropriate box):

	 4	

.Married filing joint claim

	 5	
	

.Head of household: Enter name of qualifying child or dependent on next line:

	 6	

.Married filing separate claim: Enter spouse’s name and Social Security Number above.

81 PM

80 RCVD

	 7	
.Single
	
Note: If you are married and you qualify to claim this credit, you must file a married
filing separate claim if your spouse was sentenced for at least 60 days during 2023 to a county, state or federal prison.

	 8	 I have read “Who Can File Form 140ET” on page 2, and I certify that I qualify to claim this credit on this form...	8
	
Note: If you checked “No”, STOP. DO NOT file Form 140ET.
	9	 List dependents (see instructions on page 3). If married filing a joint claim, you may list up to 2 dependents;
all others may list up to 3.
FIRST NAME

 YES  NO

SOCIAL SECURITY NUMBER
OR ITIN

LAST NAME

9A1

9A2
9A3

	10
	11
	12
	13
	14
		

Total number of dependents entered on lines 9A1 through 9A3.....................................................................	10
If you checked box 4, enter the number “2” here. If you checked box 5, 6, or 7, enter the number “1” here..	11
Add the amount on line 10 and line 11. Enter the total..................................................................................	12
Multiply the amount on line 12 by $25. Enter the result................................................................................	13
Enter the smaller of line 13 or $100...............................................................................................................	14
Direct Deposit of Refund: Check box 14A if your deposit will be ultimately placed in a foreign account; see instructions.	 14A

C		Checking or
98 S		Savings

ROUTING NUMBER	

ACCOUNT NUMBER



00
00

If this is your first claim for 2023, STOP HERE, AND GO TO THE SIGNATURE BOX BELOW.
If this is an amended claim, complete lines 15 through 17, and check box 95 at the top of the form.

AMENDED

	15 Enter the amount from line 5 of the worksheet on page 4 of the instructions................................................	15
	16 Additional refund: If line 14 is larger than line 15, subtract line 15 from line 14............................................	16
	17 Amount to pay: If line 14 is less than line 15, subtract line 14 from line 15...................................................	17
Make check payable to Arizona Department of Revenue; write your SSN on payment, and include with Form 140ET.

00
00
00

PLEASE SIGN HERE

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		 DATE		

	

SPOUSE’S SIGNATURE		 DATE		

	

	

	

	

	

	

	
	
	

	 	

OCCUPATION

SPOUSE’S OCCUPATION

	 	

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

	 	

PAID PREPARER’S STREET ADDRESS				 PAID PREPARER’S TIN
PAID PREPARER’S CITY	

ADOR 10532 (23)

STATE	

	 	

ZIP CODE		 PAID PREPARER’S PHONE NUMBER

Mail this claim to: Arizona Department of Revenue, PO Box 52138, Phoenix, AZ 85072-2138.

Print Form

Arizona Form

140ET

Who Can File Form 140ET?

Even if you qualify to claim a credit for increased excise taxes, do not file Form 140ET if either of the
following applies:
•	 You are filing a 2023 income tax return using Form 140, Form 140A, Form 140EZ, or Form 140PY.
You may claim this credit on those tax forms. To figure your credit, complete the worksheet included in
the instructions for those tax forms.
•	 You are filing Form 140PTC. You may claim the credit for increased excise taxes on Form 140PTC.
To figure your credit, see the instructions for Form 140PTC, Part 2.
If you qualify to claim a credit for increased excise taxes, file Form 140ET only if all of the following are
true.
		
TRUE	FALSE
(a)	You have a Social Security Number (SSN) that is valid for employment......................... 	
	
(b)	You are not required to file a 2023 income tax return and you do not qualify for
the property tax credit on Form 140PTC for tax year 2023.............................................. 	

	

(c)	You were an Arizona resident during 2023....................................................................... 	

	

(d)	You are not claimed as a dependent by any other taxpayer for the tax year 2023.......... 	

	

(e)	You were not sentenced for at least 60 days of 2023 to a county, state, or federal prison.	

	

(f)	 Your federal adjusted gross income is:............................................................................ 	
	
	 •	$12,500 or less if single
	 •	$25,000 or less if you are married filing a joint claim
	 •	$12,500 or less if married filing a separate claim
	•	
$25,000 or less if you are filing as head of household
	

	

If all of the items (a) through (f) above are true, you may claim this credit using Form 140ET.
Complete Form 140ET to figure your credit.

Special Note:
If your spouse was sentenced for at least 60 days during 2023 to a county, state or federal prison, the
following applies:
1. Your spouse cannot take the credit.
2.	You cannot file a joint claim with that spouse. You must file a married filing separate claim.
3. You cannot claim a credit for your spouse.
4.	If your spouse has a valid SSN, but you do not, neither you nor your spouse can claim the credit.
For complete details about how incarceration affects this credit, see the department’s publication 709.

ADOR 10532 (23)	

AZ Form 140ET (2023)

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