Arizona Resident Personal Income Tax (EZ Form) Package

Resident Personal Income Tax (EZ Form) Package
Arizona Form 140EZ
DO NOT STAPLE ANY ITEMS TO THE RETURN.

Arizona Form

140EZ
Your First Name and Middle Initial

Last Name

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

Last Name

Enter
your
SSN(s).

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

Apt. No.

City, Town or Post Office

State

2023

Your Social Security Number

	

Spouse’s Social Security No.

	

Daytime Phone (with area code)
94

2
ZIP Code

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

97

3

REVENUE USE ONLY. DO NOT MARK IN THIS AREA.

	
	
	
	

88

Check box 82F if filing under extension

82F

STOP 	You must use Arizona Form 140 if:

•	Your Arizona taxable income on line 8 is $50,000 or more.
•	You are claiming estimated payments.
•	You are taking a subtraction for:
81 PM
	 – active duty military pay
– pension income from the uniformed services of the United States
– wages earned on Indian reservation(s)
	
FILING STATUS: Check one box.
4	 	 Married filing joint return 4a  Injured Spouse Protection of Joint Overpayment
5	 	 Single

	
	

	

80 RCVD

6 Federal adjusted gross income from your federal return.........................................................................
7 Standard deduction: If you checked filing status box 4, enter $27,700; if you checked filing status
box 5, enter $13,850. If you are a surviving spouse, see instructions for amount to enter on line 7.....
8 Arizona taxable income: Subtract line 7 from line 6. If less than zero, enter “0”...................................
9 Amount of tax: Multiply line 8 by 2.5% (.025).........................................................................................
10 Family income tax credit (from worksheet see page 5 of the instructions)..............................................
11 Balance of tax: Subtract line 10 from line 9. If line 10 is more than line 9, enter “0”...........................
12 Arizona income tax withheld during 2023................................................................................................
13 2023 Arizona extension payment (Form 204).........................................................................................
14 Increased Excise Tax Credit (from worksheet - see page 6 of the instructions)......................................
15 Total payments/credits: Add lines 12 through 14.................................................................................
16 TAX DUE / AMOUNT OWED: If line 11 is more than line 15, subtract line 15 from line 11. Skip line 17.
Make check payable to Arizona Department of Revenue; include SSN on payment...........................
17 OVERPAYMENT / REFUND: If line 15 is more than line 11, subtract line 11 from line 15....................
Direct Deposit of Refund: Check box 17A if your deposit will be ultimately placed in a foreign account; see instructions.	 17A

	

C		Checking or
98 S		Savings

ROUTING NUMBER	

6

00

7
8
9
10
11
12
13
14
15

00
00
00
00
00
00
00
00
00

16
17

00
00



ACCOUNT NUMBER

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

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

FOR CALENDAR YEAR

Resident Personal Income Tax Return (EZ Form)



	

	 	

	 	

	

	 	

	 	

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 CITY	

STATE	

ZIP CODE		

PAID PREPARER’S TIN

	 	

•	 If you are sending a payment with this return, mail to:
Arizona Department of Revenue, PO Box 52016, Phoenix, AZ 85072-2016.
Include the payment with Form 140EZ.
•	 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 10534 (23)

Print Form

PAID PREPARER’S PHONE NUMBER