Arizona Individual Amended Return

Individual Amended Return
Arizona Form 140X
FOR CALENDAR YEAR
Individual Amended Income Tax Return
For Forms 140, 140A, 140EZ, 140NR and 140PY
OR FISCAL YEAR BEGINNING M M D D 2 0 2 3 AND ENDING M M D D Y Y Y Y . 66

2023

140X

1
1

Your First Name and Middle Initial

Last Name

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

Last Name

Current Home Address - number and street, rural route

2

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

97
Check a box to indicate both filing and residency status:
4	 	 Married filing joint return 4a  Injured Spouse Protection of Joint Overpayment
5	 	 Head of household: Enter name of qualifying child or dependent on next line:
6	 	 Married filing separate return: Enter spouse’s name and Social Security Number above.
7	 	Single
	 Enter the number claimed. Do not check 
8	 	Resident
9a	 	Nonresident	 9b	 	Composite	
13	 Age 65 or over...................................
10	 	 Nonresident active military	
14	Blind...................................................
11	 	 Part-year resident	  15a	 Dependents
Under 17 15b
17 & over
12	 	 Part-year resident active military	
16	 Qualifying parents or grandparents...
EXEMPTIONS

	
	
	
	
	
	
	

RESIDENCY

	
	

FILING STATUS

3

REVENUE USE ONLY. DO NOT MARK IN THIS AREA.

88

81 PM

80 RCVD

	17 Federal adjusted gross income (from your federal return)...................................................................................... 17
18 Small Business Income: Residents only: check box 18N
for no change; check box 18S
for a new election;
check box 18C
if you are changing the original amount reported. See instructions............................................... 18
	19 Modified federal adjusted gross income: Residents: Subtract line 18 from line 17.......................................................... 19
	20 Nonresidents and part-year residents only: Enter Arizona gross income here.............................................................. 	20
	 20a Arizona income ratio: If you checked box 9a, 10, 11 or 12, divide line 20 by line 17 and enter the result (not over 1.000) .20a
21 Small Business Income: Nonresidents and part-year residents only: check box 21N
for no change; check box
21S
for a new election; check box 21C
if you are changing the original amount reported. See instructions...... 21
22 Modified Arizona Gross Income: Nonresidents and part-year residents: Subtract line 21 from line 20................... 22
	23 Additions to Income. See instructions............................................................................................................. 23
	24 Subtotal: Residents: Add lines 19 and 23. Nonresidents and part-year residents: Add lines 22 and 23................... 24
	25 Subtractions from Income. See instructions...................................................................................................................... 	25
	 26 Total net capital gain or (loss). See instructions.....................................................................	26
00
	 27 Total net short-term capital gain or (loss). See instructions....................................................	27
00
	 28 Total net long-term capital gain or (loss). See instructions.......................................................... 	28
00
	 29 Net long-term capital gain from assets acquired after December 31, 2011. See instructions.... 	29
00
	30 Multiply line 29 by 25% (.25) and enter the result........................................................................................................... 	30
	31 Net capital gain derived from investment in qualified small business............................................................................. 	31
	32 Contributions to: 32a 529 College Savings Plans
32b 529A (ABLE accounts)
00
00 add 32a and 32b....... .32c
	33 Arizona adjusted gross income: Subtract lines 25, 30, 31, and 32c from line 24. If less than zero, enter “0”......................... 	33

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

DO NOT STAPLE ANY ITEMS TO THE RETURN.

Arizona Form

	

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	35
	36
	37
	38
	39
	40
	41
	42
	43
	44
	45
	46
	47

Deductions: Check box and enter amount. See instructions............................... 34I ITEMIZED 34S STANDARD	34
If you checked box 34S and claim charitable contributions, check 35C Complete page 4. See instructions................ 	35
Arizona taxable income: Subtract lines 34 and 35 from line 33. If less than zero, enter “0”...................................................... 	36
Tax liability: Multiply line 36 by 2.5% (.025) ................................................................................................................... 	37
Tax from recapture of credits from Arizona Form 301, Part 2, line 31............................................................................. 	38
Subtotal of tax: Add lines 37 and 38. Enter the total............................................................................................................ 	39
Family income tax credit (AZ residents only) 40 a
00 Dependent Tax Credit. 40b
00 40c
Nonrefundable credits from Arizona Form 301, Part 2, line 62....................................................................................... 	41
Balance of tax: Subtract lines 40c and 41 from line 39. If the sum of lines 40c and 41 is more than line 39, enter “0”.................. 	42
Withholding, Estimated, and Extension Payments 43a
00 Claim of Right 43b
00 	43c
Arizona residents only: Increased Excise Tax Credit 44a
00 Property Tax Credit	44b
00 	44c
Other refundable credits: Check the box(es) and enter the total amount.......................451308-I 452334 453349 	 45
Payment with original return plus all payments after it was filed..................................................................................... 	46
Total payments and refundable credits: Add lines 43c, 44c, 45 and 46. Enter the total.................................................... 	47

ADOR 10573 (23)	

Form 140X (2023)					 Page 1 of 5

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Your Name (as shown on page 1)

Your Social Security Number

	

	

Overpayment from original return or as later adjusted. See instructions........................................................................... 	48
Balance of credits: Subtract line 48 from line 47. Enter the difference.................................................................................... 	49
OVERPAYMENT: If line 42 is less than line 49, subtract line 42 from line 49. Enter amount of overpayment............................... 	50
Amount of line 50 to be applied to 2024 estimated tax. See instructions. If zero, enter “0”.......................................... 	51
REFUND: Subtract line 51 from line 50. If less than zero, enter amount owed on line 53.......................................................... 	52
Direct Deposit of Refund: Check box 52A if your deposit will be ultimately placed in a foreign account; see instructions.	 52A
	
ACCOUNT NUMBER
C		Checking or ROUTING NUMBER	
98
S		Savings
53 AMOUNT OWED: If line 42 is more than line 49, subtract line 49 from line 42. Enter the amount owed......................................... 53
54 Check box 54 if this amended return is the result of a net operating loss, and enter the year the loss was incurred..... 54

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Complete Parts 1(A) and 1(B), Part 2 and Part 3 to report changes made to your original tax return
or most recent amended tax return and the reason(s) for each change.
NOTE: You must complete page 5, Dependent and Other Exemption Information, if you are reporting dependents (page 1, box 15a or 15b),
or qualifying parents and grandparents (page 1, box 16.) You must also complete page 5, Part 3 if you claim Other Exemptions on page 1, line 25.
If you do not complete page 5, your dependents and other exemptions may be denied. Do not count or list yourself or your spouse as dependents.

PART 1 (A)

INCOME, DEDUCTIONS, CREDITS: In column (a), list the items you are changing. In column (b), enter the amount claimed on your original
return or most recent amended return. In column (c), enter the amount of the change. In column (d), enter the corrected amount for the item you are
changing.
(a)
INCOME, DEDUCTIONS, AND CREDITS YOU ARE CHANGING
If you are rescinding your small business election, check box 55R

(c)
AMOUNT TO
ADD OR SUBTRACT

(d)
CORRECTED
AMOUNT

See these instructions for more information regarding rescinding the election.
55a
$
$
$
55b
$
$
$
55c
$
$
$
NET CAPITAL GAIN OR (LOSS): If you are changing any amount on lines 56a through 56e, complete columns (b), (c), and (d).
(a)
ITEM

PART 1 (B)

(b)
ORIGINAL AMOUNT
REPORTED

(b)
ORIGINAL AMOUNT
REPORTED

56a Total net capital gain or (loss) reported on
Form 140, line 20; Form 140NR, line 34; or Form 140PY, line 33...................
56b Total net short-term capital gain or (loss) reported on
Form 140, line 21; Form 140NR, line 35; or Form 140PY, line 34...................
56c Total net long-term capital gain or (loss) reported on
Form 140, line 22; Form 140NR, line 36; or Form 140PY, line 35...................
56d Net long-term capital gains from assets acquired after December 31, 2011
reported on Form 140, line 23; Form 140NR, line 37; or Form 140PY, line 36
56e Amount of allowable subtraction reported on Form 140, line 24;
Form 140NR, line 38; or Form 140PY, line 37.................................................

(c)
AMOUNT TO
ADD OR SUBTRACT

$

$

$

$

$

$

$

$

$

$

$

$

$

$

$

(d)
CORRECTED
AMOUNT

PART 3

PART 2

57	 REASON FOR THE CHANGE: Give the reason for each change listed in Part 1 (A) and B):

Check box 58a
if your address on this amended return is not the same as it was on your original return (or latest return filed).
Complete Part 3 with your current address.
58b Name
58c Number and Street, R.R.
Apt. No.
58d City, Town or Post Office 	

ADOR 10573 (23)	

State	

ZIP Code

Form 140X (2023)					 Page 2 of 5

Your Name (as shown on page 1)

Your Social Security Number

PLEASE SIGN HERE

Sign and date your return. If you paid someone to prepare your return, that person must also sign and date the
return. The paid preparer must provide their street address, Paid Preparer TIN and phone 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.

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YOUR SIGNATURE		 DATE		

SPOUSE’S SIGNATURE		 DATE		

	

	 	

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	

•	

OCCUPATION

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 the payment with Form 140X. Make check payable to Arizona Department of Revenue; write your SSN, Form 140X
and tax year on payment.

•	

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 10573 (23)	

Form 140X (2023)					 Page 3 of 5

Your Name (as shown on page 1)

Your Social Security Number

2019 Form 140PY - Standard Deduction Increase You must complete this worksheet
if 2023 Form 140X - 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: A part-year resident taxpayer 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. A nonresident taxpayer must prorate the increased standard deduction by his/her Arizona income
ratio computed on page 1, line 20a.
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

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

4C

00

5C

00

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

6C

00

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

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 tax year (2022).......................

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

8C Nonresidents filing Form 140NR: Enter your Arizona income ratio from

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page 1, line 20a. All other taxpayers enter 1.000..............................................

8C

9C Multiply line 7C by the percentage on line 8C and enter the result....................

9C

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Enter the amount shown on line 9C on page 1, line 35
Be sure to check box 34S for Standard Deduction on line 34.
Check box 35C for charitable contributions on line 35. If you do not check this box, you may be denied the increased
standard deduction.

ADOR 10573 (23)	

Form 140X (2023)					 Page 4 of 5

Your Name (as shown on page 1)

Your Social Security Number

2019 Form 1402023 140X Dependent and Other Exemption Information
•	

Include page 5 with your amended return if:
•	 You are reporting dependents (box 15a and 15b) on page 1.
•	 You are reporting qualifying parents and grandparents (box 16) on page 1.
You are taking a deduction for Other Exemptions on page 1, line 25 (Subtractions from Income).

Part 1: Dependents (Box 15a and 15b) - (Forms 140, 140A, 140NR, and 140PY)
Information used to compute your allowable Dependent Tax Credit on page 1, line 40 (box 40b).
(a)
FIRST AND LAST NAME

(Do not list yourself or spouse.)

(b)
SOCIAL SECURITY
NUMBER

(c)
RELATIONSHIP

(d)

(e)

NO. OF MONTHS
LIVED IN YOUR
HOME IN 2023

Dependent Age
included in:

1

2

(Box 15a)

(Box 15b)

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15c
15d
15e
15f
15g
15h
15i
15j
15k
15l
15m
15n

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(f)

IF YOU DID NOT

CLAIM THIS PERSON
ON YOUR FEDERAL
RETURN DUE TO
EDUCATIONAL
CREDITS

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Part 2: Qualifying parents and grandparents (Box 16) - (Forms 140, 140A, and 140PY)
Information used to compute your exemption included in Subtractions from Income, line 25.
(a)

(b)

(c)

(d)

FIRST AND LAST NAME

SOCIAL SECURITY
NUMBER

RELATIONSHIP

NO. OF MONTHS
LIVED IN YOUR
HOME IN 2023

(Do not list yourself or spouse.)

(e)

16a
16b
16c
16d
16e
16f

(f)

 IF AGE 65 OR

 IF DIED IN

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OVER

2023

Part 3: Other Exemptions - (Forms 140, 140A, 140NR, and 140PY)

Information used to compute your other exemptions included in Subtractions from Income, line 25.
(a)

(b)

FIRST AND LAST NAME

SOCIAL SECURITY
NUMBER

(Do not list yourself or spouse.)

(c)

AGE 65 OR OVER
(see instructions)
C1

1
2
3
4
5
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7
8
9
10

ADOR 10573 (23)	

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(d)

STILLBORN
CHILD IN 2023

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Form 140X (2023)					 Page 5 of 5