Arizona TRANSFEROR Notice of Transfer of Credit for Motion Picture Production Cost

TRANSFEROR Notice of Transfer of Credit for Motion Picture Production Cost
Arizona Form 334-O
Transferor Notice
of Transfer of Motion Picture Credits

Arizona Form

334-O

2015

DO NOT MAIL COMPLETED FORM WITH TAX RETURN.
The transferor must submit this notice to the Department of Revenue within 30 days after the sale or transfer. Each form
must be for a transfer of a single credit by a transferor to one or more transferees. If you have more than one credit you
are transferring, complete a separate Form 334-O for each credit.

A

Transferor Information

Name

TIN

Address – number and street or PO Box

City, Town or Post Office

Authorized Contact Person

B

ZIP Code

Telephone Number (with area code)

Motion Picture Production Company Information

Name

TIN

Address – number and street or PO Box

City, Town or Post Office

Authorized Contact Person

C

State

State

ZIP Code

Telephone Number (with area code)

Credit Information

1 Credit post-approval number ......................
2 Amount of transfer from page 2,
Part D, line 5 ...............................................
3 Date of transfer ...........................................

$

00

4 Transfer credit balance before transfer ......

$

00

5 Transfer credit remaining after transfer ......

$

00

MM D D Y Y Y Y

D Transferee Information
Enter the transferee information on page 2 of this form.
Signature
The transferor hereby represents that it has neither claimed for its own behalf nor conveyed to any other transferee the credit for motion picture
production costs transferred in this notice. Effective as of the date of transfer shown in this notice, the transferor agrees to transfer the credit amount
shown on line 2 above.

TRANSFEROR SIGNATURE

TAXPAYER NAME (print or type)

TITLE

TELEPHONE NUMBER (with area code)

Do not mail completed form with tax return. Mail form separately to:
Arizona Department of Revenue • Office of Economic Research and Analysis • PO Box 29099 • Phoenix, AZ 85038-9099

ADOR 10718 (15)

Print Pg 1

Name of Transferor (as shown on page 1)

TIN

Transferee Information

D

List each transferee to whom you are transferring this credit. If you need more space, complete additional schedules.
Name

TIN

Credit amount

$

00

$

00

$

00

$

00

TOTAL: Add lines 1 through 4. Enter the total here and on page 1, Part C, line 2 ................................ $

00

1
Number and street

City or town, state and ZIP code

Authorized contact person

Telephone number
(with area code)

Name
2
Number and street

City or town, state and ZIP code

Authorized contact person

Telephone number
(with area code)

Name
3
Number and street

City or town, state and ZIP code

Authorized contact person

Telephone number
(with area code)

Name
4
Number and street

City or town, state and ZIP code

Authorized contact person

5

ADOR 10718 (15)

Telephone number
(with area code)

AZ Form 334-O (2015)

Print Pg 2

Clear Pg 2

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