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Arizona Exempt Organization Annual Information Return (OBSOLETE)
Form 99 is obsolete, and is no longer supported by the Arizona Department of Revenue.
Extracted from PDF file 2019-arizona-form-99.pdf, last modified October 2009Exempt Organization Annual Information Return (OBSOLETE)
Arizona Form 99 Arizona Exempt Organization Annual Information Return 2017 For the calendar year 2017 or fiscal year beginning m m d d 2 0 1 7 and ending m m d d 2 0 y y . CHECK ONE: Name Original Amended Address – number and street or PO Box Business Telephone Number (with area code) 68 Check box if: Employer Identification Number (EIN) City, Town or Post Office This is a first return Name change Address change A Date Arizona operations began: m m B Nature of Arizona activities: C Federal form filed: 990 990-EZ d d y y y y Other (specify) State ZIP Code Check box if return filed under extension: 82 82F REVENUE USE ONLY. DO NOT MARK IN THIS AREA. 88 Nonprofit Medical Marijuana Dispensary (NMMD) only – D NMMD Registry Identification Number: E What type of entity is the dispensary? Corporation Limited Liability Company (LLC) Partnership S corporation 66 RCVD 81 PM Sole Proprietorship F If the dispensary is an LLC, what is the federal tax classification? Corporation Disregarded Entity Partnership S corporation If the dispensary is an LLC, a partnership or an S corporation, include a schedule that lists the following ownership information: name, address, TIN, and ownership percentage at the end of the tax year. G Federal form filed: 1040 1041 1065 1120 1120-S Other (specify) Sources of Income 1 Gross sales from business activities............................................................................. 1 00 2 Less cost of goods sold or of operations: Include itemized statement........................ 2 00 3 Gross profit from business activities: Subtract line 2 from line 1................................. 3 00 4 Interest.......................................................................................................................... 4 00 5 Dividends...................................................................................................................... 5 00 6 Rents and royalties....................................................................................................... 6 00 7 Gain or (loss) from sales of assets, excluding inventory items..................................... 7 00 8 Dues, assessments, etc., from members..................................................................... 8 00 9 Dues, assessments, etc., from affiliates....................................................................... 9 00 10 Contributions, gifts, grants, etc., received..................................................................... 10 00 11 Other income: Include itemized statement.................................................................. 11 00 12 Total income: Add lines 3 through 11........................................................................................................................... 12 00 13 Compensation of officers, directors, trustees, etc......................................................... 13 00 14 Salaries and wages other than amounts included on line 2......................................... 14 00 15 Interest.......................................................................................................................... 15 00 16 Taxes............................................................................................................................ 16 00 17 Rent expense................................................................................................................ 17 00 18 Depreciation: Include schedule.................................................................................... 18 00 19 Miscellaneous expenses: Include itemized statement................................................. 19 00 20 Total expenses: Add lines 13 through 19..................................................................................................................... 20 00 21 Disbursements from current income for exempt purposes from page 2, line A6.......................................................... 22 Disbursements from principal for exempt purposes from page 2, line B6.................................................................... 23 Other disbursements not itemized on Schedule A or Schedule B: Include schedule.................................................. 21 22 23 00 00 00 24 Accumulation of income in current year: Line 12 less the sum of lines 20, 21, 22, and 23......................................... 25 Accumulation of income at beginning of year............................................................................................................... 26 Accumulation of income at end of year: Add lines 24 and 25...................................................................................... 24 25 26 00 00 00 Administrative Expenses Disbursements Accumulation of Income Penalty 27 Penalty for late filing or incomplete filing. See instructions.......................................................................................... 27 THE BUSINESS IS SUBJECT TO A PENALTY IF THIS RETURN IS FILED LATE OR IS INCOMPLETE. A.R.S. § 42-1125(K). ADOR 10418 (17) 00 Continued on page 2 Name (as shown on page 1) SCHEDULE A EIN Disbursements From Current Income for Exempt Purposes A1 Dues, assessments, etc., paid to affiliates.................................................................... A1 00 A2 Contributions, gifts, grants, etc., paid........................................................................... A2 00 A3 Benefit payments to or for members or their dependents: A3a Death, sickness, hospitalization, disability, or pension benefits.......................... A3a 00 A3b Other benefits..................................................................................................... A3b 00 A4 Dividends and other distributions to members, shareholders, or depositors..................... A4 00 A5 Other............................................................................................................................. A5 00 A6 Total: Add lines A1 through A5. Enter total here and on page 1, line 21..................................................................... A6 00 SCHEDULE B Disbursements From Principal for Exempt Purposes B1 Dues, assessments, etc., paid to affiliates.................................................................... B1 00 B2 Contributions, gifts, grants, etc., paid........................................................................... B2 00 B3 Benefit payments to or for members or their dependents: B3a Death, sickness, hospitalization, disability, or pension benefits.......................... B3a 00 B3b Other benefits..................................................................................................... B3b 00 B4 Dividends and other distributions to members, shareholders, or depositors..................... B4 00 B5 Other............................................................................................................................. B5 00 B6 Total: Add lines B1 through B5. Enter total here and on page 1, line 22.................................................................... B6 00 SCHEDULE C Balance Sheet NOTE: Amounts reported in included schedules and in this column should be end of year amounts. (a) (b) Beginning of Year End of Year Assets C1 Cash...................................................................................................................................... 00 C1 00 C2a Accounts receivable.............................................................. C2a 00 C2b Less allowance for doubtful accounts......................... C2b 00 C2c Line C2a less line C2b. Enter difference in column (b)............................................... 00 C2c 00 C3a Other notes and loans receivable: Include schedule........... C3a 00 C3b Less allowance for doubtful accounts......................... C3b 00 C3c Line C3a less line C3b. Enter difference in column (b)............................................... 00 C3c 00 C4 Inventories............................................................................................................................. 00 C4 00 C5 Investments (securities): Include schedule........................................................................... 00 C5 00 C6 Investments (other): Include schedule.................................................................................. 00 C6 00 C7a Land, buildings, and equipment; basis:................................ C7a 00 C7b Less accumulated depreciation: Include schedule.... C7b 00 C7c Line C7a less line C7b. Enter difference in column (b)............................................... 00 C7c 00 C8 Other assets (describe): 00 C8 00 C9 Total assets: Add lines C1 through C8............................................................................. 00 C9 00 Liabilities C10 Accounts payable and accrued expenses............................................................................. 00 C10 00 C11 Mortgages and other notes payable: Include schedule........................................................ 00 C11 00 C12 Other liabilities (describe): 00 C12 00 C13 Total liabilities: Add lines C10 through C12..................................................................... 00 C13 00 Net Assets C14 Capital stock or trust principal................................................................................................ 00 C14 00 C15 Paid-in or capital surplus....................................................................................................... 00 C15 00 C16 Retained earnings or accumulated income........................................................................... 00 C16 00 C17 Total net assets: Add lines C14 through C16................................................................... 00 C17 00 C18 Total liabilities and net assets: Add lines C13 and C17.................................................. 00 C18 00 PLEASE BE SURE TO SIGN THE RETURN ON PAGE 3. ADOR 10418 (17) AZ Form 99 (2017) Page 2 of 3 Name (as shown on page 1) Declaration EIN Under penalties of perjury, I declare that I have examined this return, including the accompanying schedules and statements, and to the best of my knowledge and belief, it is a true, correct and complete return, made in good faith, for the taxable year stated pursuant to the income tax laws of the State of Arizona. Please Sign Here Officer’s Signature Paid Date paid Preparer’s Signature Preparer’s Use Title Date paid Preparer’s PTIN EIN OR SSN Firm’s Name (or paid Preparer’s Name, if self-employed) Firm’s Firm’s street Address Firm’s Telephone Number Only City State ZIP Code Mail to: Arizona Department of Revenue, PO Box 52153, Phoenix, AZ 85072-2153 Print ADOR 10418 (17) AZ Form 99 (2017) Page 3 of 3
Arizona Form 99
More about the Arizona Form 99 Corporate Income Tax
For taxable years 2018 and after: Tax exempt organizations will no longer need to file either the Arizona Form 99 or copies of their federal Form 990. Tax exempt organizations that file a federal Form 990-T to report unrelated business taxable income are still required to file Arizona Form 99T.
We last updated the Exempt Organization Annual Information Return (OBSOLETE) in March 2021, and the latest form we have available is for tax year 2019. This means that we don't yet have the updated form for the current tax year. Please check this page regularly, as we will post the updated form as soon as it is released by the Arizona Department of Revenue. You can print other Arizona tax forms here.
Related Arizona Corporate Income Tax Forms:
TaxFormFinder has an additional 95 Arizona income tax forms that you may need, plus all federal income tax forms. These related forms may also be needed with the Arizona Form 99.
| Form Code | Form Name |
|---|---|
| Form 99T | Exempt Organization Business Income Tax Return |
View all 96 Arizona Income Tax Forms
Form Sources:
Arizona usually releases forms for the current tax year between January and April. We last updated Arizona Form 99 from the Department of Revenue in March 2021.
About the Corporate Income Tax
The IRS and most states require corporations to file an income tax return, with the exact filing requirements depending on the type of company.
Sole proprietorships or disregarded entities like LLCs are filed on Schedule C (or the state equivalent) of the owner's personal income tax return, flow-through entities like S Corporations or Partnerships are generally required to file an informational return equivilent to the IRS Form 1120S or Form 1065, and full corporations must file the equivalent of federal Form 1120 (and, unlike flow-through corporations, are often subject to a corporate tax liability).
Additional forms are available for a wide variety of specific entities and transactions including fiduciaries, nonprofits, and companies involved in other specific types of business.
Historical Past-Year Versions of Arizona Form 99
We have a total of seven past-year versions of Form 99 in the TaxFormFinder archives, including for the previous tax year. Download past year versions of this tax form as PDFs here:
2012 Form 99
Arizona Form 99
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