Arizona Arizona Quarterly Withholding Tax Return

Arizona Quarterly Withholding Tax Return
Arizona Form A1-QRT
Arizona Form

A1-QRT

Arizona Quarterly Withholding Tax Return

DO NOT file more than one original A1-QRT per EIN per quarter.
Taxpayer Information (Refer to the instructions before completing Part 1.)
Part 1
Business Name (As listed on the Arizona Joint Tax Application - Form JT-1)

Employer Identification Number (EIN)

Number and street or PO Box

QUARTER AND YEAR

Q Y Y Y Y

City or town, state and ZIP Code



Business telephone number (with area code)

Enter Quarter (1, 2, 3 or 4) and
four digits of year. See instructions.

REVENUE USE ONLY. DO NOT MARK IN THIS AREA.

88

Check box if:
A Amended Return B Address Change C Final Return (CANCEL ACCOUNT)
If this is your final return, the department will cancel your withholding account. Enter the date final
MM D D Y Y Y Y
wages were paid and complete Part 6.....................................	

PM
D 	Check this box if this form is being filed by the surviving employer and the periods covered 81
by this return are for less than three (3) months. Also enter the following:
	
Predecessor Employer Name.......... 	

	

66 RCVD

Predecessor Employer EIN.............. 	

E Total Arizona payroll for this quarter....................................................................................................................................	
F Total number of employees paid Arizona wages for this quarter.........................................................................................

$

Tax Liability Schedule Include all withholding amounts from all sources (i.e. wages & salary, pensions & annuities,
gambling winnings, etc.). See instructions.
A. Quarterly Deposit Schedule: Complete if prior 4 quarter average was not more than $1,500.

Part 2

A1	Tax Liability. Enter the total amount withheld during the quarter. Also enter this amount on Part 3, line 1.................... A1

Complete Section A above OR Section B below; DO NOT COMPLETE BOTH.
B. Monthly or Semi-Weekly/Next Day Deposit Schedule: Complete if prior 4 quarter average was greater than $1,500.
Semi-weekly depositors and taxpayers with a next-day tax deposit obligation during the quarter, CHECK THIS BOX and complete Part 4. 
For lines B1 through B3, enter the total amount withheld for each month in the quarter.
B1	Month 1 Liability.............................................................................................................................................................. B1
B2	Month 2 Liability.............................................................................................................................................................. B2
B3	Month 3 Liability.............................................................................................................................................................. B3
B4	Total. Enter this amount on Part 3, line 1....................................................................................................................... B4

Part 3

Tax Computation (See instructions.)

1	 Liability: Enter the amount from line A1 or line B4..........................................................................................................
2	 Payments made during this quarter. ...............................................................................................................................
3	 Total Amount Due: Subtract line 2 from line 1. Enter the difference. Use a minus sign to indicate a
negative amount..............................................................................................................................................................
Declaration

TAXPAYER'S SIGNATURE

Paid

PAID PREPARER’S SIGNATURE

Use
Only

3

Under penalties of perjury, I declare that I have examined this return and to the best of my knowledge and belief, it is a true, complete
and correct return.

Please
Sign
Here

Preparer’s

1
2

DATE

BUSINESS TELEPHONE NUMBER

DATE

PAID PREPARER’S PTIN

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

FIRM’S EIN

FIRM’S STREET ADDRESS

FIRM’S TELEPHONE NUMBER

CITY

STATE

ZIP CODE

	 Payment by EFT may be required. See instructions.
	 This form must be e-filed unless the taxpayer has a waiver or is exempt from e-filing. See instructions
ADOR 10888 (22)

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Name (as shown on page 1)

EIN

Semi-Weekly/Next Day Deposit Schedule
Part 4
A.	 First Month of Quarter (Days of the Month)
8
15 
22 
9
16 
23 
10 
17 
24 
11 
18 
25 
12 
19 
26 
5
6
13 
20 
27 
7
14 
21 
28 
Month 1 Liability: Enter total here and on Part 2, line B1..............................................................................................
1
2
3
4









29
30
31





Check a box only if you
had a next-banking day
deposit obligation.

$

B.	 Second Month of Quarter (Days of the Month)
8
15 
22 
9
16 
23 
10 
17 
24 
11 
18 
25 
12 
19 
26 
5
6
13 
20 
27 
7
14 
21 
28 
Month 2 Liability: Enter total here and on Part 2, line B2..............................................................................................
1
2
3
4









29
30
31





Check a box only if you
had a next-banking day
deposit obligation.

$

C.	 Third Month of Quarter (Days of the Month)
8
15 
22 
9
16 
23 
10 
17 
24 
11 
18 
25 
12 
19 
26 
5
6
13 
20 
27 
7
14 
21 
28 
Month 3 Liability: Enter total here and on Part 2, line B3..............................................................................................
1
2
3
4









Part 5

29
30
31





Check a box only if you
had a next-banking day
deposit obligation.

$

Amended Form A1-QRT Return Information

If you checked the box “Amended Return” in Part 1, explain why an amended Form A1-QRT is being filed (include additional sheets, if necessary):

Part 6

Final Form A1-QRT

If you checked the box “Final Return” in Part 1, check the box that indicates why this is a final return:
	1	
	 Reorganization or change in business entity (example: from corporation to partnership).
	2	
	 Business sold.
	3	
	 Business stopped paying wages and will not have any employees in the future.
	4	
	 Business permanently closed.
	5	
	 Business has only leased or temporary agency employees.
	6	
	 Other (specify reason):

	7		 Check this box if records will be kept at a location different from the address shown in Part 1.
	
	
	

Name:
Number and Street:
City:

	

State:

	

ZIP Code:

	8		 Check this box if there is a successor employer.
	
	
	

Name:
Number and Street:
City:

ADOR
10888 (22)
	

	
	

State:

AZ Form A1-QRT (2022)

	

EIN:
ZIP Code:

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