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Itemized Deductions
   ARIZONA SCHEDULE                                                                                                                                                                                          2004
                   A(PY)                                                                      For Part-Year Residents

                                                                                                 Attach to your return
NAME(S) AS SHOWN ON FORM 140PY                                                                                                                                                 YOUR SOCIAL SECURITY NUMBER


                                                                                                                                                                               SPOUSE’S SOCIAL SECURITY NUMBER


Medical and Dental Expenses • Taxes • Interest Expense • Gifts to Charity
   1 Medical and dental expenses incurred and paid while an Arizona resident plus the amount of such expenses from Arizona
                                                                                                                                                                                                               00
      sources that you incurred and paid during the part of the year while an Arizona nonresident.........................................................                                              1
   2 Taxes allowable on federal Form 1040, Schedule A, that you incurred and paid while an Arizona resident plus the amount
                                                                                                                                                                                                               00
      of such taxes from Arizona sources that you incurred and paid during the part of the year while an Arizona nonresident .............                                                              2
                                                                                                                                                                                                               00
   3 Interest expense: See instructions..................................................................................................................................................               3
   4 Gifts to charity allowable on federal Form 1040, Schedule A, that you incurred and paid while an Arizona resident plus the
                                                                                                                                                                                                               00
      amount of such gifts from Arizona sources that you incurred and paid during the part of the year while an Arizona nonresident ..                                                                  4
Casualty and Theft Losses
   5 Casualty loss(es) allowable on federal Form 1040, Schedule A, after applying the 10% federal
                                                                                                                                                                                        00
      adjusted gross income limitation and the $100 per loss floor .................................................................                    5
   6 Casualty loss(es) allowable on federal Form 4684 before applying the 10% federal adjusted gross
                                                                                                                                                                                        00
      income limitation and the $100 per loss floor..........................................................................................           6
   7 Amount of loss on line 6 incurred while you were an Arizona resident plus the amount of loss from
                                                                                                                                                                                        00
      Arizona sources on line 6 that you incurred during the part of the year while an Arizona nonresident...                                          7
                                                                                                                                                                                        %
   8 Divide line 7 by line 6, and enter the percentage....................................................................................             8
                                                                                                                                                                                                               00
   9 Multiply line 5 by the percentage on line 8.......................................................................................................................................    9
Job Expenses and Other Miscellaneous Expenses
   10 Miscellaneous expenses subject to the 2% federal adjusted gross income limitation allowable on
                                                                                                                                                                                                00
      federal Form 1040, Schedule A, before applying the limitation...............................................................                               10
   11 Amount on line 10 that you incurred and paid while an Arizona resident plus the amount on line 10 from
                                                                                                                                                                                                00
      Arizona sources that you incurred and paid during the part of the year while an Arizona nonresident ..                                                     11
                                                                                                                                                                                                %
   12 Divide line 11 by line 10, and enter the percentage ................................................................................                       12
   13 Miscellaneous deductions subject to the 2% federal adjusted gross income limit allowable on federal
                                                                                                                                                                                                00
      Form 1040, Schedule A, after applying the limitation..............................................................................                         13
                                                                                                                                                                                                00
   14 Multiply line 13 by the percentage on line 12..........................................................................................                    14
   15 Other miscellaneous expenses allowable on federal Form 1040, Schedule A, not subject to the 2%
      federal adjusted gross income limitation that you incurred and paid while an Arizona resident plus the
      amount of such expenses from Arizona sources that you incurred and paid during the part of the year
                                                                                                                                                                                                00
      while an Arizona nonresident..................................................................................................................             15
Skip lines 16 through 20 if not deducting gambling losses.
                                                                                                                                                                                                     00
    16 Wagering losses included on line 15 ......................................................................................................                 16
                                                                                                                                                                                                     00
    17 Total gambling winnings included in your Arizona gross income ............................................................                                 17
                                                                                                                                                                                                     00
    18 Authorized Arizona lottery subtraction from Form 140PY, page 2, line D32 ...........................................                                       18
                                                                                                                                                                                                     00
    19 Maximum allowable gambling loss deduction: Subtract line 18 from line 17 .........................................                                         19
                                                                                                                                                                                                     00
    20 If line 19 is less than line 16, subtract line 19 from line 16; otherwise enter “zero”.................................                                    20
    21 If you completed lines 16 through 20, subtract line 20 from line 15. If you skipped lines 16 through
                                                                                                                                                                                                     00
         20, enter amount on line 15 here............................................................................................................             21
                                                                                                                                                                                                               00
    22 Add lines 14 and 21 .........................................................................................................................................................................    22
Total Itemized Deductions
   23 Tentative Arizona itemized deduction: Add lines 1, 2, 3, 4, 9, and 22. If your federal adjusted gross
        income is more than $142,700 ($71,350 if married filing separately), complete lines 24 through 28
                                                                                                                                                             00
        below. Otherwise, enter the amount on line 23 on Form 140PY, page 1, line 21....................................                          23
   24 If your federal adjusted gross income is more than $142,700 ($71,350 if married filing separately),
        enter on line 24 the amount by which you have to reduce your federal itemized deductions because
                                                                                                                                                             00
        your federal adjusted gross income was over this threshold ..................................................................             24
   25 Enter your total federal itemized deductions allowable on federal Form 1040, Schedule A, prior to the
                                                                                                                                                             00
        federal adjusted gross income limitation................................................................................................. 25
                                                                                                                                                             %
   26 Divide line 23 by line 25, and enter the percentage................................................................................         26
                                                                                                                                                             00
   27 Multiply line 24 by the percentage on line 26, and enter the result.........................................................                27
                                                                                                                                                                                                               00
   28 Subtract line 27 from line 23. Enter the result here and on Form 140PY, page 1, line 21 ..............................................................    28
ADOR 91-0078f (04)

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azdor.gov Forms 140_SchedAPYfillable

  • 1. Itemized Deductions ARIZONA SCHEDULE 2004 A(PY) For Part-Year Residents Attach to your return NAME(S) AS SHOWN ON FORM 140PY YOUR SOCIAL SECURITY NUMBER SPOUSE’S SOCIAL SECURITY NUMBER Medical and Dental Expenses • Taxes • Interest Expense • Gifts to Charity 1 Medical and dental expenses incurred and paid while an Arizona resident plus the amount of such expenses from Arizona 00 sources that you incurred and paid during the part of the year while an Arizona nonresident......................................................... 1 2 Taxes allowable on federal Form 1040, Schedule A, that you incurred and paid while an Arizona resident plus the amount 00 of such taxes from Arizona sources that you incurred and paid during the part of the year while an Arizona nonresident ............. 2 00 3 Interest expense: See instructions.................................................................................................................................................. 3 4 Gifts to charity allowable on federal Form 1040, Schedule A, that you incurred and paid while an Arizona resident plus the 00 amount of such gifts from Arizona sources that you incurred and paid during the part of the year while an Arizona nonresident .. 4 Casualty and Theft Losses 5 Casualty loss(es) allowable on federal Form 1040, Schedule A, after applying the 10% federal 00 adjusted gross income limitation and the $100 per loss floor ................................................................. 5 6 Casualty loss(es) allowable on federal Form 4684 before applying the 10% federal adjusted gross 00 income limitation and the $100 per loss floor.......................................................................................... 6 7 Amount of loss on line 6 incurred while you were an Arizona resident plus the amount of loss from 00 Arizona sources on line 6 that you incurred during the part of the year while an Arizona nonresident... 7 % 8 Divide line 7 by line 6, and enter the percentage.................................................................................... 8 00 9 Multiply line 5 by the percentage on line 8....................................................................................................................................... 9 Job Expenses and Other Miscellaneous Expenses 10 Miscellaneous expenses subject to the 2% federal adjusted gross income limitation allowable on 00 federal Form 1040, Schedule A, before applying the limitation............................................................... 10 11 Amount on line 10 that you incurred and paid while an Arizona resident plus the amount on line 10 from 00 Arizona sources that you incurred and paid during the part of the year while an Arizona nonresident .. 11 % 12 Divide line 11 by line 10, and enter the percentage ................................................................................ 12 13 Miscellaneous deductions subject to the 2% federal adjusted gross income limit allowable on federal 00 Form 1040, Schedule A, after applying the limitation.............................................................................. 13 00 14 Multiply line 13 by the percentage on line 12.......................................................................................... 14 15 Other miscellaneous expenses allowable on federal Form 1040, Schedule A, not subject to the 2% federal adjusted gross income limitation that you incurred and paid while an Arizona resident plus the amount of such expenses from Arizona sources that you incurred and paid during the part of the year 00 while an Arizona nonresident.................................................................................................................. 15 Skip lines 16 through 20 if not deducting gambling losses. 00 16 Wagering losses included on line 15 ...................................................................................................... 16 00 17 Total gambling winnings included in your Arizona gross income ............................................................ 17 00 18 Authorized Arizona lottery subtraction from Form 140PY, page 2, line D32 ........................................... 18 00 19 Maximum allowable gambling loss deduction: Subtract line 18 from line 17 ......................................... 19 00 20 If line 19 is less than line 16, subtract line 19 from line 16; otherwise enter “zero”................................. 20 21 If you completed lines 16 through 20, subtract line 20 from line 15. If you skipped lines 16 through 00 20, enter amount on line 15 here............................................................................................................ 21 00 22 Add lines 14 and 21 ......................................................................................................................................................................... 22 Total Itemized Deductions 23 Tentative Arizona itemized deduction: Add lines 1, 2, 3, 4, 9, and 22. If your federal adjusted gross income is more than $142,700 ($71,350 if married filing separately), complete lines 24 through 28 00 below. Otherwise, enter the amount on line 23 on Form 140PY, page 1, line 21.................................... 23 24 If your federal adjusted gross income is more than $142,700 ($71,350 if married filing separately), enter on line 24 the amount by which you have to reduce your federal itemized deductions because 00 your federal adjusted gross income was over this threshold .................................................................. 24 25 Enter your total federal itemized deductions allowable on federal Form 1040, Schedule A, prior to the 00 federal adjusted gross income limitation................................................................................................. 25 % 26 Divide line 23 by line 25, and enter the percentage................................................................................ 26 00 27 Multiply line 24 by the percentage on line 26, and enter the result......................................................... 27 00 28 Subtract line 27 from line 23. Enter the result here and on Form 140PY, page 1, line 21 .............................................................. 28 ADOR 91-0078f (04)