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ARIZONA FORM
                                                                                                                                         Individual Amended Income Tax Return                                                                                                            2006
                                                                              140X                 For calendar year Y Y Y Y or fiscal year beginning M M D D Y Y Y Y and ending M M D D Y Y Y Y . 66
                                   YOUR FIRST NAME AND INITIAL                                                                                                                LAST NAME                                                                       YOUR SOCIAL SECURITY NO.
                                                                       1
                                   IF A JOINT RETURN, SPOUSE’S FIRST NAME AND INITIAL                                                                                         LAST NAME                                                                       SPOUSE’S SOCIAL SECURITY NO.
                                                                       1
                                                                                                                                                                                                                                                                     IMPORTANT
                                   PRESENT HOME ADDRESS - NUMBER AND STREET, RURAL ROUTE                                                                          APT. NO. DAYTIME PHONE (w/area code)                 94 HOME PHONE (w/area code)
                                                                                                                                                                                                                                                               You must enter your SSNs.
                                                                       2
                                   CITY, TOWN OR POST OFFICE                                                           STATE      ZIP CODE                                                                                                FOR DOR USE ONLY
                                                                       3
                                                                                                                                                                                         Original    This
                                                                           Check box to indicate both filing and residency status:                                                                 Return Return
   Filing Status




                                                                            4 Married filing joint return ............................................................................ 4
                                                                            5 Head of household: Name of qualifying child or dependent                                                         5
                                                                            6 Married filing separate return. Enter spouse’s Social Security Number                                                                88
                                                                               above and full name here. ►                                                                                     6
                                                                            7 Single ......................................................................................................... 7                  81                                            80
                                                                            8 Resident ..................................................................................................... 8
   Residency




                                                                                                                                                                                                                                                                                                    97
                                                                            9 Nonresident ............................................................................................... 9                       Original Form Filed: (Check only one)
                                                                           10 Part-year resident ...................................................................................... 10                        1Form 140 .................................................................. 1
                                                                           11 Part-year resident active military................................................................ 11                               2Form 140A ................................................................ 2
                                                                           12 Nonresident active military ......................................................................... 12                            3Form 140EZ.............................................................. 3
   Exemptions




                                                                           13 Age 65 or over: Enter the number claimed ............................................... 13                                         4Form 140NR ............................................................. 4
                                                                           14 Blind: Enter the number claimed ............................................................... 14                                  5Form 140PY ............................................................. 5
                                                                                                                                                                                                                  If 140NR or 140PY, enter corrected percentage of
                                                                           15 Dependents: Enter the number claimed ................................................... 15
                                                                                                                                                                                                                  Arizona residency...............................
                                                                           16 Qualifying parents or ancestors: Enter the number claimed ..................... 16                                                                           Do not type decimal 86                                   %
                                                                           IMPORTANT: You must enter an amount in columns (a), (b), and (c) for lines 17 and/or                                                ORIGINAL AMOUNT           AMOUNT TO BE ADDED                          CORRECTED
                                                                                                                                                                                                                     REPORTED                OR SUBTRACTED                              AMOUNT
                                                                                              18, lines 19 through 25, lines 27, 31, 32, 35, and lines 37 through 40.                                                   (a)                            (b)                                  (c)

                                                                           17 Federal adjusted gross income ........................................................................................                                                                 00 17
                                                                                                                                                                                                                                 00                                                                 00
                                                                           18 Form 140NR and 140PY filers only: Enter Arizona gross income ..................................                                                                                         00 18
                                                                                                                                                                                                                                 00                                                                 00
ATTACH PAYMENT HERE. Attach any W-2s to back of last page of the return.




                                                                           19 Additions to income .........................................................................................................                                                          00 19
                                                                                                                                                                                                                                 00                                                                 00
                                                                           20 Subtotal: Form 140, 140A, 140EZ filers: Add lines 17 and line 19. Form 140NR or
                                                                              140PY filers: Add lines 18 and 19 ...................................................................................                                                                   00 20
                                                                                                                                                                                                                                 00                                                                 00
                                                                           21 Subtractions from income ................................................................................................                                                              00 21
                                                                                                                                                                                                                                 00                                                                 00
                                                                           22 Arizona adjusted gross income. Subtract line 21 from line 20 ........................................                                                                                  00 22
                                                                                                                                                                                                                                 00                                                                 00
                                                                           23 Deductions (itemized or standard) ...................................................................................                                                                  00 23
                                                                                                                                                                                                                                 00                                                                 00
                                                                           24 Personal exemptions .......................................................................................................                                                            00 24
                                                                                                                                                                                                                                 00                                                                 00
                                                                           25 Arizona taxable income. Subtract lines 23 and 24 from line 22 ......................................                                                                                   00 25
                                                                                                                                                                                                                                 00                                                                 00
                                                                           26 Tax from tax rate table:                 Table X or Y (140, 140NR or 140PY)                                    Optional Table (140, 140A or 140EZ).................................. 26                               00
                                                                           27 Tax from recapture of credits from Arizona Form 301, Part II ..........................................                                                                                00 27
                                                                                                                                                                                                                                 00                                                                 00
                                                                           28 Subtotal of tax. Add lines 26 and 27, column (c) ................................................................................................................................. 28                                 00
                                                                           29 Clean Elections Fund Tax Reduction claimed on original return......................................                                                                                         29
                                                                                                                                                                                                                                 00                                                                 00
                                                                           30 Reduced tax. Subtract line 29 from line 28, column (c) ....................................................................................................................... 30                                     00
                                                                           31 Family income tax credit .................................................................................................                                                             00 31
                                                                                                                                                                                                                                 00                                                                 00
                                                                           32 Credits from Arizona Form 301 or Forms 310, 321, 322 or 323 ......................................                                                                                     00 32
                                                                                                                                                                                                                                 00                                                                 00
                                                                           33 Credit type: Enter form number of each credit claimed: 33 3                                                            3                3                3
                                                                           34 Subtract lines 31 and 32 from line 30 ................................................................................................................................................... 34                          00
                                                                           35 Clean Elections Fund Tax Credit. See instructions .........................................................                                                                            00 35
                                                                                                                                                                                                                                 00                                                                 00
                                                                           36 Balance of tax. Subtract line 35 from line 34. If line 35 is more than line 34, enter zero .................................................................... 36                                                    00
                                                                           37 Payments (withholding, estimated, or extension) ............................................................                                                                           00 37
                                                                                                                                                                                                                                 00                                                                 00
                                                                           38 Increased Excise Tax Credit ............................................................................................                                                               00 38
                                                                                                                                                                                                                                 00                                                                 00
                                                                           39 Property Tax Credit ..........................................................................................................                                                         00 39
                                                                                                                                                                                                                                 00                                                                 00
                                                                           40 Other refundable credits. 40A1 313 40A2 326 40A3 327 40A4 329 40A5 330                                                                                                                 00 40
                                                                                                                                                                                                                                 00                                                                 00
                                                                           41 Payment with original return plus all payments after it was filed........................................................................................................... 41                                        00
                                                                           42 Total payments and refundable credits. Add lines 37 through 41, column (c) ..................................................................................... 42                                                   00
                                                                           43 Overpayment from original return or as later adjusted. See instructions ............................................................................................. 43                                              00
                                                                           44 Balance of credits: Subtract line 43 from line 42.................................................................................................................................. 44                                00
                                                                           45 REFUND/CREDIT DUE: If line 36 is less than line 44, subtract line 36 from line 44, and enter amount of refund/credit ................... 45                                                                           00
                                                                           46 Amount of line 45 to be applied to 2007 estimated tax. If zero, enter “0” ............................................................................................ 46                                             00
                                                                           47 AMOUNT OWED: If line 36 is more than line 44, subtract line 44 from line 36, and enter the amount owed ..................................... 47                                                                       00
                                                                                   Payment enclosed. Check the box and attach payment.                                                                                                                                           DOR USE ONLY

                                                                           48 Is this amended return the result of a net operating loss? If “yes”, check the box: 48 YES                                                                                                   82                  99
ADOR 91-5380f (06)
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Form 140X (2006)                                                                                                                                                     Page 2 of 2
PART I: Dependent Exemptions - do not list yourself or spouse as dependents
                      List children and other dependents. If more space is needed, attach a separate sheet.                                    NO. OF MONTHS LIVED IN YOUR
                      FIRST AND LAST NAME                                         SOCIAL SECURITY NO.                  RELATIONSHIP           HOME DURING THE TAXABLE YEAR




                      Enter the names of the dependents listed above who do not qualify as your dependent on your federal return:




                      Enter dependents listed above who were not claimed on your federal return due to education credits:




PART II: Qualifying Parents and Ancestors of Your Parents Exemptions (Arizona residents only)
                      List below qualifying parents and ancestors of your parents for which you are claiming an exemption. If more space is needed, attach a separate sheet.
                      Do not list the same person here that you listed in Part I, above, as a dependent. For information on who is a qualifying parent or ancestor of your
                      parents, see the instructions for the original return that you filed.
                                                                                                                                              NO. OF MONTHS LIVED IN YOUR
                      FIRST AND LAST NAME                                         SOCIAL SECURITY NO.                  RELATIONSHIP          HOME DURING THE TAXABLE YEAR




PART III: Income, Deductions, and Credits
                      List the line reference from page 1 for which you are reporting a change then give the reason for each change. Attach any supporting documents
                      required. If the change(s) pertain(s) to an IRS audit, please attach a copy of the agent’s report. If you filed an amended federal return with the IRS
                      (Form 1040X), please attach a copy and all supporting schedules.




Part IV: Name and Address on Original Return
                      If your name and address is the same on this amended return as it was on your original return, write “same” on the line below.

                      Name                                                   Number and Street, etc.                                 City, State Zip

                    I have read this return and any attachments with it. Under penalties of perjury, I declare that to the best of my knowledge and
 PLEASE SIGN HERE




                    belief, they are true, correct and complete. Declaration of preparer (other than taxpayer) is based on all information of which
                    preparer has any knowledge.

                    YOUR SIGNATURE                                                               DATE                   OCCUPATION


                    SPOUSE’S SIGNATURE                                                           DATE                   SPOUSE’S OCCUPATION


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

              PAID PREPARER’S TIN                       DATE                           PAID PREPARER’S ADDRESS
      If you are sending a payment with this return, mail to Arizona Department of Revenue, PO Box 52016, Phoenix, AZ, 85072-2016.
      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 91-5380f (06)

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azdor.gov Forms 140X_f

  • 1. Print Form Reset Form ARIZONA FORM Individual Amended Income Tax Return 2006 140X For calendar year Y Y Y Y or fiscal year beginning M M D D Y Y Y Y and ending M M D D Y Y Y Y . 66 YOUR FIRST NAME AND INITIAL LAST NAME YOUR SOCIAL SECURITY NO. 1 IF A JOINT RETURN, SPOUSE’S FIRST NAME AND INITIAL LAST NAME SPOUSE’S SOCIAL SECURITY NO. 1 IMPORTANT PRESENT HOME ADDRESS - NUMBER AND STREET, RURAL ROUTE APT. NO. DAYTIME PHONE (w/area code) 94 HOME PHONE (w/area code) You must enter your SSNs. 2 CITY, TOWN OR POST OFFICE STATE ZIP CODE FOR DOR USE ONLY 3 Original This Check box to indicate both filing and residency status: Return Return Filing Status 4 Married filing joint return ............................................................................ 4 5 Head of household: Name of qualifying child or dependent 5 6 Married filing separate return. Enter spouse’s Social Security Number 88 above and full name here. ► 6 7 Single ......................................................................................................... 7 81 80 8 Resident ..................................................................................................... 8 Residency 97 9 Nonresident ............................................................................................... 9 Original Form Filed: (Check only one) 10 Part-year resident ...................................................................................... 10 1Form 140 .................................................................. 1 11 Part-year resident active military................................................................ 11 2Form 140A ................................................................ 2 12 Nonresident active military ......................................................................... 12 3Form 140EZ.............................................................. 3 Exemptions 13 Age 65 or over: Enter the number claimed ............................................... 13 4Form 140NR ............................................................. 4 14 Blind: Enter the number claimed ............................................................... 14 5Form 140PY ............................................................. 5 If 140NR or 140PY, enter corrected percentage of 15 Dependents: Enter the number claimed ................................................... 15 Arizona residency............................... 16 Qualifying parents or ancestors: Enter the number claimed ..................... 16 Do not type decimal 86 % IMPORTANT: You must enter an amount in columns (a), (b), and (c) for lines 17 and/or ORIGINAL AMOUNT AMOUNT TO BE ADDED CORRECTED REPORTED OR SUBTRACTED AMOUNT 18, lines 19 through 25, lines 27, 31, 32, 35, and lines 37 through 40. (a) (b) (c) 17 Federal adjusted gross income ........................................................................................ 00 17 00 00 18 Form 140NR and 140PY filers only: Enter Arizona gross income .................................. 00 18 00 00 ATTACH PAYMENT HERE. Attach any W-2s to back of last page of the return. 19 Additions to income ......................................................................................................... 00 19 00 00 20 Subtotal: Form 140, 140A, 140EZ filers: Add lines 17 and line 19. Form 140NR or 140PY filers: Add lines 18 and 19 ................................................................................... 00 20 00 00 21 Subtractions from income ................................................................................................ 00 21 00 00 22 Arizona adjusted gross income. Subtract line 21 from line 20 ........................................ 00 22 00 00 23 Deductions (itemized or standard) ................................................................................... 00 23 00 00 24 Personal exemptions ....................................................................................................... 00 24 00 00 25 Arizona taxable income. Subtract lines 23 and 24 from line 22 ...................................... 00 25 00 00 26 Tax from tax rate table: Table X or Y (140, 140NR or 140PY) Optional Table (140, 140A or 140EZ).................................. 26 00 27 Tax from recapture of credits from Arizona Form 301, Part II .......................................... 00 27 00 00 28 Subtotal of tax. Add lines 26 and 27, column (c) ................................................................................................................................. 28 00 29 Clean Elections Fund Tax Reduction claimed on original return...................................... 29 00 00 30 Reduced tax. Subtract line 29 from line 28, column (c) ....................................................................................................................... 30 00 31 Family income tax credit ................................................................................................. 00 31 00 00 32 Credits from Arizona Form 301 or Forms 310, 321, 322 or 323 ...................................... 00 32 00 00 33 Credit type: Enter form number of each credit claimed: 33 3 3 3 3 34 Subtract lines 31 and 32 from line 30 ................................................................................................................................................... 34 00 35 Clean Elections Fund Tax Credit. See instructions ......................................................... 00 35 00 00 36 Balance of tax. Subtract line 35 from line 34. If line 35 is more than line 34, enter zero .................................................................... 36 00 37 Payments (withholding, estimated, or extension) ............................................................ 00 37 00 00 38 Increased Excise Tax Credit ............................................................................................ 00 38 00 00 39 Property Tax Credit .......................................................................................................... 00 39 00 00 40 Other refundable credits. 40A1 313 40A2 326 40A3 327 40A4 329 40A5 330 00 40 00 00 41 Payment with original return plus all payments after it was filed........................................................................................................... 41 00 42 Total payments and refundable credits. Add lines 37 through 41, column (c) ..................................................................................... 42 00 43 Overpayment from original return or as later adjusted. See instructions ............................................................................................. 43 00 44 Balance of credits: Subtract line 43 from line 42.................................................................................................................................. 44 00 45 REFUND/CREDIT DUE: If line 36 is less than line 44, subtract line 36 from line 44, and enter amount of refund/credit ................... 45 00 46 Amount of line 45 to be applied to 2007 estimated tax. If zero, enter “0” ............................................................................................ 46 00 47 AMOUNT OWED: If line 36 is more than line 44, subtract line 44 from line 36, and enter the amount owed ..................................... 47 00 Payment enclosed. Check the box and attach payment. DOR USE ONLY 48 Is this amended return the result of a net operating loss? If “yes”, check the box: 48 YES 82 99 ADOR 91-5380f (06)
  • 2. Print Form Reset Form Form 140X (2006) Page 2 of 2 PART I: Dependent Exemptions - do not list yourself or spouse as dependents List children and other dependents. If more space is needed, attach a separate sheet. NO. OF MONTHS LIVED IN YOUR FIRST AND LAST NAME SOCIAL SECURITY NO. RELATIONSHIP HOME DURING THE TAXABLE YEAR Enter the names of the dependents listed above who do not qualify as your dependent on your federal return: Enter dependents listed above who were not claimed on your federal return due to education credits: PART II: Qualifying Parents and Ancestors of Your Parents Exemptions (Arizona residents only) List below qualifying parents and ancestors of your parents for which you are claiming an exemption. If more space is needed, attach a separate sheet. Do not list the same person here that you listed in Part I, above, as a dependent. For information on who is a qualifying parent or ancestor of your parents, see the instructions for the original return that you filed. NO. OF MONTHS LIVED IN YOUR FIRST AND LAST NAME SOCIAL SECURITY NO. RELATIONSHIP HOME DURING THE TAXABLE YEAR PART III: Income, Deductions, and Credits List the line reference from page 1 for which you are reporting a change then give the reason for each change. Attach any supporting documents required. If the change(s) pertain(s) to an IRS audit, please attach a copy of the agent’s report. If you filed an amended federal return with the IRS (Form 1040X), please attach a copy and all supporting schedules. Part IV: Name and Address on Original Return If your name and address is the same on this amended return as it was on your original return, write “same” on the line below. Name Number and Street, etc. City, State Zip I have read this return and any attachments with it. Under penalties of perjury, I declare that to the best of my knowledge and PLEASE SIGN HERE belief, they are true, correct and complete. Declaration of preparer (other than taxpayer) is based on all information of which preparer has any knowledge. YOUR SIGNATURE DATE OCCUPATION SPOUSE’S SIGNATURE DATE SPOUSE’S OCCUPATION PAID PREPARER’S SIGNATURE FIRM’S NAME (PREPARER’S IF SELF-EMPLOYED) PAID PREPARER’S TIN DATE PAID PREPARER’S ADDRESS If you are sending a payment with this return, mail to Arizona Department of Revenue, PO Box 52016, Phoenix, AZ, 85072-2016. 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 91-5380f (06)