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FORM_A1_R_2024

The Arizona Form A1-R is a withholding reconciliation return that must be completed if filing Form A1-QRT for the year 2024. It is due by January 31, 2025, and should not be submitted with any liability or refund claims; those must be filed separately. The form requires taxpayer information, federal transmittal details, and an annual summary of reported amounts.

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19 views

FORM_A1_R_2024

The Arizona Form A1-R is a withholding reconciliation return that must be completed if filing Form A1-QRT for the year 2024. It is due by January 31, 2025, and should not be submitted with any liability or refund claims; those must be filed separately. The form requires taxpayer information, federal transmittal details, and an annual summary of reported amounts.

Uploaded by

gupsakmac2
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Arizona Form

Arizona Withholding Reconciliation Return


A1-R FOR FORM A1-QRT 2024
Complete this form only if you file Form A1-QRT. Arizona Form A1-R is an information return. Do not submit any liability owed
or try to claim refunds with this return. To submit additional liability or claim a refund, file amended quarterly withholding tax Form(s)
A1-QRT. Form A1-R is due on or before January 31, 2025. Do NOT submit more than one A1-R per EIN per year.

Part 1 Taxpayer Information (Refer to the instructions before completing 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


REVENUE USE ONLY. DO NOT MARK IN THIS AREA.
88
City or town, state and ZIP Code

Business telephone number (with area code)

Check box if: A  Amended Return B  Address Change


C  Check this box if this return is an early-filed return for calendar year 2025 due to an
account cancellation during calendar year 2025.
D  Check this box if this cancellation was due to a merger or acquisition and the surviving
employer is filing Forms W-2. 81 PM 66 RCVD
E  Check this box if this form is being filed by the surviving employer and the amount on
line 10 is less than the amount on line 1 because the difference was remitted by the
predecessor employer. Also enter the following:
Predecessor Employer Name.......................................................
Predecessor Employer EIN..........................................................

Part 2 Federal Transmittal Information


1 Total Arizona Tax Withheld per federal Forms W-2, W-2c, W-2G and 1099 for 2024.............................. 1
2 Total Arizona wages paid to employees for 2024.................................................................................... 2
3 Total number of employees paid Arizona wages in 2024......................................................................... 3
4 Total number of federal Forms W-2, W-2c, W-2G, and 1099 submitted to the department..................... 4
5 Information Return Penalty...................................................................................................................... 5 00
Part 3 Annual Summary of Amounts Reported on 2024 Arizona Forms A1-QRT
Liability Reported
6 First Quarter............................................................................................................. 6
7 Second Quarter........................................................................................................ 7
8 Third Quarter............................................................................................................ 8
9 Fourth Quarter.......................................................................................................... 9
10 Total Annual Withholding Reported......................................................................... 10
Part 4 Explain Why an Amended Form A1-R is Being Filed (include additional sheet, if necessary)

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
Declaration
and correct return.
Please
Sign
Here TAXPAYER'S SIGNATURE DATE BUSINESS TELEPHONE NUMBER

Paid
PAID PREPARER’S SIGNATURE DATE PAID PREPARER’S PTIN
Preparer’s
Use FIRM’S NAME (OR PAID PREPARER’S NAME, IF SELF-EMPLOYED) FIRM’S EIN

Only
FIRM’S STREET ADDRESS FIRM’S TELEPHONE NUMBER

CITY STATE ZIP CODE

This form must be e-filed unless the taxpayer has a waiver or is exempt from e-filing. See instructions for details.
ADOR 10619 (24)

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