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Form 140-IA Individual Income Tax Installment Agreement Request

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Form Instructions

INSTRUCTIONS: ARIZONA INDIVIDUAL INCOME TAX INSTALLMENT AGREEMENT REQUEST (Form 140-IA)

If unable to pay the Arizona individual income tax you owe, file a form 140-IA to request an installment payment plan. This document can be found from the website of the Arizona Department of Revenue.

Arizona Individual Income Tax Installment Agreement Request 140-IA Step 1: Enter your first name and middle initial in the first blank box, your last name in the second blank box, and your Social Security number in the third blank box.

Arizona Individual Income Tax Installment Agreement Request 140-IA Step 2: If filing jointly, enter the same information for your spouse in the next three blank boxes.

Arizona Individual Income Tax Installment Agreement Request 140-IA Step 3: In the next two blank boxes, enter your present home street address and home phone number.

Arizona Individual Income Tax Installment Agreement Request 140-IA Step 4: In the next five blank boxes, enter your city, town or post office, state, zip code, work phone number and spouse's work phone number (if applicable).

Arizona Individual Income Tax Installment Agreement Request 140-IA Step 5: In the next two blank boxes, enter the name of your employer and (if applicable) that of your spouse's employer.

Arizona Individual Income Tax Installment Agreement Request 140-IA Step 6: In the next blank box, enter your employer's address.

Arizona Individual Income Tax Installment Agreement Request 140-IA Step 7: In the next blank box, if applicable, enter the address of your spouse's employer.

Arizona Individual Income Tax Installment Agreement Request 140-IA Step 8: In the next blank box, enter the name of your banking or financial institution.

Arizona Individual Income Tax Installment Agreement Request 140-IA Step 9: In the next blank box, enter the year or years for which you are filing this request.

Arizona Individual Income Tax Installment Agreement Request 140-IA Step 10: In the next blank box, enter the amount of your proposed monthly payment.

Arizona Individual Income Tax Installment Agreement Request 140-IA Step 11: In the next blank box, enter the proposed monthly payment due date.

Arizona Individual Income Tax Installment Agreement Request 140-IA Step 12: In the next blank box, enter your signature and the date.

Arizona Individual Income Tax Installment Agreement Request 140-IA Step 13: If applicable, your spouse should enter their signature and the date in the last blank box.

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