Blank 290 Arizona PDF Template Modify Form Now

Blank 290 Arizona PDF Template

The Arizona Form 290 is a request for penalty abatement, allowing taxpayers to seek relief from penalties imposed by the Arizona Department of Revenue. This form is essential for individuals or businesses who believe their penalties were due to reasonable causes rather than willful neglect. By submitting Form 290, taxpayers can provide the necessary information and documentation to support their request for a penalty reduction.

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Overview

The Arizona Form 290, known as the Request for Penalty Abatement, serves as a formal application for taxpayers seeking relief from certain penalties imposed by the Arizona Department of Revenue. This form is specifically designed for non-audit penalties, meaning it is not applicable for penalties resulting from an audit. Taxpayers must provide essential information, including their name, contact details, and the specific tax type associated with the penalty. The form requires a clear explanation of the reasons for the abatement request, emphasizing the need for reasonable cause rather than willful neglect. Supporting documentation is crucial; without it, requests may be denied. This could include canceled checks, tax returns, medical reports, or other relevant documents. The form also outlines who is authorized to sign on behalf of various entities, such as individuals, corporations, or partnerships. Once completed, the form should be mailed or faxed to the Arizona Department of Revenue’s Penalty Review Unit, where it will be processed within approximately six weeks.

Form Example

Arizona Form 290

Request for Penalty Abatement

UseTHE PURPOSEForm 290OFtoTHISrequestFORMan abatement of non-audit penalties.

The account for which the abatement request is being submitted must be in compliance. Compliance means there are no delinquent tax returns and all non-audit tax liabilities are paid when making the request. Provide clear and concise information to allow for a prompt reply by the department.

The request will not be considered for processing if the form is incomplete or if the account is not in compliance. The abatement request form and documentation will be returned for correction. The form and documentation will then need to be resubmitted for consideration.

IMPORTANT: If the penalty being addressed is the result of an audit, do not use Form 290. Contact the Audit Unit at the phone number shown on the assessment. The Penalty Review Unit does not process audit assessed penalties.

INFORMATION

AllPARTrequests1 - GENERALfor abatementINFORMATIONof penalties must include the name, address, email address and telephone number of the taxpayer for which the request is being made.

If you want the Arizona Department of Revenue to work with your representative or third party, complete and include Arizona Form 285, General Disclosure/ Representation Authorization Form. Ensure boxes 4b and 4c or box 5 are indicated.

PART 2 - SPECIFIC DETAILS FOR ABATEMENT

ProvideCONSIDERATIONspecific details regarding the account and periods to be considered for abatement.

TAXIfTYPEyour request is for an individual income tax return, use the Individual Taxpayer Identification Number (ITIN) number or social security number from the return.

• If your request is for a business account, use the Transaction Privilege Tax (TPT) or Marijuana Excise Tax (MET) license number.

• If your request is for a corporate or withholding account, use an Employer Identification Number (EIN).

EnterPERIOD(S)the specificOR YEAR(S)tax period(s) in date format, based on the filing frequency, that you want considered for the abatement.

For example:

• Annual filers: 2015-2016

• Quarterly filers: 01/2017-03/2017 or Q2 2018

• Monthly filers: 07/2017-02/2019

EnterPENALTYthe AMOUNTdollar amount for which you are requesting penalty abatement. There is no statutory provision that permits abatement of interest based on reasonable cause.

ExplainPART 3 - inEXPLANATIONdetail your&reason(s)DOCUMENTATIONfor requesting the abatement. You must provide specific details or reasons that directly contributed to the failure to file or pay timely for the period(s) you are requesting penalty abatement. Include in the explanation as to why there is reasonable cause for the returns and/or payments being late. Clear and concise information will allow for a prompt reply. Include additional pages if you need more space.

IMPORTANT: You must include Documentation that supports the basis of your request. Requests without

supporting documentation may be denied. Examples include:

• Proof of timely payment; including front and back of canceled checks.

• Medical reports and/or Death Certificate(s).

• Other pertinent documents that support your request for this abatement.

• Proof an extension has been filed.

BelowSituationsare someWh resituationsReasonablewhereCausereasonableMay Exist:cause may exist. There may be other situations where reasonable cause may exist. Accordingly, it’s important for you to provide specific details or reasons that directly contributed to the failure to. file or pay timely for the Circumstancesperiods you arebeyondrequestingthe control of the taxpayer while using reasonable and prudent business practices. A1.mathematicalMathematicalerroronrsa timely filed tax return.

2.Unexpected illness or unavoidable absence

A. aIndividual. Delay causedreturnsby serious illness of the taxpayer, or

member of the taxpayer’s immediate family. b. Delay caused by unavoidable absence of the

taxpayer. Vacation time is not acceptable as an unavoidable absence.

ADOR 11237 (05/23)

Instructions

Arizona Form 290

 

 

 

 

Request for Penalty Abatement

 

 

B. Entity r turns

 

 

 

 

 

 

If you want the Arizona Department of Revenue to work with

 

 

 

In the caseof corporate, estate, trust or other business

your representative or third party, complete and include

 

 

 

 

 

 

or

 

 

 

returns, delay caused by unexpected serious illness of

Arizona Form 285, General Disclosure/Representation

 

 

 

Authorization Form. Ensure boxes 4b and 4c box 5 are

 

 

 

the individual with sole authority to execute the return

indicated.

 

 

 

 

 

 

or member of such individual’s immediate family.

Handwritten signature, date, print the signer’s name and

 

 

 

Delay caused by unavoidable absence of the individual

If

 

 

with sole authority to execute return.

 

 

title. An electronic signature with a digital certificate is

 

 

 

 

 

is the basis of the request for penalty

accepted.

 

 

 

abatement, the Department shall require proof of the date

Type of Entity

 

Who must sign

 

 

unexpected illness

 

 

 

 

 

 

 

 

 

 

of illness. This proof includes, but is not limited to, doctor

 

 

 

 

statements.

 

 

 

 

 

 

 

Individuals, Joint

The individual/joint filers/sole proprietor

 

A.

In the case of individual returns, delay caused by the

Filers and Sole

must sign.

 

 

 

 

 

Proprietorships

 

 

 

3. Death

 

 

 

 

 

 

 

 

meaning of A.R.S. § 42-2003 (A)(2) or any

death of a taxpayer or member of the taxpayer’s immediate

 

family.

 

 

 

 

 

 

 

Corporations

A principal corporate officer within the

 

 

 

 

 

 

 

 

person designated by a principal corporate

 

 

 

In the case of corporate, estate, trust or other business

 

officer or any person designated in a resolution

returns, the delay must have been caused by the death of an

 

similar governing body, must sign.

B.

 

 

 

 

 

 

 

 

 

by the corporate board of directors or other

individual with the sole authority to execute the return, or a

 

 

 

 

Limited Partnerships

of the partnership must sign.

 

member of such individual’s immediate family.

 

 

 

For both individual and business returns, a reasonable time

Partnerships &

A partner having authority to act in the name

Trusts/Estates

A trustee, executor/executrix or the personal

frame should apply for filing the return and payment of tax.

 

representative of the estate must sign. See

A copy of the death certificate must be provided.

 

 

 

Fiduciary Capacity.

 

4. Absence of records

 

 

 

 

 

Form 210, Notice of Assumption of Duties in a

 

 

 

 

Limited Liability

A member having authority to act in the name

 

 

 

 

 

 

 

 

 

 

 

The taxpayer is unable to obtain records necessary to

Companies

of the company must sign.

 

determine the amount of tax due for reasons beyond the

Governmental

An officer having authority to act on behalf of

taxpayer’s control. An example would be a fire which

MAIL,AgenciesFAX OR EMAILtheFORMgovernmental290 TO:agency must sign.

destroys the taxpayer’s records.

 

 

 

 

 

 

 

 

 

 

ARIZONA DEPARTMENT OF REVENUE

1. Ignorance of the law or lack of awareness of filing and

 

paying requirements.

 

 

 

 

PENALTY REVIEW UNIT

 

 

Situations Where Reason ble C use May NOT Exist:

 

1600 W MONROE ST

 

 

2. Delegation of duties.

 

 

 

 

 

 

3. Financial difficulties have no effect on the taxpayer’s

 

PHOENIX AZ 85007-2612

 

 

ability to file returns in a timely fashion.

 

 

Fax No. (602) 716-6787

 

 

1. Interest

 

 

 

 

 

 

 

Email: PenaltyReview@azdor.gov

 

Penalti and/or fees not considered for Abatement:

Allow up to six (6) weeks for processing.

 

2. TPT licensing fees

 

 

 

 

 

 

 

3. Audit assessed penalties

 

 

 

 

 

 

 

4. Any disallowed accounting credit(s) for TPT

 

 

 

 

 

 

For additional information regarding reasonable cause,

 

 

 

 

please refer to the following:

 

 

 

 

 

 

 

• Arizona Revised Statutes § 42-2062 available at

 

 

 

 

 

 

www.azleg.gov.

 

 

of Revenue

 

Ruling

 

 

 

 

 

 

(GTR) 04-2

 

 

 

General Tax

 

and

 

 

 

 

 

 

 

Arizona Department

of Revenue

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Publication 700

 

 

 

 

 

 

 

 

 

available at www.azdor.gov.

 

 

 

 

 

 

PART 4 - SIGNATURE OF TAXPAYER OR AUTHORIZED TheREPRESENTATIVEform should be signed by one of those listed below or otherwise authorized by A.R.S. § 42-2033(A). A responsible party that has the authority to act on behalf of the taxpayer should check the box in Part 4.

ADOR 11237 (05/23)

Print Form

Instructions

Transaction Privilege & Use Tax
Corporate Income Tax
Withholding Tax
Other (Trust, Tobacco, Marijuana Excise Tax):

Arizona Form

290

Request for Penalty Abatement

PLEASE READ THE INSTRUCTIONS CAREFULLY. Ensure all applicable sections of the form are completed, all returns are filed, and taxes paid prior to submitting. The request will not be considered for processing if incomplete or the account is not in compliance. The abatement request form and

ThedocumentationArizona Departmentwill be returnedof Revenue,for correcon writtenion applicationnd must bebyresubmittedthe taxpayer,forshallconsiderationabate the penalty. if it determines that the conduct, or lack of conduct, that caused the penalty to be imposed was due to reasonable cause and not due to willful neglect.

PART 1

GENERAL INFORMATION (REQUIRED)

 

 

 

 

 

Taxpayer Name

 

 

 

 

 

 

 

Daytime Phone (with area code)

Spouse’s Name (if joint return was filed)

 

 

 

 

 

Email address:

 

 

 

Present Address - number and street, rural route

 

 

 

Apartment/Suite No.

 

City, Town or Post Office

 

 

 

 

 

 

State

ZIP Code

 

 

 

 

 

or

 

 

 

 

 

 

 

 

If you want the Arizona Department of Revenue to work with your representative, complete and include Arizona Form 285, General Disclosure/Representation

Authorization Form. Ensure boxes 4b and 4c

 

box 5 are marked.

 

 

 

 

 

PART 2

SPECIFIC DETAILS FOR ABATEMENT CONSIDERATION (REQUIRED)

 

 

 

 

TAX TYPE

 

TAXPAYER ID

 

Provide the

SPECIFIC PERIOD(S)

AMOUNT

 

PENALTY

Indicate the

for the account

 

Provide the associated

 

Provide the total

 

 

 

 

 

number for

for the account requesting abatement

 

for the account

requesting abatement

 

the account requesting

 

 

requesting abatement.

Individual Income Tax

 

ITIN or  SSN

 

 

(Do not include interest)

 

abatement

 

 

 

 

 

 

 

 

 

 

 

$

 

 

License Number

$

EIN

$

EIN

$

EIN/License Number

$

PART 3 EXPLANATION & DOCUMENTATION (REQUIRED)

Provide specific details or reasons that directly contributed to the failure to file or pay timely for the periods you are requesting penalty abatement. Include additional pages if more space is needed and documentation to support the claim of reasonable cause.

_______________________________________________________________________________________________________________________________

PART 4 SIGNATURE OF TAXPAYER OR AUTHORIZED REPRESENTATIVE (Did you print and sign the form?)

Who can sign this form? The taxpayer (individual, principal corporate officer, LLC Member/Manager, Trustee, Partner) or other authorized by A.R.S. § 42-2003(A). Other authorized representative may sign this form if they include a properly executed Arizona Form 285 (General Disclosure/ Representation Authorization Form).

Check here if you are attaching a completed Arizona Form 285 with boxes 4b and 4c or box 5 indicated.

I certify that I have the authority, within the meaning of A.R.S. § 24-2003(A) to execute this abatement request on behalf of the above-mentioned taxpayer. I understand that to knowingly prepare or present a document which is fraudulent or false is Class 5 felony pursuant to

A.R.S. § 42-1127(B)(2).

 

 

 

 

 

 

 

 

TAXPAYER’S SIGNATURE

DATE

SIGNATURE

DATE

 

 

 

 

 

 

 

 

 

 

 

 

PRINT OR TYPE NAME

 

 

 

PRINT OR TYPE NAME

 

 

 

 

 

 

 

 

 

 

 

 

 

TITLE

 

 

 

TITLE

 

 

SEND THE COMPLETED FORM TO: ARIZONA DEPARTMENT OF REVENUE PENALTY REVIEW UNIT

1600 W MONROE ST PHOENIX AZ 85007-2612 FAX to: (602) 716-6787 or EMAIL to: PenaltyReview@azdor.gov

ADOR 11237 (05/23)

Print Form

Document Characteristics

Fact Name Description
Purpose The Arizona Form 290 is used to request an abatement of non-audit penalties imposed by the Arizona Department of Revenue.
Governing Law This form is governed by Arizona Revised Statutes § 42-2003(A) and § 42-1127(B)(2).
Eligibility Taxpayers can request abatement if the penalty was due to reasonable cause and not willful neglect.
Documentation Requirement Requests must include supporting documentation, such as canceled checks or medical reports, to justify the abatement.
Tax Types The form can be used for various tax types, including Individual Income Tax, Corporate Income Tax, and Transaction Privilege Tax.
Signature Requirement The form must be signed by the taxpayer or an authorized representative, depending on the entity type.
Processing Time Allow up to six weeks for the Arizona Department of Revenue to process the abatement request.
Additional Form If a taxpayer wants the Department to communicate with a representative, they must also submit Arizona Form 285.
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