File by Mail Instructions for your 2023 Federal Amended Tax Return

Important: Your taxes are not finished until all required steps are completed.

Samantha k Stewart
1045 S San Jose, Apt. 207
Mesa, AZ 85202-3848
|
Balance | Your federal amended tax return shows you are due a refund of
Due/ | $1,622.00. The IRS estimates it will take up to 16 weeks to process
Refund | your amended tax return. Your refund will be mailed to you
|
______________________________________________________________________________________
|
What You | Your amended tax return - Form 1040-X. Remember to sign and date
Need to | the return.
Mail |
| Be sure to attach all forms or schedules that changed to your amended
| return.
|
| Mail your return and attachments to:
| Department of the Treasury
| Internal Revenue Service
| Ogden, UT 84201-0052
|
| Note: Your state return may be due on a different date. Please
| review your state filing instructions.
|
| Don't forget correct postage on the envelope.
|
______________________________________________________________________________________
|
What You | Keep these instructions and a copy of your return for your records.
Need to | You can download or print a copy of your return by logging into your
Keep | TurboTax account.
|
______________________________________________________________________________________
|
2023 | Adjusted Gross Income Correct Amount $ 46,003.00
Federal | Taxable Income Correct Amount $ 32,153.00
Tax | Total Tax Correct Amount $ 3,641.00
Return | Total Payments/Credits Correct Amount $ 5,692.00
Summary | Amount to be Refunded $ 1,622.00
|
______________________________________________________________________________________

Page 1 of 1
Hi Samantha,

We just want to thank you for using TurboTax this year! It's our goal to make
your taxes easy and accurate, year after year.

With TurboTax Deluxe:

Your Head Start On Next Year:
When you come back next year, taxes will be so easy! We'll have all
your information saved and ready to transfer in to your new return.
We'll ask you questions about what changed since we last talked, and
we'll be ready to get you the credits and deductions you deserve, no
matter what life throws at you.

Here's the final wrap up for your 2023 taxes:

Your federal refund is: $ 1,622.00

Your Guarantee of Accuracy:

Breathe easy. The calculations on your return are backed with our
100% Accuracy Guarantee.
- We double checked your return for errors along the way.
- We helped with step-by-step guidance to get your answers on the right
IRS forms.
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changed, like a new job, new house - or more kids!

Also included:
- We e-filed your federal returns for free, so you could get your refund
the fastest way possible.
- We provide the Audit Support Center free of charge, in the unlikely
event you get audited.

Many happy returns from TurboTax.

 Your amended return checklist
Just follow these steps and you’re done!

1 If you’re amending a state return, separate it from your federal return

and follow the instructions
Your returns will print together, so you’ll need to separate them. Both returns start
with an instruction sheet featuring the Intuit TurboTax logo on the top right.

If you added or changed a tax form (like a W-2), attach a copy to each return.
If a copy of your federal return is printed under your state return, attach the federal
copy to your state return.

2 Sign and date your return(s)

You’ll have to sign and date at the bottom of your return(s). Your federal return is
named Form 1040X. If you’re filing a state return, the form is located right after the
state instructions sheet.

3 If you have a balance due, pay online or send a check with your return
You can pay your federal taxes online at www.irs.gov/payments.

If you’re getting a refund, you’ll get a paper check in the mail.

4 Write the correct address on your envelope(s)

You can find the mailing address for your federal return on the federal instructions sheet. If
you’re filing a state return, the address is listed on the state instructions sheet.

5 Drop your return(s) off at the post office

We recommend sending your return(s) by certified mail to ensure correct postage
and proof of delivery.

That’s it! Here are a few things to keep in mind after you mail your returns:

• Your amended returns will take 12-16 weeks to process.

• You can track your federal amended return at https://www.irs.gov/filing/wheres-my-
amended-return.
• If you used a paid version of TurboTax, you’ll be able to access your amended return at any
time. When you log in to TurboTax, scroll down on Tax Home, and click on My Docs to
download a copy.
 1040-X
Form Department of the Treasury—Internal Revenue Service

Amended U.S. Individual Income Tax Return OMB No. 1545-0074

(Rev. February 2024) Go to www.irs.gov/Form1040X for instructions and the latest information.
This return is for calendar year (enter year) 2023 or fiscal year (enter month and year ended)
Your first name and middle initial Last name Your social security number
Samantha K Stewart 625-68-5982
If joint return, spouse’s first name and middle initial Last name Spouse’s social security number

Home address (number and street). If you have a P.O. box, see instructions. Apt. no. Presidential Election Campaign
1045 S San Jose 207 Check here if you, or your spouse
if filing jointly, didn’t previously
City, town, or post office. If you have a foreign address, also complete spaces below. State ZIP code
want $3 to go to this fund, but now
Mesa AZ 852023848 do. Checking a box below will not
Foreign country name Foreign province/state/county Foreign postal code change your tax or refund.
You Spouse
Amended return filing status. You must check one box even if you are not changing your filing status. Caution: In general, you can’t
change your filing status from married filing jointly to married filing separately after the return due date.
Single Married filing jointly Married filing separately (MFS) Head of household (HOH) Qualifying surviving spouse (QSS)
If you checked the MFS box, enter the name of your spouse unless you are amending a Form 1040-NR. If you checked the HOH or QSS box,
enter the child’s name if the qualifying person is a child but not your dependent:
Enter on lines 1 through 23, columns A through C, the amounts for the return A. Original amount B. Net change—
reported or as amount of increase C. Correct
year entered above. previously adjusted or (decrease)— amount
Use Part II on page 2 to explain any changes. (see instructions) explain in Part II
Income and Deductions
1 Adjusted gross income. If a net operating loss (NOL) carryback is
included, check here . . . . . . . . . . . . . . . . 1 39,728. 6,275. 46,003.
2 Itemized deductions or standard deduction . . . . . . . . . 2 13,850. 0. 13,850.
3 Subtract line 2 from line 1 . . . . . . . . . . . . . . . 3 25,878. 6,275. 32,153.
4a Reserved for future use . . . . . . . . . . . . . . . . 4a
b Qualified business income deduction . . . . . . . . . . . . 4b 0. 0.
5 Taxable income. Subtract line 4b from line 3. If the result for column C
is zero or less, enter -0- in column C . . . . . . . . . . . . 5 25,878. 6,275. 32,153.
Tax Liability
6 Tax. Enter method(s) used to figure tax (see instructions):
Table 6 2,885. 756. 3,641.
7 Nonrefundable credits. If a general business credit carryback is included,
check here . . . . . . . . . . . . . . . . . . . 7 0. 0.
8 Subtract line 7 from line 6. If the result is zero or less, enter -0- . . . 8 2,885. 756. 3,641.
9 Reserved for future use . . . . . . . . . . . . . . . . 9
10 Other taxes . . . . . . . . . . . . . . . . . . . . 10 0. 0. 0.
11 Total tax. Add lines 8 and 10 . . . . . . . . . . . . . . 11 2,885. 756. 3,641.
Payments
12 Federal income tax withheld and excess social security and tier 1 RRTA
tax withheld. (If changing, see instructions.) . . . . . . . . . 12 3,314. 2,378. 5,692.
13 Estimated tax payments, including amount applied from prior year’s return 13 0. 0.
14 Earned income credit (EIC) . . . . . . . . . . . . . . . 14 0. 0.
15 Refundable credits from: Schedule 8812 Form(s) 2439 4136
8863 8885 8962 or other (specify): 15 0. 0.
16 Total amount paid with request for extension of time to file, tax paid with original return, and additional
tax paid after return was filed . . . . . . . . . . . . . . . . . . . . . . . . 16 0.
17 Total payments. Add lines 12 through 15, column C, and line 16 . . . . . . . . . . . . . 17 5,692.
Refund or Amount You Owe
18 Overpayment, if any, as shown on original return or as previously adjusted by the IRS . . . . . 18 429.
19 Subtract line 18 from line 17. (If less than zero, see instructions.) . . . . . . . . . . . . 19 5,263.
20 Amount you owe. If line 11, column C, is more than line 19, enter the difference . . . . . . . 20
21 If line 11, column C, is less than line 19, enter the difference. This is the amount overpaid on this return 21 1,622.
22 Amount of line 21 you want refunded to you . . . . . . . . . . . . . . . . . . . 22 1,622.
23 Amount of line 21 you want applied to your (enter year): estimated tax 23
Complete and sign this form on page 2.
For Paperwork Reduction Act Notice, see separate instructions. Form 1040-X (Rev. 2-2024)
Form 1040-X (Rev. 2-2024) Page 2
Part I Dependents
Complete this part to change any information relating to your dependents. A. Original number
B. Net change—
of dependents C. Correct
This would include a change in the number of dependents. reported or as
amount of increase
number
Enter the information for the return year entered at the top of page 1. or (decrease)
previously adjusted
24 Reserved for future use . . . . . . . . . . . . . . . . 24
25 Your dependent children who lived with you . . . . . . . . . 25 0 0
26 Reserved for future use . . . . . . . . . . . . . . . . 26
27 Other dependents . . . . . . . . . . . . . . . . . . 27 0 0
28 Reserved for future use . . . . . . . . . . . . . . . . 28
29 Reserved for future use . . . . . . . . . . . . . . . . 29
30 List ALL dependents (children and others) claimed on this amended return.
Dependents (see instructions): (d) Check the box if qualifies for
(see instructions):
(b) Social security (c) Relationship
If more
(a) First name Last name number to you Child tax credit Credit for other
than four dependents
dependents,
see
instructions
and check
here
Part II Explanation of Changes. In the space provided below, tell us why you are filing Form 1040-X.
Attach any supporting documents and new or changed forms and schedules.
I recieved my 1099 after I filed my federal and state taxes

Remember to keep a copy of this form for your records.

Under penalties of perjury, I declare that I have filed an original return, and that I have examined this amended return, including accompanying schedules
and statements, and to the best of my knowledge and belief, this amended return is true, correct, and complete. Declaration of preparer (other than
taxpayer) is based on all information about which the preparer has any knowledge.
Your signature Date Your occupation If the IRS sent you an Identity
Sign Protection PIN, enter it here
Here Call Center Representative (see inst.)
Spouse’s signature. If a joint return, both must sign. Date Spouse’s occupation If the IRS sent your spouse an
Identity Protection PIN, enter it here
(see inst.)
Phone no. (480)289-8607 Email address
Preparer’s name Preparer’s signature Date PTIN Check if:
Paid
Self-employed
Preparer
Firm’s name Self-Prepared Phone no.
Use Only Firm’s address Firm’s EIN
For forms and publications, visit www.irs.gov/Forms. REV 02/11/24 Intuit.cg.cfp.sp Form 1040-X (Rev. 2-2024)
BAA
 1040 U.S. Individual Income Tax Return 2023
Form Department of the Treasury—Internal Revenue Service

OMB No. 1545-0074 IRS Use Only—Do not write or staple in this space.

For the year Jan. 1–Dec. 31, 2023, or other tax year beginning , 2023, ending , 20 See separate instructions.
Your first name and middle initial Last name Your social security number
Samantha k Stewart 625 68 5982
If joint return, spouse’s first name and middle initial Last name Spouse’s social security number

Home address (number and street). If you have a P.O. box, see instructions. Apt. no. Presidential Election Campaign
1045 S San Jose 207 Check here if you, or your
City, town, or post office. If you have a foreign address, also complete spaces below. State ZIP code spouse if filing jointly, want $3
to go to this fund. Checking a
Mesa AZ 852023848 box below will not change
Foreign country name Foreign province/state/county Foreign postal code your tax or refund.
You Spouse

Filing Status Single Head of household (HOH)

Married filing jointly (even if only one had income)
Check only
one box. Married filing separately (MFS) Qualifying surviving spouse (QSS)
If you checked the MFS box, enter the name of your spouse. If you checked the HOH or QSS box, enter the child’s name if the
qualifying person is a child but not your dependent:

Digital At any time during 2023, did you: (a) receive (as a reward, award, or payment for property or services); or (b) sell,
Assets exchange, or otherwise dispose of a digital asset (or a financial interest in a digital asset)? (See instructions.) Yes No
Standard Someone can claim: You as a dependent Your spouse as a dependent
Deduction Spouse itemizes on a separate return or you were a dual-status alien

Age/Blindness You: Were born before January 2, 1959 Are blind Spouse: Was born before January 2, 1959 Is blind
Dependents (see instructions): (2) Social security (3) Relationship (4) Check the box if qualifies for (see instructions):
(1) First name Last name number to you Child tax credit Credit for other dependents
If more
than four
dependents,
see instructions
and check
here . .

Income 1a Total amount from Form(s) W-2, box 1 (see instructions) . . . . . . . . . . . . . 1a 39,728.
b Household employee wages not reported on Form(s) W-2 . . . . . . . . . . . . . 1b
Attach Form(s)
W-2 here. Also c Tip income not reported on line 1a (see instructions) . . . . . . . . . . . . . . 1c
attach Forms d Medicaid waiver payments not reported on Form(s) W-2 (see instructions) . . . . . . . . 1d
W-2G and
1099-R if tax e Taxable dependent care benefits from Form 2441, line 26 . . . . . . . . . . . . 1e
was withheld. f Employer-provided adoption benefits from Form 8839, line 29 . . . . . . . . . . . 1f
If you did not g Wages from Form 8919, line 6 . . . . . . . . . . . . . . . . . . . . . 1g
get a Form
W-2, see
h Other earned income (see instructions) . . . . . . . . . . . . . . . . . . 1h 0.
instructions. i Nontaxable combat pay election (see instructions) . . . . . . . 1i
z Add lines 1a through 1h . . . . . . . . . . . . . . . . . . . . . . 1z 39,728.
Attach Sch. B 2a Tax-exempt interest . . . 2a b Taxable interest . . . . . 2b
if required. 3a Qualified dividends . . . 3a b Ordinary dividends . . . . . 3b
4a IRA distributions . . . . 4a b Taxable amount . . . . . . 4b
Standard 11,891. 6,275.
Deduction for— 5a Pensions and annuities . . 5a b Taxable amount . . . . . . 5b
• Single or 6a Social security benefits . . 6a b Taxable amount . . . . . . 6b
Married filing
separately, c If you elect to use the lump-sum election method, check here (see instructions) . . . . .
$13,850 7 Capital gain or (loss). Attach Schedule D if required. If not required, check here . . . . . 7
• Married filing
jointly or 8 Additional income from Schedule 1, line 10 . . . . . . . . . . . . . . . . . 8 0.
Qualifying
surviving spouse, 9 Add lines 1z, 2b, 3b, 4b, 5b, 6b, 7, and 8. This is your total income . . . . . . . . . . 9 46,003.
$27,700 10 Adjustments to income from Schedule 1, line 26 . . . . . . . . . . . . . . . 10
• Head of
household, 11 Subtract line 10 from line 9. This is your adjusted gross income . . . . . . . . . . 11 46,003.
$20,800
• If you checked
12 Standard deduction or itemized deductions (from Schedule A) . . . . . . . . . . 12 13,850.
any box under 13 Qualified business income deduction from Form 8995 or Form 8995-A . . . . . . . . . 13
Standard
Deduction, 14 Add lines 12 and 13 . . . . . . . . . . . . . . . . . . . . . . . . 14 13,850.
see instructions.
15 Subtract line 14 from line 11. If zero or less, enter -0-. This is your taxable income . . . . . 15 32,153.
For Disclosure, Privacy Act, and Paperwork Reduction Act Notice, see separate instructions. Form 1040 (2023)
Form 1040 (2023) Page 2

Tax and 16 Tax (see instructions). Check if any from Form(s): 1 8814 2 4972 3 . . 16 3,641.
Credits 17 Amount from Schedule 2, line 3 . . . . . . . . . . . . . . . . . . . . 17
18 Add lines 16 and 17 . . . . . . . . . . . . . . . . . . . . . . . . 18 3,641.
19 Child tax credit or credit for other dependents from Schedule 8812 . . . . . . . . . . 19
20 Amount from Schedule 3, line 8 . . . . . . . . . . . . . . . . . . . . 20
21 Add lines 19 and 20 . . . . . . . . . . . . . . . . . . . . . . . . 21
22 Subtract line 21 from line 18. If zero or less, enter -0- . . . . . . . . . . . . . . 22 3,641.
23 Other taxes, including self-employment tax, from Schedule 2, line 21 . . . . . . . . . 23 0.
24 Add lines 22 and 23. This is your total tax . . . . . . . . . . . . . . . . . 24 3,641.
Payments 25 Federal income tax withheld from:
a Form(s) W-2 . . . . . . . . . . . . . . . . . . 25a 3,314.
b Form(s) 1099 . . . . . . . . . . . . . . . . . . 25b 2,378.
c Other forms (see instructions) . . . . . . . . . . . . . 25c
d Add lines 25a through 25c . . . . . . . . . . . . . . . . . . . . . . 25d 5,692.
If you have a 26 2023 estimated tax payments and amount applied from 2022 return . . . . . . . . . . 26
qualifying child, 27 Earned income credit (EIC) . . . . . . . . . . . .No. . 27
attach Sch. EIC.
28 Additional child tax credit from Schedule 8812 . . . . . . . . 28
29 American opportunity credit from Form 8863, line 8 . . . . . . . 29
30 Reserved for future use . . . . . . . . . . . . . . . 30
31 Amount from Schedule 3, line 15 . . . . . . . . . . . . 31
32 Add lines 27, 28, 29, and 31. These are your total other payments and refundable credits . . 32
33 Add lines 25d, 26, and 32. These are your total payments . . . . . . . . . . . . 33 5,692.
Refund 34 If line 33 is more than line 24, subtract line 24 from line 33. This is the amount you overpaid . . 34 2,051.
35a Amount of line 34 you want refunded to you. If Form 8888 is attached, check here . . . . 35a 2,051.
Direct deposit? b Routing number X X X X X X X X X c Type: Checking Savings
See instructions.
d Account number X X X X X X X X X X X X X X X X X
36 Amount of line 34 you want applied to your 2024 estimated tax . . . 36
Amount 37 Subtract line 33 from line 24. This is the amount you owe.
You Owe For details on how to pay, go to www.irs.gov/Payments or see instructions . . . . . . . . 37
38 Estimated tax penalty (see instructions) . . . . . . . . . . 38
Third Party Do you want to allow another person to discuss this return with the IRS? See
Designee instructions . . . . . . . . . . . . . . . . . . . . . Yes. Complete below. No
Designee’s Phone Personal identification
name no. number (PIN)

Sign Under penalties of perjury, I declare that I have examined this return and accompanying schedules and statements, and to the best of my knowledge and
belief, they are true, correct, and complete. Declaration of preparer (other than taxpayer) is based on all information of which preparer has any knowledge.
Here Your signature Date Your occupation If the IRS sent you an Identity
Protection PIN, enter it here
Joint return? Call Center Representative (see inst.)
See instructions. Spouse’s signature. If a joint return, both must sign. Date Spouse’s occupation If the IRS sent your spouse an
Keep a copy for Identity Protection PIN, enter it here
your records. (see inst.)

Phone no. (480)289-8607 Email address

Preparer’s name Preparer’s signature Date PTIN Check if:
Paid Self-employed
Preparer
Firm’s name Self-Prepared Phone no.
Use Only
Firm’s address Firm’s EIN
Go to www.irs.gov/Form1040 for instructions and the latest information. BAA REV 02/11/24 Intuit.cg.cfp.sp Form 1040 (2023)
Form 5329 Additional Taxes on Qualified Plans
(Including IRAs) and Other Tax-Favored Accounts
OMB No. 1545-0074

2023
Department of the Treasury Attach to Form 1040, 1040-SR, 1040-NR, or 1041. Attachment
Internal Revenue Service Go to www.irs.gov/Form5329 for instructions and the latest information. Sequence No. 29
Name of individual subject to additional tax. If married filing jointly, see instructions. Your social security number
Samantha k Stewart 625-68-5982
Home address (number and street), or P.O. box if mail is not delivered to your home Apt. no.

Fill in Your Address Only City, town or post office, state, and ZIP code. If you have a foreign address, also complete the spaces
if You Are Filing This below. See instructions.
Form by Itself and Not If this is an amended
With Your Tax Return return, check here
Foreign country name Foreign province/state/county Foreign postal code

If you only owe the additional 10% tax on the full amount of the early distributions, you may be able to report this tax directly on
Schedule 2 (Form 1040), line 8, without filing Form 5329. See instructions.
Part I Additional Tax on Early Distributions. Complete this part if you took a taxable distribution (other than a qualified
disaster distribution) before you reached age 59½ from a qualified retirement plan (including an IRA) or modified
endowment contract (unless you are reporting this tax directly on Schedule 2 (Form 1040)—see above). You may also
have to complete this part to indicate that you qualify for an exception to the additional tax on early distributions or for
certain Roth IRA distributions. See instructions.
1 Early distributions includible in income (see instructions). For Roth IRA distributions, see instructions . 1 6,275.
2 Early distributions included on line 1 that are not subject to the additional tax (see instructions).
Enter the appropriate exception number from the instructions: 99 . . . . . . . . . . 2 11,890.
3 Amount subject to additional tax. Subtract line 2 from line 1 . . . . . . . . . . . . . . 3
4 Additional tax. Enter 10% (0.10) of line 3. Include this amount on Schedule 2 (Form 1040), line 8 . . 4
Caution: If any part of the amount on line 3 was a distribution from a SIMPLE IRA, you may have to
include 25% of that amount on line 4 instead of 10%. See instructions.
Part II Additional Tax on Certain Distributions From Education Accounts and ABLE Accounts. Complete this part
if you included an amount in income, on Schedule 1 (Form 1040), line 8z, from a Coverdell education savings account
(ESA) or a qualified tuition program (QTP), or on Schedule 1 (Form 1040), line 8q, from an ABLE account.
5 Distributions included in income from a Coverdell ESA, a QTP, or an ABLE account . . . . . . 5
6 Distributions included on line 5 that are not subject to the additional tax (see instructions) . . . . 6
7 Amount subject to additional tax. Subtract line 6 from line 5 . . . . . . . . . . . . . . 7
8 Additional tax. Enter 10% (0.10) of line 7. Include this amount on Schedule 2 (Form 1040), line 8 . . 8
Part III Additional Tax on Excess Contributions to Traditional IRAs. Complete this part if you contributed more to your
traditional IRAs for 2023 than is allowable or you had an amount on line 17 of your 2022 Form 5329.
9 Enter your excess contributions from line 16 of your 2022 Form 5329. See instructions. If zero, go to line 15 9
10 If your traditional IRA contributions for 2023 are less than your maximum
allowable contribution, see instructions. Otherwise, enter -0- . . . . . . 10
11 2023 traditional IRA distributions included in income (see instructions) . . . 11
12 2023 distributions of prior year excess contributions (see instructions) . . . 12
13 Add lines 10, 11, and 12 . . . . . . . . . . . . . . . . . . . . . . . . . . 13
14 Prior year excess contributions. Subtract line 13 from line 9. If zero or less, enter -0- . . . . . . 14
15 Excess contributions for 2023 (see instructions) . . . . . . . . . . . . . . . . . . 15
16 Total excess contributions. Add lines 14 and 15 . . . . . . . . . . . . . . . . . . 16
17 Additional tax. Enter 6% (0.06) of the smaller of line 16 or the value of your traditional IRAs on December
31, 2023 (including 2023 contributions made in 2024). Include this amount on Schedule 2 (Form 1040), line 8 17
Part IV Additional Tax on Excess Contributions to Roth IRAs. Complete this part if you contributed more to your Roth
IRAs for 2023 than is allowable or you had an amount on line 25 of your 2022 Form 5329.
18 Enter your excess contributions from line 24 of your 2022 Form 5329. See instructions. If zero, go to line 23 18
19 If your Roth IRA contributions for 2023 are less than your maximum allowable
contribution, see instructions. Otherwise, enter -0- . . . . . . . . . 19
20 2023 distributions from your Roth IRAs (see instructions) . . . . . . . 20
21 Add lines 19 and 20 . . . . . . . . . . . . . . . . . . . . . . . . . . . 21
22 Prior year excess contributions. Subtract line 21 from line 18. If zero or less, enter -0- . . . . . . 22
23 Excess contributions for 2023 (see instructions) . . . . . . . . . . . . . . . . . . 23
24 Total excess contributions. Add lines 22 and 23 . . . . . . . . . . . . . . . . . . 24
25 Additional tax. Enter 6% (0.06) of the smaller of line 24 or the value of your Roth IRAs on December 31,
2023 (including 2023 contributions made in 2024). Include this amount on Schedule 2 (Form 1040), line 8 25
For Privacy Act and Paperwork Reduction Act Notice, see your tax return instructions. Form 5329 (2023)
Form 5329 (2023) Page 2
Part V Additional Tax on Excess Contributions to Coverdell ESAs. Complete this part if the contributions to your
Coverdell ESAs for 2023 were more than is allowable or you had an amount on line 33 of your 2022 Form 5329.
26 Enter the excess contributions from line 32 of your 2022 Form 5329. See instructions. If zero, go to line 31 26
27 If the contributions to your Coverdell ESAs for 2023 were less than the
maximum allowable contribution, see instructions. Otherwise, enter -0- . . 27
28 2023 distributions from your Coverdell ESAs (see instructions) . . . . . 28
29 Add lines 27 and 28 . . . . . . . . . . . . . . . . . . . . . . . . . . . 29
30 Prior year excess contributions. Subtract line 29 from line 26. If zero or less, enter -0- . . . . . . 30
31 Excess contributions for 2023 (see instructions) . . . . . . . . . . . . . . . . . . 31
32 Total excess contributions. Add lines 30 and 31 . . . . . . . . . . . . . . . . . . 32
33 Additional tax. Enter 6% (0.06) of the smaller of line 32 or the value of your Coverdell ESAs on December
31, 2023 (including 2023 contributions made in 2024). Include this amount on Schedule 2 (Form 1040), line 8 33
Part VI Additional Tax on Excess Contributions to Archer MSAs. Complete this part if you or your employer contributed
more to your Archer MSAs for 2023 than is allowable or you had an amount on line 41 of your 2022 Form 5329.
34 Enter the excess contributions from line 40 of your 2022 Form 5329. See instructions. If zero, go to line 39 34
35 If the contributions to your Archer MSAs for 2023 are less than the maximum
allowable contribution, see instructions. Otherwise, enter -0- . . . . . . 35
36 2023 distributions from your Archer MSAs from Form 8853, line 8 . . . . 36
37 Add lines 35 and 36 . . . . . . . . . . . . . . . . . . . . . . . . . . . 37
38 Prior year excess contributions. Subtract line 37 from line 34. If zero or less, enter -0- . . . . . . 38
39 Excess contributions for 2023 (see instructions) . . . . . . . . . . . . . . . . . . 39
40 Total excess contributions. Add lines 38 and 39 . . . . . . . . . . . . . . . . . . 40
41 Additional tax. Enter 6% (0.06) of the smaller of line 40 or the value of your Archer MSAs on
December 31, 2023 (including 2023 contributions made in 2024). Include this amount on Schedule 2
(Form 1040), line 8 . . . . . . . . . . . . . . . . . . . . . . . . . . . . 41
Part VII Additional Tax on Excess Contributions to Health Savings Accounts (HSAs). Complete this part if you,
someone on your behalf, or your employer contributed more to your HSAs for 2023 than is allowable or you had an
amount on line 49 of your 2022 Form 5329.
42 Enter the excess contributions from line 48 of your 2022 Form 5329. If zero, go to line 47 . . . . 42
43 If the contributions to your HSAs for 2023 are less than the maximum
allowable contribution, see instructions. Otherwise, enter -0- . . . . . . 43
44 2023 distributions from your HSAs from Form 8889, line 16 . . . . . . 44
45 Add lines 43 and 44 . . . . . . . . . . . . . . . . . . . . . . . . . . . 45
46 Prior year excess contributions. Subtract line 45 from line 42. If zero or less, enter -0- . . . . . . 46
47 Excess contributions for 2023 (see instructions) . . . . . . . . . . . . . . . . . . 47
48 Total excess contributions. Add lines 46 and 47 . . . . . . . . . . . . . . . . . . 48
49 Additional tax. Enter 6% (0.06) of the smaller of line 48 or the value of your HSAs on December 31,
2023 (including 2023 contributions made in 2024). Include this amount on Schedule 2 (Form 1040), line 8 49
Part VIII Additional Tax on Excess Contributions to an ABLE Account. Complete this part if contributions to your ABLE
account for 2023 were more than is allowable.
50 Excess contributions for 2023 (see instructions) . . . . . . . . . . . . . . . . . . 50
51 Additional tax. Enter 6% (0.06) of the smaller of line 50 or the value of your ABLE account on
December 31, 2023. Include this amount on Schedule 2 (Form 1040), line 8 . . . . . . . . . 51
Part IX Additional Tax on Excess Accumulation in Qualified Retirement Plans (Including IRAs). Complete this part
if you did not receive the minimum required distribution from your qualified retirement plan.
52 Minimum required distribution for 2023 (see instructions) . . . . . . . . . . . . . . . 52
53 Amount actually distributed to you in 2023 (see instructions) . . . . . . . . . . . . . . 53
54 Subtract line 53 from line 52. If zero or less, enter -0- . . . . . . . . . . . . . . . . 54
55 Additional tax. See instructions for how to calculate the additional tax. If you qualify for the 10% tax
rate on excess accumulations in at least one qualified retirement plan, check this box.
Include this amount on Schedule 2 (Form 1040), line 8 or Form 1041, Schedule G, line 8 . . . . . 55
Under penalties of perjury, I declare that I have examined this form, including accompanying attachments, and to the best of my knowledge and
Sign Here Only if You belief, it is true, correct, and complete. Declaration of preparer (other than taxpayer) is based on all information of which preparer has any knowledge.
Are Filing This Form
by Itself and Not With
Your Tax Return Your signature Date
Print/Type preparer’s name Preparer’s signature Date PTIN
Check if
Paid self-employed
Preparer
Firm’s name Firm’s EIN
Use Only
Firm’s address Phone no.
Form 5329 (2023)
BAA REV 02/11/24 Intuit.cg.cfp.sp
 ELECTRONIC POSTMARK - CERTIFICATION OF ELECTRONIC FILING

Taxpayer: Samantha k Stewart

Primary SSN: 625-68-5982

Federal Return Submitted: 2024-01-31T17:35:51.469-08:00

Federal Return Acceptance Date: 01/31/2024

The Intuit Electronic Postmark shows the date and time Intuit received your federal tax return. The Intuit
Electronic Postmark documents the filing date of your income tax return, and the electronic postmark
information should be kept on file with your tax return and other tax-related documentation.

There are two important aspects of the Intuit Electronic Postmark:

1. THE INTUIT ELECTRONIC POSTMARK.

The electronic postmark shows the date and time Intuit received the federal return, and is deemed the
filing date if the date of the electronic postmark is on or before the date prescribed for filing of the
federal individual income tax return.

TIMELY FILING:
For your federal return to be considered filed on time, your return must be postmarked on or before
midnight April 15, 2024 . Intuit’s electronic postmark is issued in the Pacific Time (PT) zone.
If you are not filing in the PT zone, you will need to add or subtract hours from the Intuit Electronic
Postmark time to determine your local postmark time. For example, if you are filing in the Eastern Time
(ET) zone, and you electronically file your return at 9 AM on April 15, 2024 , your Intuit
electronic postmark will indicate April 15, 2024 , 6 AM. If your federal tax return is rejected,
the IRS still considers it filed on time if the electronic postmark is on or before April 15, 2024 ,
and a corrected return is submitted and accepted before April 20, 2024 . If your return is
submitted after April 20, 2024 , a new time stamp is issued to reflect that your return was
submitted after the IRS deadline, and consequently, is no longer considered to have been filed on time.

If you request an automatic six-month extension, your return must be electronically postmarked by
midnight October 15, 2024 . If your federal tax return is rejected, the IRS will still consider
it filed on time if the electronic postmark is on or before October 15, 2024 , and the
corrected return is submitted and accepted by October 20, 2024

2. THE ACCEPTANCE DATE.

Once the IRS accepts the electronically filed return, the acceptance date will be provided by the Intuit
Electronic Filing Center. This date is proof that the IRS accepted the electronically filed return.
File by Mail Instructions for your 2023 Arizona Amended Tax Return
Important: Your taxes are not finished until all required steps are completed.

Samantha K Stewart
1045 S San Jose Apt 207
Mesa, AZ 85202-3848
|
Balance | Your Arizona state amended tax return shows you owe a balance due of
Due/ | $157.00.
Refund |
| You are paying by check.
|
| You can also pay your balance due by eCheck or credit card. For more
| information, go to www.aztaxes.gov and select the 'Make a Payment'
| link.
|
______________________________________________________________________________________
|
What You | Your amended tax return - Form 140X. Remember to sign and date
Need to | the return.
Mail |
| Your payment - Mail a check or money order for $157.00, payable to
| "Arizona Department of Revenue". Write your Social Security number
| and "2023 Form 140X" on the check. Mail the return and check
| together.
|
| Attach the Form(s) W-2 and 1099-R to the back of your return.
|
| Do not staple your return.
|
| Do not staple any documents, schedules, or payments to your return.
|
| Mail your return, attachments and payment to:
| Amended return with payment to:
| Arizona Department of Revenue, P.O. Box 52016, Phoenix, AZ 85072-2016
|
| Amended return with no payment to:
| Arizona Department of Revenue, P.O. Box 52138, Phoenix, AZ 85072-2138
|
| Don't forget correct postage on the envelope.
|
______________________________________________________________________________________
|
What You | Keep these instructions and a copy of your return for your records.
Need to | You can download or print a copy of your return by logging into your
Keep | TurboTax account.
|
______________________________________________________________________________________
|
2023 | Adjusted Gross Income As Originally Filed $ 39,728.00
Arizona | Adjusted Gross Income Corrected Amount $ 46,003.00
Tax | Taxable Income As Originally Filed $ 25,878.00
Return | Taxable Income Corrected Amount $ 32,153.00
Summary | Total Tax Corrected Amount $ 804.00
| Total Payments/Credits Corrected Amount $ 944.00
| Payment Due $ 157.00
|
______________________________________________________________________________________

Page 1 of 2
File by Mail Instructions for your 2023 Arizona Amended Tax Return
Important: Your taxes are not finished until all required steps are completed.

Samantha K Stewart
1045 S San Jose Apt 207
Mesa, AZ 85202-3848
|
Special | Your printed state tax forms may have special formatting on them,
Formatting | such as bar codes or other symbols. This is to enable fast
| processing. Don't worry, these forms have been approved by your
| taxing authority and are acceptable for printing and mailing.
|
______________________________________________________________________________________

Page 2 of 2
DO NOT STAPLE ANY ITEMS TO THE RETURN. Arizona Form FOR CALENDAR YEAR
Resident Personal Income Tax Return 2023
Check box 82F
140
82F if filing under extension OR FISCAL YEAR BEGINNING 2 0 2 3 AND ENDING . 66F
Your First Name and Middle Initial Last Name Your Social Security Number
Enter
1 Samantha k Stewart 625 68 5982
your
Spouse’s First Name and Middle Initial (if box 4 or 6 checked) Last Name Spouse’s Social Security No.
SSN(s).
1
Current Home Address - number and street, rural route Apt. No. Daytime Phone (with area code)
2 1045 S San Jose 207 94 (480)289-8607
City, Town or Post Office State ZIP Code Last Names Used in Last Four Prior Year(s) (if different)
3 Mesa AZ 85202-3848 97
EXEMPTIONS FILING STATUS

REVENUE USE ONLY. DO NOT MARK IN THIS AREA.

4 Married filing joint return 4a Injured Spouse Protection of Joint Overpayment
88
5 Head of household. Enter name of qualifying child or dependent on next line.

6 Married filing separate return. Enter spouse’s name and Social Security Number above.
7 Single
 ÐEnter the number claimed. Do not put a check mark.
8 Age 65 or over (you and/or spouse) If completing lines 8, 9, and 11a, also complete lines 38,
9 Blind (you and/or spouse) 39, and 41. For lines 10a and 10b, also complete line 49. 81 PM 80 RCVD
10a Dependents: Under age of 17. 10b Dependents: Age 17 and over.
11a Qualifying parents and grandparents
(Box 10a and 10b): Dependent Information. See instructions. For more space, check the box and complete page 4, Part 1.
(a) (b) (c) (d) (e) (f)
FIRST AND LAST NAME SOCIAL SECURITY RELATIONSHIP NO. OF MONTHS 9Dependent Age
included in:
9 if you did not claim
this person on your
Dependents

(Do not list yourself or spouse.) NUMBER LIVED IN YOUR

HOME IN 2023 1 2 federal return due to
educational credits
(Box 10a) (Box 10b)
10c 
10d 
10e 
(Box 11a): Qualifying parents and grandparents. See instructions. For more space, check the box and complete page 4, Part 2.
Place any required federal and AZ schedules or other documents after Form 140.

(a) (b) (c) (d) (e) (f)

Qualifying Parentsand

FIRST AND LAST NAME SOCIAL SECURITY RELATIONSHIP NO. OF MONTHS 9IF AGE 65 OR 9 IF DIED
Grandparents

(Do not list yourself or spouse.) NUMBER LIVED IN YOUR

OVER IN 2023
HOME IN 2023

11b
11c
12 Federal adjusted gross income (from your federal return) ................................................................................... 12 46,003 00
13 Small Business Income: 13S check the box if you are filing Arizona Form 140-SBI and enter the amount from Form 140-SBI, line 10.. 13 00
14 Modified federal adjusted gross income. Subtract line 13 from line 12...................................................................... 14 46,003 00
15 Non-Arizona municipal interest.................................................................................................................................... 15 00
Additions

16 Partnership Income adjustment. See instructions ......................................................................................................... 16 00

17 Total federal depreciation ............................................................................................................................................ 17 00
18 Other Additions to Income: Complete Other Additions to Arizona Gross Income schedule on page 5...................... 18 00
19 Subtotal: Add lines 14 through 18 and enter the total ....................................................................................................... 19 46,003 00
20 Total net capital gain or (loss). See instructions ..................................................................... 20 00
21 Total net short-term capital gain or (loss). See instructions .................................................... 21 00
22 Total net long-term capital gain or (loss). See instructions ...................................................... 22 00
23 Net long-term capital gain from assets acquired after December 31, 2011. See instructions. 23 0 00
24 Multiply line 23 by 25% (.25) and enter the result ....................................................................................................... 24 0 00
25 Net capital gain derived from investment in qualified small business.......................................................................... 25 00
26 Recalculated Arizona depreciation .............................................................................................................................. 26 00
Subtractions

27 Partnership Income adjustment. See instructions ......................................................................................................... 27 00

28 Interest on U.S. obligations such as U.S. savings bonds and treasury bills ................................................................ 28 00
29a Exclusion for federal, Arizona state or local government pensions (up to $2,500 per taxpayer) ................................. 29a 00
29b Exclusion for benefits, annuities and pensions for retired/retainer pay of the uniformed services.............................. 29b 00
30 U.S. Social Security or Railroad Retirement Act benefits included as income on your federal return (taxable amount) 30 00
31 Certain wages of American Indians ............................................................................................................................. 31 00
32 Pay received for active service as a member of the reserves, national guard or the U.S. armed forces .................... 32 00
33 Net operating loss adjustment. See instructions............................................................................................................ 33 00
34 Contributions to: 34a 529 College Savings Plans 00 34b 529A (ABLE accounts) 00 add 34a and 34b 34c 00
35 Subtract lines 24 through 34c from line 19. Enter the difference................................................................................ 35 46,003 00
ADOR 10413 (23)
1555 AZ Form 140 (2023) REV 01/13/24 Intuit.cg.cfp.sp Page 1 of 6
 Your Name (as shown on page 1) Your Social Security Number

Samantha K Stewart 625-68-5982

36 Other Subtractions from Income. Complete Other Subtraction from Arizona Gross Income schedule on page 6........ 36 00
37 Subtract line 36 from line 35. Enter the difference ........................................................................................................ 37 46,003 00
38 Age 65 or over: Multiply the number in box 8 by $2,100 ....................................................................................................... 38 00
Exemptions

39 Blind: Multiply the number in box 9 by $1,500 ...................................................................................................................... 39 00

40 Other Exemptions. See instructions......40E Multiply the number in box 40E by $2,300............................................. 40 00
41 Qualifying parents and grandparents: Multiply the number in box 11a by $10,000........................................................................ 41 00
42 Arizona adjusted gross income: Subtract lines 38 through 41 from line 37. If less than zero, enter “0”................................ 42 46,003 00
43 Deductions: Check box and enter amount. See instructions ........................ 43I ITEMIZED...43S STANDARD 43 13,850 00
44 If you checked box 43S and claim charitable contributions, check 44C Complete page 3. See instructions................... 44 00
45 Arizona taxable income: Subtract lines 43 and 44 from line 42. If less than zero, enter “0”..................................................... 45 32,153 00
46 Tax: Multiply line 45 by 2.5% (.025). Enter the result............................................................................................................. 46 804 00
Balance of Tax

47 Tax from recapture of credits from Arizona Form 301, Part 2, line 31 ............................................................................ 47 00
48 Subtotal of tax: Add lines 46 and 47. Enter the total ........................................................................................................... 48 804 00
49 Dependent Tax Credit. See instructions ........................................................................................................................ 49 00
50 Family income tax credit (from the worksheet - see instructions) .......................................................................................... 50 00
51 Nonrefundable Credits from Arizona Form 301, Part 2, line 62 ...................................................................................... 51 00
52 Balance of tax: Subtract lines 49, 50 and 51 from line 48. If the sum of lines 49, 50 and 51 is greater than line 48, enter “0” ....... 52 804 00
53 2023 AZ income tax withheld.......................................................................................................................................... 53 915 00
54 2023 AZ estimated tax payments.. 54a 29 00 Claim of Right 54b 00 Add 54a and 54b . 54c 29 00
55 2023 AZ extension payment (Form 204) ........................................................................................................................ 55 00
Total Payments and
Refundable Credits

56 Increased Excise Tax Credit (from the worksheet - see instructions) .................................................................................... 56 00
57 Property Tax Credit from Arizona Form 140PTC ............................................................................................................ 57 00
58 Other refundable credits: Check the box(es) and enter the total amount......................581 308-I 582 334 583 349 58 00
59 Total payments and refundable credits: Add lines 53 through 58. Enter the total....................................................... 59 944 00
60 TAX DUE: If line 52 is larger than line 59, subtract line 59 from line 52. Enter amount of tax due. Skip lines 61, 62 and 63............ 60 00
61 OVERPAYMENT: If line 59 is larger than line 52, subtract line 52 from line 59. Enter amount of overpayment ............................ 61 140 00
Overpayment
Tax Due or

62 Amount of line 61 to be applied to 2024 estimated tax................................................................................................... 62 0 00

63 Balance of overpayment: Subtract line 62 from line 61. Enter the difference ........................................................................ 63 140 00
Solutions Teams
64 - 74 Voluntary Gifts to: Assigned to Schools ........... 64 00 Arizona Wildlife ............... 65 00
Child Abuse Prevention ........... 66 00 Domestic Violence Services67 00 Political Gift..................... 68 00
Voluntary Gifts

Neighbors Helping Neighbors.. 69 00 Special Olympics ................ 70 00 Veterans’ Donations Fund 71 00

Sustainable State Parks
I Didn’t Pay Enough Fund........ 72 00 and Road Fund ................... 73 00 Spay/Neuter of Animals .. 74 00
75 Political Party (if amount is entered on line 68 - check only one): 751 Democratic 752 Libertarian 753 Republican
76 Estimated payment penalty ............................................................................................................................................ 76 00
77 771 Annualized/Other 772 Farmer or Fisherman 773 Form 221 included
Penalty

78 Add lines 64 through 74 and 76; enter the total.............................................................................................................. 78 00

79 REFUND: Subtract line 78 from line 63. If less than zero, enter amount owed on line 80 .......................................................... 79 140 00
Direct Deposit of Refund: Check box 79A if your deposit will be ultimately placed in a foreign account; see instructions. 79A
Amount Owed

ROUTING NUMBER ACCOUNT NUMBER

C Checking or
Refund or

98 S Savings
80 AMOUNT OWED: Add lines 60 and 78. Make check payable to Arizona Department of Revenue; write your SSN on payment;
and include with your return ................................................................................................................................................. 80 00

Under penalties of perjury, I declare that I have read this return and any documents with it, and to the best of my knowledge and belief, they are
true, correct and complete. Declaration of preparer (other than taxpayer) is based on all information of which preparer has any knowledge.
PLEASE SIGN HERE

Ä Call Center Representative

YOUR SIGNATURE DATE OCCUPATION

Ä
SPOUSE’S SIGNATURE DATE SPOUSE’S OCCUPATION

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

PAID PREPARER’S STREET ADDRESS PAID PREPARER’S TIN

PAID PREPARER’S CITY STATE ZIP CODE PAID PREPARER’S PHONE NUMBER

If you are sending a payment with this return, mail to Arizona Department of Revenue, PO Box 52016, Phoenix, AZ 85072-2016. Include the payment with Form 140.
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 10413 (23)

1555 AZ Form 140 (2023) REV 01/13/24 Intuit.cg.cfp.sp Page 2 of 6
 Arizona Form Arizona Individual Income Tax Payment Voucher EPV
AZ-140V for Electronic Filing of Form 140, 140PY or 140NR 2023
Your First Name and Middle Initial Last Name Your Social Security Number
Enter
1 Samantha Stewart 625 68 5982
your
Spouse’s First Name and Middle Initial Last Name Spouse’s Social Security No.
SSN(s).
1
Current Home Address - number and street, rural route Apt. No. Daytime Phone (with area code)
2 1045 S San Jose 207 94 (480)289-8607
City, Town or Post Office State ZIP Code REVENUE USE ONLY. DO NOT MARK IN THIS AREA.
3 88
Mesa AZ 85202-3848
Please indicate the filing status below:
Married filing joint return
Head of household: Enter name of qualifying child or dependent on next line.

Married filing separate return: Enter spouse’s name and Social Security Number above.
Single 81 PM 80 RCVD

Enter the amount of payment enclosed ................................................................................ $ 157 00

If you are mailing this payment

To ensure proper application of this payment, be sure that you:
9 Do not send cash.
9 Make your check or money order payable to Arizona Department of Revenue.
9 Write your SSN, “2023 Tax” and 140 on your payment.
9 Include your payment with this form.
9 Mail to Arizona Department of Revenue, PO Box 29085, Phoenix, AZ 85038-9085.

If you are making an electronic payment

You can make this 140V payment by eCheck or credit card!

American Express  Visa  Discover Card  MasterCard
www.AZTaxes.gov

9 Click on “Make a Payment” and select “140V” as the Payment Type.

9 Do not mail this form. We will apply this payment to your account.

NOTE: To avoid interest and penalties you must pay the full amount of your tax by April 15, 2024. You will not
receive an additional notice from the Arizona Department of Revenue unless an error exists with your return.

ADOR 10944 (23) 1555 REV 01/13/24 Intuit.cg.cfp.sp

 Arizona Form Individual Amended Income Tax Return FOR CALENDAR YEAR

140X 2023
DO NOT STAPLE ANY ITEMS TO THE RETURN.
For Forms 140, 140A, 140EZ, 140NR and 140PY
OR FISCAL YEAR BEGINNING 2 0 2 3 AND ENDING . 66
Your First Name and Middle Initial Last Name Your Social Security Number
Enter
1 Samantha K Stewart 625 68 5982
your
Spouse’s First Name and Middle Initial (if box 4 or 6 checked) Last Name Spouse’s Social Security No.
SSN(s).
1
Current Home Address - number and street, rural route Apt. No. Daytime Phone (with area code)
2 1045 S San Jose 207 94 (480)289-8607
City, Town or Post Office State ZIP Code Last Names Used in Last Four Prior Year(s) (if different)
3 Mesa AZ 85202-3848 97
Check a box to indicate both filing and residency status: REVENUE USE ONLY. DO NOT MARK IN THIS AREA.
FILING STATUS

88
4 Married filing joint return 4a Injured Spouse Protection of Joint Overpayment
5 Head of household: Enter name of qualifying child or dependent on next line:

6 Married filing separate return: Enter spouse’s name and Social Security Number above.
7 Single
Enter the number claimed. Do not check Ð
EXEMPTIONS
8 Resident
RESIDENCY

9a Nonresident 9b Composite 13 Age 65 or over .................................. 0

10 Nonresident active military 14 Blind.................................................. 0 81 PM 80 RCVD
11 Part-year resident 15a Dependents 0 Under 17 15b 0 17 & over
12 Part-year resident active military 16 Qualifying parents or grandparents .. 0
17 Federal adjusted gross income (from your federal return)...................................................................................... 17 46,003 00
18 Small Business Income: Residents only: check box 1൩N for no change; check box 18S for a new election;
check box 18C if you are changing the original amount reported. See instructions............................................... 18 0 00
19 Modified federal adjusted gross income: Residents: Subtract line 18 from line 17.......................................................... 19 46,003 00
20 Nonresidents and part-year residents only: Enter Arizona gross income here.............................................................. 20 0 00
20a Arizona income ratio: If you checked box 9a, 10, 11 or 12, divide line 20 by line 17 and enter the result (not over 1.000) 20a
21 Small Business Income: Nonresidents and part-year residents only: check box 21N for no change; check box
21S for a new election; check box 21C if you are changing the original amount reported. See instructions...... 21 00
Place any required federal and AZ schedules or other documents after Form 140X.

22 Modified Arizona Gross Income: Nonresidents and part-year residents: Subtract line 21 from line 20................... 22 00
23 Additions to Income. See instructions............................................................................................................. 23 0 00
24 Subtotal: Residents: Add lines 19 and 23. Nonresidents and part-year residents: Add lines 22 and 23................... 24 46,003 00
25 Subtractions from Income. See instructions ..................................................................................................................... 25 0 00
26 Total net capital gain or (loss). See instructions .................................................................... 26 00
27 Total net short-term capital gain or (loss). See instructions ................................................... 27 00
28 Total net long-term capital gain or (loss). See instructions.......................................................... 28 00
29 Net long-term capital gain from assets acquired after December 31, 2011. See instructions... 29 0 00
30 Multiply line 29 by 25% (.25) and enter the result .......................................................................................................... 30 0 00
31 Net capital gain derived from investment in qualified small business............................................................................. 31 0 00
32 Contributions to: 32a 529 College Savings Plans 00 32b 529A (ABLE accounts) 00 add 32a and 32b....... 32c 0 00
33 Arizona adjusted gross income: Subtract lines 25, 30, 31, and 32c from line 24. If less than zero, enter “0” ........................ 33 46,003 00

34 Deductions: Check box and enter amount. See instructions .............................. 34I ITEMIZED 34S STANDARD 34 13,850 00
35 If you checked box 34S and claim charitable contributions, check 35C Complete page 4. See instructions ............... 35 0 00
36 Arizona taxable income: Subtract lines 34 and 35 from line 33. If less than zero, enter “0” ..................................................... 36 32,153 00
37 Tax liability: Multiply line 36 by 2.5% (.025) .................................................................................................................. 37 804 00
38 Tax from recapture of credits from Arizona Form 301, Part 2, line 31 ............................................................................ 38 0 00
39 Subtotal of tax: Add lines 37 and 38. Enter the total ........................................................................................................... 39 804 00
40 Family income tax credit (AZ residents only) 40 a 00 Dependent Tax Credit. 40b 00 40c 0 00
41 Nonrefundable credits from Arizona Form 301, Part 2, line 62....................................................................................... 41 0 00
42 Balance of tax: Subtract lines 40c and 41 from line 39. If the sum of lines 40c and 41 is more than line 39, enter “0” ................. 42 804 00
43 Withholding, Estimated, and Extension Payments 43a 944 00 Claim of Right 43b 0 00 43c 944 00
44 Arizona residents only: Increased Excise Tax Credit 44a 0 00 Property Tax Credit 44b 0 00 44c 0 00
45 Other refundable credits: Check the box(es) and enter the total amount.........................451 308-I 452 334 453 349 45 0 00
46 Payment with original return plus all payments after it was filed .................................................................................... 46 00
47 Total payments and refundable credits: Add lines 43c, 44c, 45 and 46. Enter the total ................................................... 47 944 00

ADOR 10573 (23) 1555 Form 140X (2023) REV 01/13/24 Intuit.cg.cfp.sp Page 1 of 5
 Your Name (as shown on page 1) Your Social Security Number
Samantha K Stewart 625-68-5982

48 Overpayment from original return or as later adjusted. See instructions .......................................................................... 48 297 00
49 Balance of credits: Subtract line 48 from line 47. Enter the difference ................................................................................... 49 647 00
50 OVERPAYMENT: If line 42 is less than line 49, subtract line 42 from line 49. Enter amount of overpayment .............................. 50 00
51 Amount of line 50 to be applied to 2024 estimated tax. See instructions. If zero, enter “0” ......................................... 51 00
52 REFUND: Subtract line 51 from line 50. If less than zero, enter amount owed on line 53 ......................................................... 52 00
Direct Deposit of Refund: Check box 52A if your deposit will be ultimately placed in a foreign account; see instructions. 52A
C Checking or ROUTING NUMBER ACCOUNT NUMBER
98
S Savings
53 AMOUNT OWED: If line 42 is more than line 49, subtract line 49 from line 42. Enter the amount owed......................................... 53 157 00
54 Check box 54 if this amended return is the result of a net operating loss, and enter the year the loss was incurred.... 54 2 0

Complete Parts 1(A) and 1(B), Part 2 and Part 3 to report changes made to your original tax return
or most recent amended tax return and the reason(s) for each change.

NOTE: You must complete page 5, Dependent and Other Exemption Information, if you are reporting dependents (page 1, box 15a or 15b),
or qualifying parents and grandparents (page 1, box 16.) You must also complete page 5, Part 3 if you claim Other Exemptions on page 1, line 25.
If you do not complete page 5, your dependents and other exemptions may be denied. Do not count or list yourself or your spouse as dependents.
INCOME, DEDUCTIONS, CREDITS: In column (a), list the items you are changing. In column (b), enter the amount claimed on your original
return or most recent amended return. In column (c), enter the amount of the change. In column (d), enter the corrected amount for the item you are
changing.
(a) (b) (c) (d)
PART 1 (A)

INCOME, DEDUCTIONS, AND CREDITS YOU ARE CHANGING ORIGINAL AMOUNT AMOUNT TO CORRECTED
If you are rescinding your small business election, check box 55R REPORTED ADD OR SUBTRACT AMOUNT
See these instructions for more information regarding rescinding the election.

55a Federal Adjusted Gross Income $ 39,728 $ 6,275 $ 46,003

55b Arizona Adjusted Gross Income $ 39,728 $ 6,275 $ 46,003
55c $ $ $
NET CAPITAL GAIN OR (LOSS): If you are changing any amount on lines 56a through 56e, complete columns (b), (c), and (d).
(a) (b) (c) (d)
ITEM ORIGINAL AMOUNT AMOUNT TO CORRECTED
REPORTED ADD OR SUBTRACT AMOUNT

56a Total net capital gain or (loss) reported on

Form 140, line 20; Form 140NR, line 34; or Form 140PY, line 33 .................. $ $ $
PART 1 (B)

56b Total net short-term capital gain or (loss) reported on

Form 140, line 21; Form 140NR, line 35; or Form 140PY, line 34 .................. $ $ $
56c Total net long-term capital gain or (loss) reported on
Form 140, line 22; Form 140NR, line 36; or Form 140PY, line 35 .................. $ $ $
56d Net long-term capital gains from assets acquired after December 31, 2011
reported on Form 140, line 23; Form 140NR, line 37; or Form 140PY, line 36 $ 0 $ 0$ 0
56e Amount of allowable subtraction reported on Form 140, line 24;
Form 140NR, line 38; or Form 140PY, line 37 ................................................ $ 0 $ 0 $ 0
57 REASON FOR THE CHANGE: Give the reason for each change listed in Part 1 (A) and B):

No change
PART 2

Check box 58a if your address on this amended return is not the same as it was on your original return (or latest return filed).
Complete Part 3 with your current address.
58b Name 58c Number and Street, R.R. Apt. No.
PART 3

Samantha Stewart
58d City, Town or Post Office State ZIP Code

ADOR 10573 (23) Form 140X (2023) REV 01/13/24 Intuit.cg.cfp.sp Page 2 of 5
1555
 Your Name (as shown on page 1) Your Social Security Number
Samantha K Stewart 625-68-5982

Sign and date your return. If you paid someone to prepare your return, that person must also sign and date the
return. The paid preparer must provide their street address, Paid Preparer TIN and phone number.

Under penalties of perjury, I declare that I have read this return and any documents with it, and to the best of my knowledge and belief, they are true,
correct and complete. Declaration of preparer (other than taxpayer) is based on all information of which preparer has any knowledge.
PLEASE SIGN HERE

Ä Call Center Representative

YOUR SIGNATURE DATE OCCUPATION

Ä
SPOUSE’S SIGNATURE DATE SPOUSE’S OCCUPATION

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

PAID PREPARER’S STREET ADDRESS PAID PREPARER’S TIN

PAID PREPARER’S CITY STATE ZIP CODE PAID PREPARER’S PHONE NUMBER

• If you are sending a payment with this return, mail to:

Arizona Department of Revenue
PO Box 52016
Phoenix, AZ 85072-2016
Include the payment with Form 140X. Make check payable to Arizona Department of Revenue; write your SSN, Form 140X
and tax year on payment.

• 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

REV 01/13/24 Intuit.cg.cfp.sp

ADOR 10573 (23) 1555 Form 140X (2023) Page 3 of 5