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REVENUE USE ONLY. DO NOT MARK IN THIS AREA.
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RCVD
Employers required to make more than one Arizona withholding
payment per calendar quarter, but not required to pay by Electronic
Funds Transfer (EFT), use Form A1-WP to transmit Arizona withholding
payments to the department. Employers making withholding payments
by electronic funds transfer or on the Internet should not use this form.
Employers required to make quarterly withholding payments should not
use this form.
Internet payments: Employers that register may make their
withholding payments on the Internet with e-check or credit card.
There is a fee to pay by credit card. Visit www.AZTaxes.gov for further
information.
Electronic Funds Transfer (EFT)
Employers who anticipate their Arizona withholding tax liability for calendar
year 2022 to be $500 or more must make Arizona withholding payments
via EFT. If the employer makes its withholding payments by EFT,
the employer should not submit Form A1-WP to the department.
Participants in the Electronic Funds Transfer program must enroll online at
www.AZTaxes.gov at least 30 days prior to the first applicable transaction.
NOTE: Employers required to make withholding payments via
EFT that fail to do so will be subject to a penalty of 5% of the amount
of the payment not made by EFT. See A.R.S. § 42-1125(O).
Employers who anticipate their Arizona withholding tax liability for
calendar year 2022 to be less than $500 may elect voluntary participation
in the EFT program. Or they may elect to pay by check, money order,
or credit card.
Refer to A.R.S. § 42-1129 and the related Arizona Administrative Code
rules (A.A.C. R15-10-301 through R15-10-307) for detailed information
regarding electronic funds transfer.
Taxpayer Information
Type or print the name, address, and phone number in the boxes in
the Taxpayer Information section. If the taxpayer has a foreign address,
enter the information in the following order: city, province or state, and
country. Follow the country’s practice for entering the postal code. Do
not abbreviate the country’s name.
Employer Identification Number (EIN)
Enter the EIN. An EIN can be obtained from the Internal Revenue
Service.
Quarter and Year
The charts below identify which months or payments are included in
each quarter:
For these months:
Enter this number
for the quarter:
January, February, March 1
April, May, June 2
July, August, September 3
October, November, December 4
For this payment:
Enter this number
for the quarter:
Extension payment for Form A1-APR 4
Enter the quarter from one of the charts above. Enter the four-digit year.
Amount of Payment
Enter the amount of payment enclosed.
NOTE: Do not submit Form A1-WP if the payment is zero or
no payment is enclosed. Do not submit Form A1-WP to list prior
payments made during the quarter. Do not submit Form A1-WP for a
negative amount (to apply a credit as a payment or to claim a credit
as an overpayment).
ADOR 10889 (21)
Instructions
Make check payable to: Arizona Department of Revenue and include EIN on payment.
Mail top portion with payment to: Arizona Department of Revenue, PO Box 29085, Phoenix, AZ 85038-9085.
Return Top Portion with Payment
Arizona Department of Revenue
PO Box 29085
Phoenix AZ 85038-9085
IMPORTANT: Arizona law requires certain taxpayers to make
withholding tax payments at the same time as federal withholding
deposits are due. Failure to make payment may result in a 25%
penalty in addition to other penalties and interest required by law.
Employer Identication Number (EIN)
Qtr Year Amount of Payment
Q Y Y Y Y
Dollars Cents
Enter Quarter (1, 2, 3, or 4)
Four digits of year for which payment is made.
Arizona Form A1-WP Payment of Arizona Income Tax Withheld
Taxpayer Information
Name
Number and street or PO Box
City or town, state and ZIP Code
Business telephone number (with area code)