Arizona Form A1-WP                                             Payment of Arizona Income Tax Withheld

 Arizona Department of Revenue                                                                 Employer Identification Number (EIN)
 PO Box 29085
 Phoenix  AZ  85038-9085                                                                        Qtr    Year                     Amount of Payment

                                                                                                QQ    Y               Y YY YY YYDollars       Cents

 Taxpayer Information
 Business Name (As listed on the Arizona Joint Tax Application - Form JT-1)                     Enter Quarter (1, 2, 3, or 4)
                                                                                                Four digits of year for which payment is made.
 Number and street or PO Box
                                                                                                REVENUEIMPORTANTUSE ONLY. DO NOT MARK IN THIS AREA.
                                                                                                88
 City or town, state and ZIP Code                                             You MUST complete the yellow-colored 
                                                                              fields before printing this form. 
 Business telephone number (with area code)                                    
                                                                              INCOMPLETE FORMS WILL NOT BE 
 IMPORTANT:  Arizona law requires certain taxpayers to make                   PROCESSED81           PMand will not be66consideredRCVD              as 
 withholding tax payments at the same time as federal withholding 
                                                                              received or filed by the department.
 deposits are due. Failure to make payment may result in a 25% 
 penalty in addition to other penalties and interest required by law.
                                                                                                                                         Print
                                            Return Top Portion with Payment
  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.

                                                           Instructions

Employers required to  make more than one  Arizona withholding                Taxpayer Information
payment per calendar  quarter, but not required  to pay by Electronic         Type or print the name, address, and phone number in the boxes in 
Funds Transfer (EFT), use Form A1-WP to transmit Arizona withholding          the Taxpayer Information section. If the taxpayer has a foreign address, 
payments to the department. Employers making withholding payments             enter the information in the following order:  city, province or state, and 
by electronic funds transfer or on the Internet should not use this form.     country. Follow the country’s practice for entering the postal code. Do 
Employers required to make quarterly withholding payments should not          not abbreviate the country’s name.
use this form. 
 Internet  payments:    Employers that  register may make their               Employer Identification Number (EIN)
 withholding  payments on the Internet with e-check or credit card.           Enter the EIN.  An EIN can be obtained  from the Internal Revenue 
 There is a fee to pay by credit card.  Visit www.AZTaxes.gov for further     Service.
 information.
                                                                              Quarter and Year
Electronic Funds Transfer (EFT)                                               The charts below identify which months or payments are included in 
                                                                              each quarter:
Employers who anticipate their Arizona withholding tax liability for calendar 
year 2023 to be $500 or more must make Arizona withholding payments                                                             Enter this number 
via EFT. If the employer makes its withholding payments by EFT,               For these months:                                  for the quarter:
the employer should not submit Form A1-WP to the department.                  January, February, March                                  1
                                                                              April, May, June                                          2
Participants in the Electronic Funds Transfer program must enroll online at   July, August, September                                   3
www.AZTaxes.gov at least 30 days prior to the first applicable transaction.   October, November, December                               4
 NOTE:  Employers required to make withholding payments via                                                                     Enter this number 
 EFT that fail to do so will be subject to a penalty of 5% of the amount      For this payment:                                  for the quarter:
 of the payment not made by EFT.  See A.R.S. § 42-1125(O).                    Extension payment for Form A1-APR                         4
                                                                              Enter the quarter from one of the charts above. Enter the four-digit year.
Employers who anticipate their  Arizona withholding  tax  liability for 
calendar year 2023 to be less than $500 may elect voluntary participation     Amount of Payment
in the EFT program.  Or they may elect to pay by check, money order,          Enter the amount of payment enclosed.
or credit card.
                                                                              NOTE:  Do not submit Form  A1-WP if the payment  is zero or 
Refer to A.R.S. § 42-1129 and the related Arizona Administrative Code         no payment  is enclosed.   Do not submit Form A1-WP  to  list prior 
rules (A.A.C. R15-10-301 through R15-10-307) for detailed information         payments made during the quarter.  Do not submit Form A1-WP for a 
regarding electronic funds transfer.                                          negative amount (to apply a credit as a payment or to claim a credit 
                                                                              as an overpayment).

ADOR 10889 (22)