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Arizona Form 290 Request for Penalty Abatement

THE PURPOSE OF THIS FORM PERIOD(S) OR YEAR(S)

Use Form 290 to request an abatement of non-audit Enter the specific tax period(s) in date format, based on
penalties. the filing frequency, that you want considered for the
abatement.
The account for which the abatement request is being
submitted must be in compliance. Compliance means For example:
there are no delinquent tax returns and all non-audit tax • Annual filers: 2015-2016
liabilities are paid when making the request. Provide clear • Quarterly filers: 01/2017-03/2017 or Q2 2018
and concise information to allow for a prompt reply by the • Monthly filers: 07/2017-02/2019
department.
PENALTY AMOUNT
The request will not be considered for processing if the
form is incomplete or if the account is not in compliance. Enter the dollar amount for which you are requesting
The abatement request form and documentation will be penalty abatement. There is no statutory provision that
returned for correction. The form and documentation will permits abatement of interest based on reasonable
then need to be resubmitted for consideration. cause.
IMPORTANT: If the penalty being addressed is the result PART 3 - EXPLANATION & DOCUMENTATION
of an audit, do not use Form 290. Contact the Audit Unit Explain in detail your reason(s) for requesting the
at the phone number shown on the assessment. The abatement. You must provide specific details or reasons
Penalty Review Unit does not process audit assessed that directly contributed to the failure to file or pay timely
penalties. for the period(s) you are requesting penalty abatement.
INFORMATION Include in the explanation as to why there is reasonable
cause for the returns and/or payments being late. Clear and
PART 1 - GENERAL INFORMATION concise information will allow for a prompt reply. Include
additional pages if you need more space.
All requests for abatement of penalties must include the
name, address, email address and telephone number of the IMPORTANT: You must include Documentation that
taxpayer for which the request is being made. supports the basis of your request. Requests without
supporting documentation may be denied.
If you want the Arizona Department of Revenue to
work with your representative or third party, complete
Examples include:
and include Arizona Form 285, General Disclosure/ • Proof of timely payment; including front
Representation Authorization Form. Ensure boxes 4b and back of canceled checks.
and 4c or box 5 are indicated. • Medical reports and/or Death Certificate(s).
• Other pertinent documents that support
PART 2 - SPECIFIC DETAILS FOR ABATEMENT your request for this abatement.
CONSIDERATION • Proof an extension has been filed.
Provide specific details regarding the account and periods Situations Where Reasonable Cause May Exist:
to be considered for abatement.
Below are some situations where reasonable cause may
TAX TYPE exist. There may be other situations where reasonable
it’s important for you
cause may exist. Accordingly,
• If your request is for an individual income tax return, to provide specific details or reasons that directly
use the Individual Taxpayer Identification Number contributed to the failure to file or pay timely for the
(ITIN) number or social security number from the periods you are requesting
.
return.
Circumstances beyond the control of the taxpayer while
• If your request is for a business account, use the
using reasonable and prudent business practices.
Transaction Privilege Tax (TPT) or Marijuana Excise 1. Mathematical errors
Tax (MET) license number.
A mathematical error on a timely filed tax return.
• If your request is for a corporate or withholding 2. Unexpected illness or unavoidable absence
account, use an Employer Identification Number (EIN). A. Individual returns
a. Delay caused by 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

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Arizona Form 290 Request for Penalty Abatement

B. Entity returns
If you want the Arizona Department of Revenue to work with
In the case of corporate, estate, trust or other business your representative or third party, complete and include
returns, delay caused by unexpected serious illness of Arizona Form 285, General Disclosure/Representation
or
the individual with sole authority to execute the return Authorization Form. Ensure boxes 4b and 4c box 5 are
or member of such individual’s immediate family. indicated.
Delay caused by unavoidable absence of the individual Handwritten signature, date, print the signer’s name and
with sole authority to execute return. title. An electronic signature with a digital certificate is
If unexpected illness accepted.
is the basis of the request for penalty
abatement, the Department shall require proof of the date
of illness. This proof includes, but is not limited to, doctor Type of Entity Who must sign
statements. Individuals, Joint The individual/joint filers/sole proprietor
3. Death Filers and Sole must sign.
A. Proprietorships
In the case of individual returns, delay caused by the
Corporations A principal corporate officer within the
death of a taxpayer or member of the taxpayer’s immediate meaning of A.R.S. § 42-2003 (A)(2) or any
family. person designated by a principal corporate
B. officer or any person designated in a resolution
In the case of corporate, estate, trust or other business
by the corporate board of directors or other
returns, the delay must have been caused by the death of an similar governing body, must sign.
individual with the sole authority to execute the return, or a Partnerships & A partner having authority to act in the name
member of such individual’s immediate family. Limited Partnerships of the partnership must sign.
For both individual and business returns, a reasonable time 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. Form 210, Notice of Assumption of Duties in a
4. Absence of records Fiduciary Capacity.
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 Agencies the governmental agency must sign.
destroys the taxpayer’s records. MAIL, FAX OR EMAIL FORM 290 TO:
Situations Where Reasonable Cause May NOT Exist:

ARIZONA DEPARTMENT OF REVENUE
1. Ignorance of the law or lack of awareness of filing and
paying requirements. PENALTY REVIEW UNIT
2. Delegation of duties. 1600 W MONROE ST
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
Penalties and/or fees not considered for Abatement:
Email: PenaltyReview@azdor.gov
1. Interest
2. TPT licensing fees Allow up to six (6) weeks for processing.
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.
Publication 700
• Arizona Department of Revenue General Tax Ruling and
Arizona Department of Revenue
(GTR) 04-2
available at www.azdor.gov.
PART 4 - SIGNATURE OF TAXPAYER OR AUTHORIZED
REPRESENTATIVE

The form 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

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                        Arizona Form 
                                                                                                                                           Request for Penalty Abatement
                                   290

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  
documentation will be returned for correction and must be resubmitted for consideration.   

The Arizona Department of Revenue, on written application by the taxpayer, shall abate 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

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 or box 5 are marked. 

PART 2                                     SPECIFIC DETAILS FOR ABATEMENT CONSIDERATION (REQUIRED)
                                                                                                                         Provide the associated           Provide the SPECIFIC PERIOD(S)         Provide the total PENALTY 
Indicate the TAX TYPE for the account                                                                              TAXPAYER ID number for                 for the account requesting  abatement  AMOUNT for the account  
                        requesting abatement                                                                       the account requesting                                                        requesting abatement.  
                                                                                                                                           abatement                                             (Do not include interest)
 Individual Income Tax                                                                                          ITIN or  SSN
                                                                                                                                                                                                $
 Transaction Privilege & Use Tax                                                                               License Number
                                                                                                                                                                                                $
 Corporate Income Tax                                                                                          EIN
                                                                                                                                                                                                $
 Withholding Tax                                                                                               EIN
                                                                                                                                                                                                $
 Other (Trust, Tobacco, Marijuana Excise Tax):                                                                 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)
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