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STATE OF ARIZONA ACTIVE 2010 SPECIAL ENROLLMENT FORM - benefitoptions az

STATE OF ARIZONA ACTIVE 2010 SPECIAL ENROLLMENT FORM - benefitoptions az-2025

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The document is the 2010 Special Enrollment Form for active employees of the State of Arizona, detailing options for medical, dental, vision, short-term disability, and supplemental life insurance coverage. It includes sections for employee and dependent information, plan selections with associated costs, and a certification statement for accuracy. The form emphasizes the requirement to provide Social Security numbers for dependents and outlines the consequences of providing false information.

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What is payment type 204 in Arizona?

You can make an extension payment online by using the Make an Individual or Small Business Income Payment option on .AZTaxes.gov. For Payment Type select 204 or 204-SBI, for proper application of your extension payment.

What Arizona withholding percentage should I choose?

Note: Under-withholding can result in you owing tax and/or underpayment penalties when you ﬁle your Arizona return at the end of the year. For tax year 2023 and beyond, the tax rate for Arizona taxable income is 2.5%.

Who must file an Arizona nonresident return?

Nonresidents are subject to Arizona tax on any income earned from Arizona sources. Nonresidents may also exclude income Arizona law does not tax. Individuals subject to tax by both Arizona and another state on the same income may also be eligible for a tax credit.

What is Arizona form 204?

Individual Fiscal Year Filers: This form is being used to transmit the Arizona extension payment.

What are the benefits of working for the State of Arizona?

The State of Arizona offers a robust array of benefits for State employees, including health and life insurance, short- and long-term disability, employee assistance, wellness programs and much more. Links to some of the frequently visited benefits information: Employee Discounts (including tuition discounts)

Does Arizona grant automatic extension?

To file an extension on an individual return, individuals use Arizona Form 204 to apply for an automatic extension to file. The completed extension form must be filed by April 15, 2025.

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