Employer Affidavit

If ADOR received your Arizona income tax return and found that the social security number (SSN) and/or name on the W-2 form do not match the identification number and/or name on the tax return, ADOR will need to verify the withholding amount shown on the return before it can issue a refund. To accomplish the verification, ADOR must obtain additional information from you.

Form Number
11161
Form Year Form Publish Date
Current Download 03/28/2018