Schedule A (Form It-40pnr) - Section 1: Income Or Loss - 2010
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1
2Schedule A
Schedule A Section 1: Income or Loss
Enclosure
2010
Form IT-40PNR
(Complete Proration, Section 2 and Section 3 on back)
Sequence No. 01
State Form 48719
(R9 / 9-10)
Name(s) shown on Form IT-40PNR
Your Social Security Number
Section 1: Income or (Loss) Enter in Column A the same income or loss you reported on your 2010 federal income tax return, Form
1040, 1040A or 1040EZ (except for line 19B and/or a net operating loss carryforward on line 20B; see instructions). Round all entries.
Column A
Column B
Line-by-line instructions begin on page 13.
Income from Federal Return
Income Taxed by Indiana
.00
.00
1. Your wages, salaries, tips, commissions, etc _____________
1A
1B
.00
.00
2. Spouse’s wages, salaries, tips, commissions, etc _________
2A
2B
.00
.00
3. Taxable interest income _____________________________
3A
3B
.00
.00
4. Dividend income __________________________________
4A
4B
5. Taxable refunds, credits, or offsets of state
.00
.00
and local taxes from your federal return ________________
5A
5B
.00
.00
6. Alimony received __________________________________
6A
6B
.00
.00
7. Business income or loss from federal Schedule C or C-EZ _
7A
7B
8. Capital gain or loss from sale or exchange
.00
.00
of property from your federal return ____________________
8A
8B
.00
.00
9. Other gains or (losses) from Form 4797 ________________
9A
9B
.00
.00
10. Total IRA distribution ________________________________ 10A
10B
.00
.00
11. Total pensions and annuities _________________________ 11A
11B
12. Net rent or royalty income or loss reported on
.00
.00
federal Schedule E ________________________________ 12A
12B
.00
.00
13. Income or loss from partnerships _____________________ 13A
13B
.00
.00
14. Income or loss from trusts and estates _________________ 14A
14B
.00
.00
15. Income or loss from S corporations ____________________ 15A
15B
.00
.00
16. Farm income or loss from federal Schedule F ____________ 16A
16B
.00
.00
17. Unemployment compensation ________________________ 17A
17B
. 00
.00
18. Taxable Social Security benefi ts _______________________ 18A
18B
19. Indiana apportioned income from
.00
Schedule IT-40PNRA ___________________________________________________________ 19B
.00
.00
20. Other income reported on your federal return ____________ 20A
20B
List source(s). (Do not include federal net operating loss in Column B. See instructions on page 15.)
.00
.00
21. Subtotal: add lines 1 through 20. _____________________ 21A
21B
23410111694
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