Form IT-65
Indiana Department of Revenue
2013
Indiana Partnership Return
State Form 11800
(R12 / 8-13)
for Calendar Year Ending December 31, 2013
or Other Tax Year Beginning
2013 and Ending
Check box if amended.
Check box if name changed.
Name of Partnership
Federal Identification Number
Number and Street
Indiana County or O.O.S.
Principal Business Activity Code
City
State
ZIP Code
M. Year of initial
Telephone Number
K. Date of organization
In the State of
L. State of commercial domicile
Indiana return
N. Accounting method: Cash
Accrual
Other
O. Check all boxes that apply to entity:
Initial Return
Final Return
In Bankruptcy
Composite Return
P. Enter total number of partners:
Enter number of nonresident partners:
Q. I have on file a valid extension of time to file my return (federal Form 7004 or an electronic extension of time).
Y
R. This is a limited liability company electing partnership treatment on the federal return.
Y
S. This partnership is a member of another partnership(s).
Y
Round all entries
Aggregate Partnership Distributive Share Income (see worksheet)
1. Total net income (loss) from U.S. partnership return, Form 1065 Schedule K, lines 1 through 11
less line 12, and a portion of line 13 related to investment income (see instructions);
.00
use minus sign for negative amounts ______________________________________________
1
.00
2. a. Enter name of addback or deduction (see instructions)
Code. No.
2a
.00
b. Enter name of addback or deduction
Code. No.
2b
.00
c. Enter name of addback or deduction
Code. No.
2c
.00
d. Enter name of addback or deduction
Code. No.
2d
.00
e. Enter name of addback or deduction
Code. No.
2e
f. Enter the total amount of addbacks and deductions from any additional sheets (use a
.00
minus sign for negative amount) ________________________________________________
2f
.00
3. Total partnership income, as adjusted (add lines 1 through 2f) __________________________
3
.
4. Enter percentage for Indiana apportioned adjusted gross income from IT-65 Schedule E line 9,
%
if applicable __________________________________________________________________
4
Summary of Calculations
.00
5. Sales/use tax due on purchases subject to use tax from Sales/Use Tax worksheet (from page 16)
5
.00
6. Total composite tax from completed Schedule IT-65COMP (15G). Attach schedule __________
6
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