Form
Indiana Full-Year Resident Individual
1999
IT-40
Due April 17, 2000
Income Tax Return
Revised 9/99
SF# 154
If you are not filing for the calendar year January 1 through December 31, 1999,enter period from: _________to: _________
Your Social
Spouse’s Social
Check the box if you are
Security Number
Security Number
married filing separately.
Your First Name
Initial
Last Name
If filing a joint return, Spouse’s First Name
Initial
Last Name
Present Address (Number and Street or Rural Route)
School District
Number (see page 34)
City
State
Zip Code + 4
Foreign Country
(if applicable)
If you have a loss (or negative entry),
Enter the 2-digit county code numbers (found on page 6 in the instruction booklet) for the
please indicate so by placing it in a
county where you lived and worked on January 1, 1999.
bracket. Example: ( 1.00 )
Taxpayer
Spouse
Please round all entries to
County where
County where
County where
County where
nearest whole dollar (see
you lived
you worked
you lived
you worked
instructions, pg 7)
1
1. Enter your Federal Adjusted Gross Income from your federal return (see page 9) .......................
2
2. Tax Add-Back: certain taxes deducted from federal Schedule C, C-EZ, E, and/or F only .............
3
3. Net Operating Loss Carryforward from federal Form 1040, line 21,‘Other Income’ ......................
4
4. Income taxed on federal Form 4972 (attach Form 4972: see page 10) .......................................
5
5. Add lines 1 through 4 ................................................................................Total Indiana Income
6
6. Indiana deductions: Enter amount from Schedule 1, line 19 and attach Schedule 1 ...................
7
7. Line 5 minus line 6 ................................................................. Indiana Adjusted Gross Income
8. Number of exemptions claimed on your federal return
x $1,000.
8
00
(If no federal return was filed, enter $1,000 per qualifying person: see page 15.) ........................
9. Additional exemption for certain dependent children (see page 15).
9
00
Enter number
x $1,500 .....................................................................................................
10. Check box(es) below for additional exemptions if, by December 31, 1999:
You were:
65 or older
or blind. Spouse was:
65 or older
or blind.
00
10
Total the Number of boxes checked
x $1,000. ...............................................................
11. Check box(es) below for additional exemptions if, by December 31, 1999:
You were:
65 or older and line 1 above is less than $40,000.
Spouse was:
65 or older and line 1above is less than $40,000.
11
00
Total the number of box(es) checked
x $500 ..................................................................
12
00
12. Add lines 8, 9, 10 and 11 ............................................................................... Total Exemptions
13
13. Line 7 minus line 12
..................... State Taxable Income
(if answer is less than zero, leave blank)
14
14. State Adjusted Gross Income Tax: Multiply line 13 by 3.4% (.034) ..............................................
15
15. County Income Tax. See instructions on page 15 ........................................................................
16
16. Use Tax due on out-of-state purchases (see page 19) .................................................................
17
17. Household Employment Taxes: Attach Schedule IN-H (see page 19) ..........................................
18
18. Add lines 14 through 17. Enter here and on line 26 on the back ................................ Total Tax
19
19. Indiana State Tax Withheld:
...................
(From box 18 of your W-2s, box A of WH-18s or from 1099s)
20
20. Indiana County Tax Withheld:
(From box 21 of your W-2s, box B of WH-18s or from 1099s) .................
21
21. 1999 Estimated Tax Paid: Include any extension payment made on Form IT-9 ..........................
22
22. Unified Tax Credit for the Elderly: see instructions on page 20 ...............................................
23
23. Earned Income Credit: Enter amount from Section D, line D4 and attach Schedule IN-EIC .......
24
24. Indiana Credits: Enter the total from Schedule 2, line 12 and attach Schedule 2 .........................
25
25. Add lines 19 through 24. Enter here and on line 27 on the back ...........................Total Credits
Turn the page
DD
AA
BB
CC