Form It-40 - Indiana Full-Year Resident Individual Income Tax Return - 1999 Page 2
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526. Enter the Total Tax from line 18 on the front of this form ..................................................................
26
27. Enter the Total Credits from line 25 on the front of this form ............................................................
27
28. If line 27 is more than line 26, subtract line 26 from line 27 (if smaller, skip to line 35) ...................
28
29.
Amount of line 28 to be donated to the Indiana Nongame and
Endangered Wildlife Fund (see instructions on page 30) .................................................
29
30. Subtract line 29 from line 28 ....................................................................................
30
SUBTOTAL
31. Amount to be applied to your 2000 estimated tax account (see instructions on page 30) ...............
31
32. Penalty for Underpayment of Estimated Tax for 1999: Attach Schedule IT-2210 or IT-2210A ........
32
33. Refund: Line 30 minus lines 31 and 32 (if less than zero see instructions on page 31)......Y
R
33
OUR
EFUND
If you want to
34a. Routing Number
DIRECT DEPOSIT
See Instructions
b. Account Number
your refund, you must
on page 31
complete lines
c. Type of Account
Checking
Savings
34a, b & c on the left.
35. If line 26 is more than line 27, subtract line 27 from line 26. Add to this any amounts
35
from lines 31 and 32, and enter total here (see instructions on page 31) ............
SUBTOTAL
36
36. Penalty if filed after due date (see instructions on page 31) ............................................................
37. Interest if filed after due date (see instructions on page 31) ............................................................
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38. Amount Due: Add lines 35, 36 and 37 ................................................................. A
Y
O
MOUNT
OU
WE
38
No payment is due if you owe less than $1.00. Do Not Send Cash. Make your check or money
order payable to: Indiana Department of Revenue. Discover
®
Card payers must see page 32
for instructions.
Out-of-State Income Information
Taxpayer $
• Enter any salary, wage, tip &/or commission received from
Spouse
$
Illinois, Kentucky, Michigan, Ohio, Pennsylvania and/or Wisconsin:
If any individual listed at the top of the IT-40
Taxpayer - Check box if you filed federal Schedule C or C-EZ for 1999.
died during 1999, enter date of death below.
Spouse
- Check box if you filed federal Schedule C or C-EZ for 1999.
Taxpayer’s
1999
m
m
d
d
date of death
• If two-thirds of your gross income was made from farming or fishing, please check here.
Spouse’s date
Important: If you checked the box, you must attach Schedule IT-2210 or IT-2210A .
1999
m
m
d
d
of death
• Enter the number of motor vehicles you and your spouse own or lease.
• Are all these vehicles registered with the Indiana Bureau of Motor Vehicles?
Yes
No
If No, attach an explanation.
Authorization
Under penalty of perjury, I have examined this return and all attachments and to the best of my knowledge and belief, it is true, complete
and correct. I also understand that if this is a joint return, any refund will be made payable to us jointly and each of us is liable for all
taxes due under this return. I also give the Indiana Department of Revenue permission to confirm information that I have placed on
this form and any attachments with the Social Security Administration. This consent includes my authorization for the Social Security
Administration to release my social security number, name, and date of birth. I understand that information obtained under this section
will remain confidential and will be used solely for Department of Revenue official purposes. This consent is in effect until such time
as I withdraw my authorization.
Yes
No
I authorize the Department to discuss my return with my tax preparer.
Your Signature
Date
Your Daytime Telephone Number
Spouse's Signature
Date
Spouse’s Daytime Telephone Number
Paid Preparer’s name
OR
Federal I.D. Number,
PTIN
Social Security Number
Address
Preparer’s Daytime Telephone Number
City
Preparer’s Signature
Date
State
Zip Code + 4
Mail to: Indiana Department of Revenue, P.O. Box 40, Indianapolis, IN 46206-0040.
Keep a copy for your records.
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