Indiana Amended Individual Income Tax Return
Form
Tax
IT-40X
Year
If you are not filing for the calendar year January 1 through December 31, enter period from:
State Form 44405
(R14 / 9-15)
to:
Your Social
Spouse’s Social
Security Number
Security Number
Your first name
Initial
Last name
Suffix
If filing a joint return, spouse’s first name
Initial
Last name
Suffix
Present address (number and street or rural route)
Place “X” in box if you are
married filing separately.
City
State
Zip/Postal code
Foreign country 2-character code
Place “X” in box
Enter loss year
if amendment
For department
due to an NOL.
use only
Are you filing an amended federal return?
Yes
No
If yes, attach a copy of your federal Form 1040X.
Enter the 2-digit county code numbers for the county where you lived and worked on January 1 of the tax year.
County where
County where
County where
County where
you lived
you worked
spouse lived
spouse worked
A
B
C
As Shown on
Amount of
Correct
Complete Part 1 on the back to explain any changes.
Original Return
Change
Amount
00
00
00
1. Amount from line 1 of Form IT-40/IT-40EZ/IT-40PNR ......
1
00
00
00
2. Indiana add-backs from Schedule 1 (or Schedule B) .......
2
00
00
00
3. Add lines 1 and 2..............................................................
3
00
00
00
4. Indiana deductions from Schedule 2 (or Schedule C) ......
4
00
00
00
5. Subtract line 4 from line 3.................................................
5
00
00
00
6. Exemptions from Schedule 3 (or Schedule D) .................
6
00
00
00
7. Subtract line 6 from line 5.................................................
7
00
00
00
8. State adjusted gross income tax: see instructions ...........
8
00
00
00
9. County tax ........................................................................
9
00
00
00
10. Other taxes from Schedule 4 (or Schedule E)..................
10
00
00
00
11. Add lines 8, 9 and 10 (tax) (if less than zero, enter zero)
11
00
00
00
......................
12
12. Credits from Schedule 5 (or Schedule F)
00
00
00
13. Offset credits from Schedule 6 (or Schedule G) ...............
13
00
00
14. Amount previously paid ....................................................
14
00
00
00
15. Add lines 12, 13 and 14 (net credits)................................
15
00
00
16. Donations (see instructions) .............................................
16
00
00
00
17. Amount applied to the next year’s estimated tax account
17
00
00
18. Amount previously refunded.............................................
18
00
00
00
19. Penalty for the underpayment of estimated tax ................
19
00
00
00
20. Add lines 11, 16, 17, 18 and 19 (tentative amount due) ...
20
*16115111694*
16115111694