Form It-20np - Indiana Nonprofit Organization Unrelated Business Income Tax Return - 2012

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Indiana Department of Revenue

2012

Form IT-20NP

Indiana Nonprofit Organization Unrelated Business Income Tax Return

Calendar Year Ending December 31, 2012 or

State Form 148

(R11 / 8-12)

Fiscal Year Beginning and Ending

2012

Check box if amended.

Check box if name changed.

Federal Identification Number (FID)

Name of Organization

Principal Business Activity Code

Number and Street

Indiana County or O.O.S.

City

State

ZIP Code

Telephone Number

( )

K Check all boxes that apply:

Initial Return

Final Return

In Bankruptcy

Schedule M

L Do you have on file a valid extension of time to file your return (federal Form 7004 or an electronic extension of time)? Yes

Due Date: 15th day of the fifth month following close of the tax year.

Adjusted Gross Income Tax Calculation on Unrelated Business Income

Round all entries

1. Unrelated business taxable income (before NOL) deduction and specific deduction from federal return

Form 990T (attach Form 990T); use minus sign for negative amounts . ......................................................... 1

2. Specific deduction (generally $1,000; see instructions) ..................................................................................

3. Interest on U.S. government obligations on the federal return less related expenses ...................................

4. Deduction for qualified patents income . ..........................................................................................................

5. Enter total from lines 2 through 4 .....................................................................................................................

6. Subtotal for unrelated business income (subtract line 5 from line 1) . .............................................................. 6

7. Indiana modifications. See instructions.

(Use a minus sign to denote negative amounts.) .................................................................................................. 7

8. Unrelated business income, as adjusted (add lines 6 and 7). (If not apportioning, enter same

amount on line 10.) . ........................................................................................................................................... 8

9. Enter Indiana apportionment percentage, if applicable, from line 9 of IT-20 Schedule E apportionment

(attach schedule) . .............................................................................................................................................. 9

10. Unrelated business apportioned to Indiana (multiply line 8 by line 9; otherwise, enter line 8 amount).......... 10

11. Enter Indiana NOL deduction without specific deduction (attach Schedule IT-20NOL; see instructions) ..... 11

12. Taxable Indiana unrelated business income (subtract line 11 from line 10) . .................................................. 12

13. Taxable income from other forms (Form 1120-POL) . ...................................................................................... 13

14. Subtotal (add lines 12 and 13) .......................................................................................................................... 14

15. Indiana tax on unrelated business income (multiply line 14 by tax rate). See instructions for line 15 ........ 15

16. Sales/use tax on purchases subject to use tax from Sales/Use Tax Worksheet ........................................... 16

17. Total tax due (add lines 15 and 16) . .................................................................................................Total Tax

Credit for Estimated Tax and Other Payments

18. Quarterly estimated tax paid:

Qrt. 1 Qrt. 2 Qtr. 3 Qtr. 4 Enter total

19. Amount paid with extension ............................................................................................................................. 19

20. Amount of overpayment credit (from tax year ending ) . ............................................................. 20

21. Enter name of other credit Code No. 21a

21b

22. Total credits (add lines 18, 19, 20, and 21) . .............................................................................. Total Credits

23. Balance of tax due (line 17 minus 22; if line 22 is greater than line 17, proceed to lines 24, 25, and 28) ..... 23

24. Penalty for the underpayment of income tax. Attach Schedule IT-2220 ........................................................ 24

Check box if using annualization method

25. Interest: If payment is made after the original due date, compute interest.......................................................... 25

26. Penalty: If paid late, enter 10% of line 23; see instructions. If line 17 is zero, enter $10 per day filed past

due date.. .......................................................................................................................................................... 26

27. Total payment due (add lines 23 through 26). (Payment must be made in U.S. funds) PAY THIS AMOUNT 27

28. Total overpayment (line 22 minus lines 17, 24-26) . ......................................................................................... 28

29. Amount of line 28 to be refunded ..................................................................................................................... 29

30. Amount of line 28 to be applied to the following year's estimated tax account ................................................ 30

You must go to the certification and authorization section on page 2 to complete this return.

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