Form It-40 - Indiana Full-Year Resident Individual Income Tax Retun - 2011
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1
2Indiana Full-Year Resident
2011
Form
IT-40
Due April 17, 2012
Individual Income Tax Return
State Form 154
(R10 / 9-11)
If
ling for a
scal year, enter the dates (see instructions) (MM/DD/YYYY):
fi
fi
from
to:
Your Social
Spouse’s Social
Security Number
Security Number
Place “X” in box if applying for ITIN
Place “X” in box if applying for ITIN
Your
rst name
Initial
Last name
Suf
x
fi
fi
If
ling a joint return, spouse’s
rst name
Initial
Last name
Suf
x
fi
fi
fi
Present address (number and street or rural route)
Place “X” in box if you are
married
ling separately.
fi
City
State
Zip/Postal code
Foreign country 2-character code (see pg. 6)
School corporation number (see pages 55 and 56)
2-digit county code
Enter below the
numbers (found on the back of Schedule CT-40) for the county where you lived and
worked on January 1, 2011.
County where
County where
County where
County where
you
you
spouse
spouse
lived
worked
lived
worked
Round all entries
1. Enter your federal adjusted gross income (AGI) from your federal tax return (from Form 1040,
Federal AGI
line 37; Form 1040A, line 21; or from Form 1040EZ, line 4) ___________________
1
.00
Indiana Add-Backs
2. Enter amount from Schedule 1, line 8, and enclose Schedule 1 ________
2
.00
3. Add line 1 and line 2 ____________________________________________________________
3
.00
Indiana Deductions
4. Enter amount from Schedule 2, line 12, and enclose Schedule 2 _______
4
.00
Indiana Adjusted Income
5. Subtract line 4 from line 3 __________________________________
5
.00
6. You must complete Schedule 3. Enter amount from Schedule 3, line 5,
Indiana Exemptions
and enclose Schedule 3 ______________________________________
6
.00
State Taxable Income
7. Subtract line 6 from line 5 _____________________________________
7
.00
8. State adjusted gross income tax: multiply line 7 by 3.4% (.034)
(if answer is less than zero, leave blank) ____________________ 8
.00
9. County tax. Enter county tax due from Schedule CT-40
(if answer is less than zero, leave blank) ____________________ 9
.00
10. Other taxes. Enter amount from Schedule 4, line 5 (enclose sch.) 10
.00
Indiana Taxes
11. Add lines 8, 9 and 10. Enter total here and on line 15 on the back ___________
11
.00
15111111694
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