Fillable Form 2016: IT-40 Individual Income Tax Return Indiana (State of Indiana)

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Form 2016: IT-40 Individual Income Tax Return Indiana (State of Indiana)

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The Form 2016: IT-40 Individual Income Tax Return Indiana (State of Indiana) form is 2 pages long and contains:

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Indiana Full-Year Resident
Individual Income Tax Return
2016
Form
IT-40
State Form 154
(R15 / 9-16)
Due April 18, 2017
If ling for a scal year, enter the dates (see instructions) (MM/DD/YYYY):
from to:
Spouse’s Social
Security Number
Place “X” in box if you are
married ling separately.
Your Social
Security Number
Place “X” in box if applying for ITIN Place “X” in box if applying for ITIN
Present address (number and street or rural route)
Enter below the 2-digit county code numbers (found on the back of Schedule CT-40) for the county where you lived and
worked on January 1, 2016.
County where
spouse lived
County where
spouse worked
County where
you lived
County where
you worked
1. Enter your federal adjusted gross income (AGI) from your federal tax return (from Form 1040,
line 37; Form 1040A, line 21; or from Form 1040EZ, line 4)
___________________ Federal AGI 1 .00
2. Enter amount from Schedule 1, line 8, and enclose Schedule 1 ________ Indiana Add-Backs 2 .00
3. Add line 1 and line 2 ____________________________________________________________ 3 .00
4. Enter amount from Schedule 2, line 12, and enclose Schedule 2 _______ Indiana Deductions 4 .00
5. Subtract line 4 from line 3 __________________________________ Indiana Adjusted Income 5 .00
6. You must complete Schedule 3. Enter amount from Schedule 3, line 5,
and enclose Schedule 3
______________________________________ Indiana Exemptions 6 .00
7. Subtract line 6 from line 5 _____________________________________ State Taxable Income 7 .00
8. State adjusted gross income tax: multiply line 7 by 3.3% (.033)
(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 4 (enclose sch.) 10 .00
11. Add lines 8, 9 and 10. Enter total here and on line 15 on the back ___________ Indiana Taxes 11 .00
Your rst name Initial Last name
If ling a joint return, spouse’s rst name
Initial Last name
City State Zip/Postal code
Foreign country 2-character code (see instructions)
Round all entries
Sux
Sux
*15116111694*
15116111694
12. Enter credits from Schedule 5, line 9 (enclose schedule) ____ 12 .00
13. Enter oset credits from Schedule 6, line 8 (enclose schedule) 13 .00
14. Add lines 12 and 13 ______________________________________________ Indiana Credits 14 .00
15. Enter amount from line 11 ___________________________________________ Indiana Taxes 15 .00
16. If line 14 is equal to or more than line 15, subtract line 15 from line 14 (if smaller, skip to line 23) 16 .00
17. Enter donations from Schedule IN-DONATE (enclose schedule); cannot be greater than line16 17 .00
18. Subtract line 17 from line 16 _________________________________________ Overpayment 18 .00
19. Amount from line 18 to be applied to your 2017 estimated tax account (see instructions).
Enter your county code county tax to be applied _ $ a .00
Spouse’s county code county tax to be applied _ $ b .00
Indiana adjusted gross income tax to be applied _________ $ c .00
Total to be applied to your estimated tax account (a + b + c; cannot be more than line 18) _____ 19d .00
20. Penalty for underpayment of estimated tax from Schedule IT-2210 or IT-2210A (enclose sch.) _ 20 .00
21. Refund: Line 18 minus lines 19d and 20. Note: If less than zero, see line 23 ___ Your Refund 21 .00
22. Direct Deposit (see instructions)
a. Routing Number
b. Account Number
c. Type: Checking Savings Hoosier Works MC
d. Place an “X” in the box if refund will go to an account outside the United States
23. If line 15 is more than line 14, subtract line 14 from line 15. Add to this any amount on line 20
(see instructions)
_____________________________________________________________ 23 .00
24. Penalty if led after due date (see instructions) ______________________________________ 24 .00
25. Interest if led after due date (see instructions) ______________________________________ 25 .00
26. Amount Due: Add lines 23, 24 and 25 ______________________________ Amount You Owe 26 .00
Do not send cash. Please make your check or money order payable to:
Indiana Department of Revenue. Credit card payers must see instructions.
Sign and date this return after reading the Authorization statement on Schedule 7. You must enclose Schedule 7.
_____________________________________________________
_________________________________________________
Your Signature Date Spouse’s Signature Date
• If enclosing payment mail to: Indiana Department of Revenue, P.O. Box 7224, Indianapolis, IN 46207-7224.
• Mail all other returns to: Indiana Department of Revenue, P.O. Box 40, Indianapolis, IN 46206-0040.
*15116121694*
15116121694
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Form 2016: IT-40 Individual Income Tax Return Indiana (State of Indiana)

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Completed 20 July 2020

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