Form It-20g - Governmental Units And Agencies Gross Income Tax Return - 1999
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1Indiana Department of Revenue
FORM
Governmental Units and Agencies
1999
IT-20G
(Do Not Write Above)
Gross Income Tax Return
Federal Identification Number
(Rev. 9/99)
For the Calendar Year Ending December 31, 1999
or Fiscal Year Beginning __________, 1999 and Ending __________, _____
SF 21099
Name of Agency
Federal Business Activity Code Number
Date last audited
by the Indiana
Department of
Revenue
Street Address
County
Indiana Taxpayer Identification Number
Date Incorporated
Telephone Number
City or Town, State, and Zip Code
(
)
High Tax Rate
Low Tax Rate
Schedule A - Gross Income Tax Computation
Column A = 1.2% (.012)
Column B = .3% (.003)
GROSS RECEIPTS RECEIVED
1.
Gas ............................................................................................................
2.
Power and light ......................................................................................
3.
Water ......................................................................................................
4.
Sale of by-products from sewage utility ...........................................
5.
Concession stand receipts ..................................................................
6.
Miscellaneous income ..........................................................................
7A
7.
Totals (add lines 1 through 6) .............................................................
7B
8A
8B
8.
Nontaxable receipts (itemize on Schedule B below) ........................
9.
Exemption ($83.33 per month, total of columns A and B may not
9A
9B
exceed $1,000) .........................................................................................
10.
Add lines 8 and 9 for each column ......................................................
11.
Amounts subject to tax (line 7 minus line 10 of each column) .......
12.
Multiply amounts on line 11 by the tax rate for each column .........
12A
12B
..........
Total Schedule A gross income tax (add total amounts on line 12A and line12B)
13.
13
Schedule B - Explanation of Nontaxable Items of Income
DEDUCTED FROM RECEIPTS
Line Number
Item Deducted
Column A
Column B
Totals
Schedule C - Payments and Credits
Total quarterly IT-6 or EFT estimated payments (itemize payments below)
14.
14
Qtr. 1 __________ Qtr. 2 __________ Qtr. 3 __________ Qtr. 4 __________ Enter total.................
15
15.
Enter extension payment _____ and prior year overpayment credit _____ from tax year_____Enter total
16
Other credits (attach detailed explanation) .......................................................................................................
16.
Total payments and credits (add lines 14, 15, and 16) ....................................................................................
17.
Balance of tax due (line 13 minus line 17 - if line 17 is greater than 13, proceed to line 23 and 20).............
18.
19
19.
If payment is made after the original due date, compute penalty of 10% of line 18 or $5.00, whichever is greater
20
Penalty for the underpayment of quarterly tax from Schedule IT-2220 (Attach IT-2220) ........................
20.
21
21.
If payment is made after the original due date, add interest (contact the Department for the current interest rate)
22
Total tax, penalty, and interest (add lines 18, 19, 20, and 21) ..................................... Pay This Amount
22.
Total overpayment (line 17 minus lines 13 and 20) .............................
23
23.
24
24.
Amount of line 23 to be refunded .........................................................
Amount of line 23 to be credited to the following year's estimated account (line 23 minus line 24)..........
25
25.
Under penalties of perjury, I declare I have examined this return, including accompanying schedules and statements, and to the best of my
Mail To:
Indiana Dept. of Revenue
knowledge and belief, it is true, correct, and complete. I authorize the Department to discuss my return with my tax preparer. Yes
No
100 North Senate Ave.
Signature of Officer
Date
Print or Type Name
Title
Indianapolis, IN
46204-2253
Paid Preparer's Name
Preparer's FID, SSN, or PTIN Number
Federal I.D. Number
Social Security Number
Street Address
Daytime Telephone Number
PTIN Number
City
State
Zip+4
Preparer's Signature
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