Form It-20g - Governmental Units And Agencies (Final) Gross Income Tax Return
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1Indiana Department of Revenue
Governmental Units and Agencies
FORM
2002
IT-20G
(Do Not Write Above)
(Final) Gross Income Tax Return
Federal Identification Number
For the Calendar Year Ending December 31, 2002
State Form 21099
or Fiscal Year Beginning _________/_________/ 2002 to December 31, 2002
AA
(R1/9-02)
A
Name of Agency
Date last audited
Federal Business Activity Code Number
by the Indiana
Department of
B
H
Revenue
Indiana Taxpayer Identification Number
Street Address
County
K
D
I
C
Date Incorporated
City
State
Zip Code
Telephone Number
(
)
E
F
G
J
L
Schedule A - Final Gross Income Tax Computation for Calendar Year Beginning 1-1-2002 or
Due date is April 15, 2003
Fiscal Year Beginning in 2002 through December 31, 2002
High Tax Rate
Low Tax Rate
Column A = 1.2% (.012)
Column B = .3% (.003)
Gross Receipts Received
1. Gas .................................................................................................
FINAL FORM
2. Power and light ..............................................................................
IT-20G
3. Water .............................................................................................
4. Sale of by-products from sewage utility .......................................
5. Concession stand receipts .............................................................
6. Miscellaneous income ...................................................................
7. Totals (add lines 1 through 6) ........................................................ 7A
7B
8. Nontaxable receipts for period through 12-31-2002.
(itemize on Schedule B on reverse side) ........................................ 8A
8B
9. Exemption ($83.33 per month, total of columns A and B
may not exceed $1,000) .................................................................. 9A
9B
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
13. Total Schedule A-final gross income tax (add amounts on line 12A and line 12B) ........................... 13
Schedule C - All Payments and Credits through December 31, 2002
14. Total quarterly IT-6 or EFT estimated tax paid in 2002 (itemize payments below)
Qtr. 1 ________ Qtr. 2 ________ Qtr. 3 ________ Qtr. 4 ________ Enter total ............................... 14
15. Enter total extension payment _____ and prior year overpayment credit ____from tax year_____
15
a
b
c
16. Other credits applied through 12-31-2002 (attach detailed explanation) ............................................. 16
17. Total payments and credits (add lines 14, 15, and 16) .........................................................................
18. Balance of tax due (line 13 minus line 17 - if line 17 is greater than 13, proceed to line 23 and 20) ......
19. Late Penalty: If paying late compute penalty of 10% of line 18 or $5.00, whichever is greater ................ 19
20. Penalty for the underpayment of quarterly estimated tax (attach Schedule IT-2220) ......................... 20
21. If payment is made after the original due date, add interest (contact the Department for the current interest rate) ...... 21
22. Total tax, penalty, and interest (add lines 18, 19, 20, and 21) If remittance is due,
make check payable to the Indiana Department of Revenue ................ Pay in U.S. funds. Amount
22
23. Total overpayment (line 17 minus lines 13 and 20) ........................ 23
24. Refund: Enter amount from line 23 to be refunded ........................ 24
Under penalties of perjury, I declare I have examined this return, including accompanying schedules and statements, and to the best of my
CC
DD
knowledge and belief, it is true, correct, and complete. I authorize the Department to discuss my return with my tax preparer. Yes
Signature of Officer
Date
Print or Type Name
Title
LL
M M
1
Federal I.D. Number
Check Box
Paid Preparer's Name
Preparer's FID, SSN, or PTIN Number
OO
2
Social Security Number
FF
NN
PTIN Number
3
Street Address
Daytime Telephone Number of Preparer
GG
PP
E-mail address
City
State
Zip+4
Preparer's Signature
HH
II
JJ
EE
V N
Please mail form to: Indiana Dept. of Revenue, 100 North Senate Ave., Indianapolis, IN 46204-2253
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