Form It-40pnr - Indiana Part-Year Or Full-Year Nonresident Individual Income Tax Return - 2009

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Form

Indiana Part-Year or Full-Year Nonresident

IT-40PNR

Individual Income Tax Return

2009

State Form 472

(R8 / 9-09)

If you are not ﬁ ling for the calendar year January 1 through December 31, 2009, enter period from:

/2009

Due April 15, 2010

to:

Your Social

Spouse’s Social

Security Number

Place “X” in box if applying for ITIN

Your ﬁ rst name

Initial

Last name

If ﬁ ling a joint return, spouse’s ﬁ rst name

Initial

Last name

Present address (number and street or rural route)

Place “X” in box if you are

married ﬁ ling separately.

City

State

Zip code + 4

Foreign Country (if applicable)

School Corporation Number (see pages 48 and 49)

Enter below the 2-digit county code numbers (found on the back of Schedule CT-40PNR) for the county where you lived and

worked on January 1, 2009.

County where

you lived

you worked

spouse worked

spouse lived

Round all entries

1. Complete Schedule A ﬁ rst. Enter here the amount from Section 3,

line 37B, and attach Schedule A.............................................................................. Indiana Income

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2. Enter amount from Schedule B, line 13, and attach Schedule B ...................... Indiana Add-Backs

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3. Add line 1 and line 2 ............................................................................................................................. 3

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4. Enter amount from Schedule C, line 12, and attach Schedule C .................... Indiana Deductions

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5. Subtract line 4 from line 3..................................................................................................................... 5

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6. You must complete Schedule D. Enter amount from Schedule D, line 7,

and attach Schedule D ................................................................................... Indiana Exemptions

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7. Subtract line 6 from line 5 (if answer is less than zero, leave blank)............. State Taxable Income

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8. State adjusted gross income tax: multiply line 7 by 3.4% (.034) ......... 8

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