Form It-40pnr - Indiana Part-Year Or Full-Year Nonresident Individual Income Tax Return - 2009 Page 2

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12. Enter credits from Schedule F, line 9 (attach schedule) ...................... 12
00
●
13. Enter offset credits from Schedule G, line 7 (attach 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. Amount from line 16 to be donated to the Indiana Nongame Wildlife Fund ................................
17
00
●
18. Subtract line 17 from line 16........................................................................................Overpayment
18
00
●
19. Amount from line 18 to be applied to your 2010 estimated tax account
(see instructions on page 9).
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 ................................. 20
00
●
21. Refund: Line 18 minus lines 19d and 20.
21
00
Note: If less than zero, see line 23 instructions
Your Refund
●
22. a. Routing Number
Direct Deposit
b. Account Number
(see page 11)
c. Type:
Checking
Savings
Hoosier Works MC
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 on page 11)
............................................................................................................... 23
00
●
24. Penalty if fi led after due date (see instructions) ................................................................................... 24
00
●
25. Interest if fi led after due date (see instructions) ................................................................................... 25
00
●
26. Amount Due: Add lines 23, 24 and 25 ................................................................Amount You Owe
26
00
●
► No payment is due if you owe less than $1. 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 Filing Authorization statement on Schedule H. Attach Schedule H.
_____________________________________________________
_________________________________________________
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.

157091201

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