Fillable Form It-65 - Indiana Partnership Return

Form IT-65

Indiana Department of Revenue

Indiana Partnership Return

State Form 11800 (R8/8-09)

for Calendar Year Ending December 31, 2009

or Other Tax Year Beginning ________/_______/ 2009 and Ending ________/________/ ________

Check box if amended.

Check box if name changed.

Federal Identification Number

Name of Partnership

Number and Street

Indiana County or O.O.S.

Principal Business Activity Code

Telephone Number

City

State

ZIP Code

(

)

K. Date of organization

O. Check all boxes that apply to entity:

Initial Return

Final Return

In Bankruptcy

Composite Return

In the State of

P. Enter total number of partners:

Enter number of nonresident partners:

Q. Do you have on file a valid extension of time to file your return

L. State of commercial domicile

(federal Form 7004 or an electronic extension of time)?

M. Year of initial Indiana return

R. Are you a limited liability company electing partnership treatment on your federal return?

N. Accounting method:

S. Is this partnership a member of any other partnership(s)?

Cash

Accrual

Other

Aggregate Partnership Distributive Share Income (see worksheet)

Round all entries

Total net income (loss) from U.S. partnership return, Form 1065 Schedule K, lines 1 through 11

less line 12, and a portion of line 13 related to investment income (see instructions) ......................................................................................

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2a. Enter name of addback or deduction (see instructions) _________________________________________

Code No. _________

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2b. Enter name of addback or deduction ________________________________________________________

Code No. _________

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2c. Enter name of addback or deduction ________________________________________________________

Code No. _________

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2d. Enter name of addback or deduction ________________________________________________________

Code No. _________

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2e. Enter name of addback or deduction ________________________________________________________

Code No. _________

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2f.

Enter the total amount of addbacks and deductions from any additional sheets (enter negative amount in <brackets>) ............................... 2f

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Total partnership income, as adjusted (add lines 1 through 2f) .......................................................................................................................

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Enter average percentage for Indiana apportioned adjusted gross income from IT-65 Schedule E line (4c), if applicable ............................

Summary of Calculations

Sales/use tax due on purchases subject to use tax from Sales/Use Tax worksheet (from page 19)...............................................................

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Total composite tax from completed Schedule IT-65COMP (15G). Attach schedule .......................................................................................

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Total tax (add lines 5 and 6). Caution: If line 7 is zero, see line 12 late file penalty .........................................................................................

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Total amount of withholding (attach WH-18 statement(s) for composite members) ........................................................................................

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Other payments/credits belonging to the partnership (attach documentation) ................................................................................................

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10. Subtotal (line 7 minus lines 8 and 9). If total is greater than zero, proceed to lines 11, 12, and 13 .................................................................. 10

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11. Interest: Enter total interest due; see instructions (contact the Department for current interest rate) ............................................................ 11

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12. Penalty: If paying late, enter 10% of line 10. If line 7 is zero, enter $10 per day filed past the due date; see instructions ............................. 12

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13. Penalty: If failing to include all nonresident partners on composite return, enter $500; see instructions....................................................... 13

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14. Total Amount Due (add lines 10 through 13). If less than zero, enter on line 15. Make payment in U.S. funds............................................. 14

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15. Overpayment (line 8 plus line 9, minus lines 7, 11, 12, and 13) ....................................................................................................................... 15

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

16. Refund: Amount from line 15. No carryforward allowed. Enter as a positive figure ........................................................................................ 16

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Certification of Signatures and Authorization Section

Under penalties of perjury, I declare I have examined this return, including all accompanying schedules and statements, and to the best of my knowledge

and belief it is true, correct, and complete.

Corporation's Email Address EE

I authorize the Department to discuss my return with my personal

representative (see page 11)

Signature of Corporate Officer

Date

Paid Preparer: Firm’s Name (or yours if self-employed)

Check One:

Federal ID Number

PTIN OR

Social Security Number

Print or Type Name of Corporate Officer