Form It-20s - Schedule In K-1 - Shareholder'S Share Of Indiana Adjusted Gross Income, Deductions, Modifications And Credits - 2005

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IT-20S 2005
Indiana Department of Revenue
Schedule IN K-1
Shareholder's Share of Indiana Adjusted Gross Income, Deductions, Modifications and Credits
State Form 49193
(R4/8-05)
For Tax Year Beginning ________/________/ 2005 and Ending ________/________/ __________
AA
BB
Name of Corporation
Federal Identification Number
A
B
Distributions -
Provide IN K-1 information for each shareholder. Attach IN K-1 to IT-20S return.
Pro rata amounts for lines 1 through 12 of any non-resident shareholders must be multiplied by the Indiana apportionment percent, if applicable from
IT-20S, line 5.
Identification Section of Shareholder:
(a) Name of Shareholder:
(b) Social Security Number or Federal Identification Number:
(c) Shareholder's State of Residence:
(d) Indiana Tax Withheld for Nonresident Shareholder:
$
(e) Shareholder's Federal Pro Rata Percentage:
%
Distributive Share Amounts
(Omit Cents)
1.
Ordinary income (loss) from trade or business activities ..............................................
2.
Income (loss) from rental real estate activities .............................................................
3.
Other net rental income (loss) .....................................................................................
4.
Interest income ...........................................................................................................
5a.
Ordinary dividends .......................................................................................................
6.
Royalties .....................................................................................................................
7.
Net short-term capital gain (loss) Schedule D, Form 1120S .........................................
8a.
Net long-term capital gain (loss) Schedule D, Form 1120S ..........................................
9.
Net IRC Section 1231 gain (loss) Form 4797 ...............................................................
10.
Other income (loss) .....................................................................................................
11.
IRC Section 179 expense deduction ............................................................................
F
12A. Portion of expenses related to investment portfolio income, including investment interest
expense and other (federal non-itemized) deductions ..................................................
12B. Other information from line 17 of federal K-1 related to investment interest and expenses
not listed elsewhere ....................................................................................................
13.
Total pro rata distributions (add lines 1 through 10, subtract lines 11 and 12 when ......
applicable).
14.
State modifications - Designate the distributive share amount of each
modification for Indiana adjusted gross income from line 2 on front of
Form IT-20S: 2(a) __________
2(b) __________
2(c) __________
2(d) __________
2(e) __________
2(f) __________
Total distributive share of modifications
15.
Pro rata share of Indiana pass-through tax credits from corporation (indicate
type and total amount):________________________________________________)

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