Form It-40rnr - Reciprocal Nonresident Indiana Individual Income Tax Return

Information for Lake County, Indiana

If you and/or your spouse worked in Lake County, Indiana, on Jan.1, 2008, enter your and/or your spouse's 4-digit identifying

number from the Lake County Chart below.

Your 4-digit Lake County number

Spouse's 4-digit Lake County number

Authorization

Under penalty of perjury, I have examined this return and all attachments and to the best of my knowledge and belief, it is true, com-

plete and correct. I understand that if this is a joint return, any refund will be made payable to us jointly and each of us is liable for

all taxes due under this return. Also, my request for direct deposit of my refund includes my authorization to the Indiana Department

of Revenue to furnish my financial institution with my routing number, account number, account type and Social Security number to

ensure my refund is properly deposited. I give permission to the Department to contact the Social Security Administration to confirm

that the Social Security number(s) used on this return is correct.

Daytime telephone number

Your Signature __________________________________

Date _____________

E-mail address where we can reach you

Spouse’s Signature ______________________________

Date _____________

□

I authorize the department to discuss my return with my

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

personal representative (see below)

Yes

If yes, complete the information below.

______________________________________________________

□

Personal Representative’s Name (please print)

IN-OPT on file with paid preparer if not filing electronically

□

____________________________________________________

Federal I.D. Number

PTIN OR

Social Security Number

Telephone

number

Telephone

number

Address _____________________________________________

Address _______________________________________________

City ________________________________________________

City __________________________________________________

State _____________________

Zip Code + 4 ___________

State _______________________

Zip Code + 4 ___________

Signature __________________________

Date ______________

at the top of this page the 4-digit number

First, you must check the “Yes” box which

Lake County Chart

(from the chart to the left) associated with

follows the sentence “I authorize the De-

4504

Cedar Lake

4529

Lowell

that location. If you and/or your spouse

partment to discuss my tax return with my

worked in Lake County community not on

personal representative.”

4506

Crown

4530

Merrillville

the list, enter the 4-digit number 4599.

Point

Next, enter:

4511

Dyer

4531

Munster

•

Authorization/Signature Section

The name of the individual you are des-

4512

East

4532

New Chicago

If this is a joint return, both you and your

ignating as your personal representa-

Chicago

spouse must sign and date the tax re-

tive.

•

4513

Gary

4540

Schererville

turn. Please enter your daytime telephone

That person's telephone number.

•

number so we can call you if we have any

That person's complete address.

4515

Griffith

4541

Schneider

questions about your tax return. Also, en-

ter your e-mail address if you would like us

If you complete this area, you are authoriz-

4516

Hammond

4546

St. John

to be able to contact you by e-mail.

ing the Department to be in contact with

4518

Highland

4549

Whiting

someone other than you concerning in-

Personal Representative Information

formation about this tax return. After your

4519

Hobart

4550

Winfield

Typically, the Department will contact you

return is filed, the Department will commu-

(and your spouse, if filing jointly) if there

nicate primarily with your designated per-

4524

Lake

4599

Other

are any questions or concerns about your

sonal representative.

Station

Communities

tax return. If you want the Department to

be able to discuss your tax return with

Note: If you are due a refund, it will be paid

Lake County Information

someone else (e.g. the person who pre-

to you (and your spouse, if filing jointly)

If you and/or your spouse worked in Lake

pared it, a relative or friend, etc.), you’ll

even if you designate a personal repre-

County, Indiana, on Jan. 1, 2008, enter

need to complete this area.

sentative.

*160081101*

160081201

Form It-40rnr - Reciprocal Nonresident Indiana Individual Income Tax Return - 2008 Page 2

Related Articles

Related forms

Related Categories