Form It-20s/it-65 - Schedule In K-1 - Shareholder'S/partner'S Share Of Indiana Adjusted Gross Income, Deductions, Modifications, And Credits - 2014

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IT-20S/IT-65
2014 Schedule IN K-1
Indiana Department of Revenue
State Form 49181 (R14 / 8-14)
Shareholder’s/Partner’s Share of Indiana Adjusted Gross Income, Deductions, Modifications, and Credits
Tax Year Beginning
2014 and Ending
Name of S Corporation/Partnership
Federal Identification Number
Distributions - Provide IN K-1 to each shareholder/partner. Enclose IN K-1 with IT-20S/IT-65 return. For
information on the acceptable electronic data file format, visit the department’s website at
Pro rata amounts for lines 1 through 26 of any nonresident shareholder/partner
must be multiplied by the Indiana apportionment percent, if applicable, from IT-20S/IT-65, line 4.
Part 1 – Shareholder/Partner’s Identification Section
(a) If shareholder/partner is an individual (please print clearly)
Social Security Number:
Last Name:
First Name:
a1 ___________________________________
a2 ___________________________
a3
(b) If shareholder/partner is an other entity (please print clearly)
Federal Identification Number:
Name:
b1 ___________________________________________________________________
b2
(c) Shareholder/partner’s state of residence or commercial domicile ............................................c1
(d) Indiana tax withheld for nonresident shareholder/partner (on WH-18 or IT-6WTH) ................. d
00
Enter federal ID number of the entity remitting withholding ____________________________
.
%
(e) Shareholder/partner’s federal pro rata percentage ................................................................. e
00
(f) Shareholder/partner’s tax as computed on IT-20SCOMP/IT-65COMP Column F .................. f
Part 2 - Distributive Share Amount
(use apportioned figures for nonresident shareholders/partners)
00
1. Ordinary business income (loss) ....................................................................................................
00
2. Net rental real estate income (loss) ...............................................................................................
00
3. Other net rental income (loss) ........................................................................................................
00
4. Guaranteed payments (for IT-65 filers only; if filing IT-20S, skip to line 5) ..............................
00
5. Interest income ...............................................................................................................................
00
6. Ordinary dividends .........................................................................................................................
00
7. Royalties ......................................................................................................................................
00
8. Net short-term capital gain (loss) ..................................................................................................
00
9. Net long-term capital gain (loss) ....................................................................................................
00
10. Net IRC Section 1231 gain (loss) ..................................................................................................
00
11. Other income (loss) .......................................................................................................................
00
12. IRC Section 179 expense deduction ..............................................................................................
13a. Portion of expenses related to investment portfolio income, including investment interest
00
expense and other (federal nonitemized) deductions ..................................................................
13b.Other information from line 20 of federal K-1 related to investment interest and expenses
00
not listed elsewhere .....................................................................................................................
14. Total pro rata distributions (Add lines 1 through 11; subtract lines 12, 13a, and 13b
00
when applicable.) ...........................................................................................................................
Continued on next page
*13614111594*
13614111594

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