Form It-40 - Indiana Full-Year Resident Individual Income Tax Return

Attachment

Schedule IN-EIC

Schedule IN-EIC: Indiana’s Earned Income Credit

Form IT-40/IT-40PNR

Sequence No. 05

Attach only if claiming this credit

State Form 49469 (R1 / 8-02)

Enter your first name, middle initial and last name and spouses full name if filing a joint return

Your Social

Security Number

Section A: Figure your Total Federal Income

Enter the “total income” before federal deductions (e.g. IRA deduction, student loan deduction, etc.) from

your federal Form 1040, Form 1040A, or Form 1040EZ (if less than zero, enter zero) .................................

A1 $ ____________

❒

Is the line A1 amount less than $12,000?

Yes, Continue to Section B.

No, STOP. You do not get this credit.

Section B: Qualifying Child (Read the instructions to explain the terms used below.)

First

Enter each child’s name here

Last

➠ ➠ ➠ ➠ ➠

Enter each child’s

SSN

Social Security Number

Check only one box in each section for each child listed.

❒

Your child

❒

Adopted child

❒

Grandchild

❒

B-1

Stepchild

❒

Foster child, (not related)

Other (related foster child, or

❒

other related child - see instructions)

❒

Under age 18

❒

Age 18

B-2

❒

Age 19 - 24 and a full-time student

❒

Age 19 or older and totally disabled

❒

Child lived with you at least 1/2 of the

year (If not, see below)

B-3

Child was born or died in 2002,

❒

and lived with you while alive in 2002.

You must have a qualifying child to continue to Section C. A child qualifies only if a box is checked in Sections B-1, B-2 and B-3.

If you do not have a qualifying child, STOP. You do not get this credit.

(Attach a separate sheet of paper to list additional children.)

Section C: Figure your Earned Income

Before you begin:

If you were a household employee and received a W-2 for less than $1,300 in 2002 or were a minister or

member of a religious order, see Special Rules in the booklet or on the back of this schedule before

completing this section. Also see Special Rules if your federal adjusted gross income includes workfare

payments or any amount paid to an inmate in a penal institution.

Enter your (and spouses if filing joint) wages, salary, tips and other compensation from federal Form 1040,

1040A, or Form 1040EZ .................................................................................................................................... C1 $ _____________

If you were self-employed, complete the worksheet on the back and enter the amount from line 4 ................. C2 $ _____________

Add lines C1 and C2 and enter here (if this is a loss, STOP. You do not get this credit) ................................. C3 $ _____________

Enter amount from Section A line A1 above $ _______________ Multiply by 80% (.80) and enter here ........ C4 $ _____________

Is the amount on line C3 equal to or greater than the amount on line C4?

❒

No, STOP. You do not get this credit.

Yes, Continue to Section D on the back to figure your credit.

Form It-40 - Indiana Full-Year Resident Individual Income Tax Return - 2002 Page 4

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