Form It-40 - Indiana Full-Year Resident Individual Income Tax Return - 2003
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Indiana Full-Year Resident
2003
Due April 15, 2004
IT-40
Individual Income Tax Return
State Form 154
If you are not filing for the calendar year January 1 through December 31, 2003,enter period from: _________to: _________
8-03
Check the box if you
Your Social
Spouse’s Social
are married filing
Security Number
Security Number
separately.
C
A
B
Your first name
Initial
Last name
F
D
E
If filing a joint return, spouse’s first name
Initial
Last name
G
H
I
Present address (number and street or rural route) (If you have a P.O. box, see page 6.)
School District
Number (see page 34)
N
J
City
State
Zip Code + 4
Foreign Country
(if applicable)
K
L
M
O
Enter the 2-digit county code numbers (found on page 7 in the instruction booklet) for the
If you have a loss (or negative entry),
county where you lived and worked on January 1, 2003.
please indicate so by placing it in a
Taxpayer
Spouse
bracket. Example: ( 1.00 )
P
R
S
Q
Please round all entries to
County where
County where
County where
County where
nearest whole dollar
you lived
you worked
you lived
you worked
(see instructions, pg 7)
1
1. Enter your federal adjusted gross income from your federal return (see page 10) .......................
2
2. Tax Add-Back: certain taxes deducted from federal Schedule C, C-EZ, E, and/or F .....................
3
3. Net operating loss carryforward from federal Form 1040, ‘Other income’ line ..............................
4
4. Income taxed on federal Form 4972 (attach Form 4972: see page 10) .......................................
5
5. Other (see instructions on page 10) ...............................................................................................
6
6. Add lines 1 through 5 ................................................................................ Total Indiana Income
7
7. Indiana deductions: Enter amount from Schedule 1, line 20 and attach Schedule 1 ...................
8. Line 6 minus line 7 ................................................................. Indiana Adjusted Gross Income
8
9. Number of exemptions claimed on your federal return
x $1,000.
00
9
(If no federal return was filed, enter $1,000 per qualifying person: see page 16.) ........................
10. Additional exemption for certain dependent children (see page 16.)
00
10
Enter number
x $1,500 .....................................................................................................
11. Check box(es) below for additional exemptions if, by December 31, 2003:
You were:
65 or older
or blind. Spouse was:
65 or older
or blind.
00
11
Total the number of boxes checked
x $1,000 ..................................................................
12. Check box(es) below for additional exemptions if, by December 31, 2003:
You were:
65 or older and line 1 above is less than $40,000.
Spouse was:
65 or older and line 1 above is less than $40,000.
00
12
Total the number of boxes checked
x $500 ....................................................................
00
13
13. Add lines 9, 10, 11 and 12 .............................................................................. Total Exemptions
14
14. Line 8 minus line 13
..................... State Taxable Income
(if answer is less than zero, leave blank)
15
15. State adjusted gross income tax: Multiply line 14 by 3.4% (.034) ................................................
16
16. County income tax. See instructions on page 17 .........................................................................
17
17. Use tax due on out-of-state purchases (see page 20) ...................................................................
18
18. Household employment taxes: Attach Schedule IN-H (see page 20) ...........................................
19
19. Indiana advance earned income credit payments from W-2(s) (see page 20) .............................
20
20. Add lines 15 through 19. Enter here and on line 29 on the back ................................ Total Tax
21
21. Indiana state tax withheld:
......................
(From box 17 of your W-2s, box A of WH-18s or from 1099s)
22
22. Indiana county tax withheld:
(From box 19 of your W-2s, box B of WH-18s or from 1099s) ...................
23
23. 2003 Estimated tax paid: Include any extension payment made on Form IT-9 ............................
24
24. Unified tax credit for the elderly: see instructions on page 22 .................................................
25
25. Earned income credit: Attach Schedule IN-EIC and enter amount from Section A, line A2 .........
26
26. Lake County residential income tax credit (see page 23) ..............................................................
27
27. Indiana credits: Enter the total from Schedule 2, line 12 and attach Schedule 2 ..........................
28
28. Add lines 21 through 27. Enter here and on line 30 on the back ........................... Total Credits
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CC
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