Form It-20s - Schedule In K-1 - Shareholders'S Share Of Indiana Adjusted Gross Income, Deductions, Modifications, And Credits - 2013

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IT-20S
2013 Schedule IN K-1
Indiana Department of Revenue
State Form 49193 (R13 / 8-13)
Shareholder’s Share of Indiana Adjusted Gross Income, Deductions, Modifications, and Credits
Tax Year Beginning
2013 and Ending
Name of S Corporation
Federal Identification Number
Distributions - Provide IN K-1 to each shareholder. Enclose IN K-1 with IT-20S return. For information on the
acceptable electronic data file format, visit the Department’s website at Pro rata
amounts for lines 1 through 25 of any nonresident shareholder must be multiplied by the Indiana
apportionment percent, if applicable, from IT-20S, line 4.
Part 1 – Shareholder’s Identification Section
(a) If Shareholder Is an Individual (please print clearly)
Social Security Number:
Last Name:
First Name:
a1 ___________________________________
a2 ___________________________
a3
(b) If Shareholder Is an Other Entity (please print clearly)
Federal Identification Number:
Name:
b1 ___________________________________________________________________
b2
(c) Shareholder’s State of Residence or Commercial Domicile ....................................................c1
(d) Indiana Tax Withheld for Nonresident Shareholder (on WH-18) .............................................. d
00
Enter federal ID number from pass-through WH-18 _________________________________
.
%
(e) Shareholder’s Federal Pro Rata Percentage .......................................................................... e
00
(f) Shareholder’s Tax as Computed on IT-20SCOMP Column G ................................................ f
Part 2 - Distributive Share Amount
r
(use apportioned figures for nonresident shareholde
)
00
1. Ordinary business income (loss) ....................................................................................................
00
2. Net rental real estate income (loss) ...............................................................................................
00
3. Other net rental income (loss) ........................................................................................................
00
4. Interest income ...............................................................................................................................
00
5. Ordinary dividends .........................................................................................................................
00
6. Royalties ......................................................................................................................................
00
7. Net short-term capital gain (loss) ..................................................................................................
00
8. Net long-term capital gain (loss) ....................................................................................................
00
9. Net IRC Section 1231 gain (loss) ..................................................................................................
00
10. Other income (loss) .......................................................................................................................
00
11. IRC Section 179 expense deduction ..............................................................................................
12a. Portion of expenses related to investment portfolio income, including investment interest
00
expense and other (federal nonitemized) deductions ..................................................................
12b.Other information from line 17 of federal K-1 related to investment interest and expenses
00
not listed elsewhere .....................................................................................................................
13. Total pro rata distributions (Add lines 1 through 10; subtract lines 11, 12a, and 12b
00
when applicable.) ...........................................................................................................................
Continued on next page
*12113111594*
12113111594

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