Schedule A (Form It-40pnr) - Section 1: Income Or Loss - 2012 Page 2

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Schedule A
Schedule A Proration;
Enclosure
2012
Form IT-40PNR
Sequence No. 01A
Section 2: Adjustments to Income
Page 2 of 2
Proration Section See instructions on page 17.
21C. Note: Nonresident military personnel see special instructions on page 17.
.00
and complete worksheet. ________________________________________________________ 21C
21D. For all other individuals, divide the amount on line 21B by the amount on line 21A (see instructions
if either line 21A and/or 21B are less than zero). Please round your answer to a decimal followed
by three numbers. Example: $3,100
$8,000 = .3875, which rounds to .388 (do not enter a
÷
.
number greater than 1.00). Enter result here and on Schedule D, line 6 _________________________
21D
Section 2: Adjustments to Income Note: Enter in Column A only those deductions claimed on your 2012 federal income tax return,
Form 1040, 1040A or 1040EZ. Round all entries.
Column A
Column B
Line-by-line instructions continue on page 17.
Federal Adjustments
Indiana Adjustments
.00
22. Educator expenses (see instructions) _________________
22A
23. Certain business expenses of reservists,
.00
.00
performing artists, etc _____________________________
23A
23B
.00
.00
24. Health savings account deduction ____________________
24A
24B
.00
.00
25. Moving expenses (see instructions on page 17 ) _________
25A
25B
.00
.00
26. Deductible part of self-employment tax ________________
26A
26B
.00
.00
27. Self-employed, SEP, SIMPLE, and qualifi ed plans _______
27A
27B
.00
.00
28. Self-employed health insurance deduction _____________
28A
28B
.00
.00
29. Penalty on early withdrawal of savings ________________
29A
29B
.00
.00
30. Alimony paid ____________________________________
30A
30B
.00
.00
31. IRA deduction ____________________________________
31A
31B
.00
.00
32. Student loan interest deduction (see instructions) ________
32A
32B
.00
33. Tuition and fees deduction (see instructions)____________
33A
.00
34. Domestic production activities deduction _______________
34A
.00
.00
35. Other (see instructions)
35A
35B
.00
.00
36. Add lines 22 through 35 ____________________________
36A
36B
Section 3: Totals
37. Subtract line 36 from line 21 of Section 1. Carry
.00
.00
amount from line 37B to Form IT-40PNR, line 1 ________
37A
37B
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23412121694

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