Form It-65 - Indiana Partnership Return - 2016 Page 2

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7.
Total tax (add lines 5 and 6). Caution: If line 7 is zero, see line 16 late file penalty ___________
7
.00
8.
Total amount of pass-through withholding (enclose IN K-1 from the paying entity) ___________
8
.00
9.
Total composite withholding IT-6WTH payments (see instructions) _______________________
9
.00
10. Other payments/credits (enclose documentation) ____________________________________
10
.00
11. EDGE credit. Enter the total EDGE credit amount claimed (line 19 on Schedule IN-EDGE) ____
11
.00
12. EDGE-R credit. Enter the total EDGE-R credit amount claimed (line 19 on Schedule IN-EDGE-R) 12
13. Certified Credits. Enter the total of certified credits claimed from Schedule IN-OCC and enclose
.00
this schedule with your return. ___________________________________________________
13
.00
14. Subtotal (line 7 minus lines 8-13). If total is greater than zero, proceed to lines 15-17 ________
14
.00
15. Interest:Enter total interest due; see instructions (contact the department for current interest rate) 15
16. Penalty: If paying late, enter 10% of line 14. If line 7 is zero, enter $10 per day filed past the
.00
due date; see instructions _______________________________________________________
16
17. Penalty: If failing to include all nonresident partners on composite return, enter $500;
.00
see instructions _______________________________________________________________
17
18. Total Amount Due (add lines 14-17). If less than zero, enter on line 19.
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Make payment in U.S. funds _____________________________________________________
18
19. Overpayment and Refund Amount (add lines 8-13, and then subtract lines 7, 15, 16, and 17).
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No carryforward allowed. _______________________________________________________
19
Certification of Signatures and Authorization Section
Under penalties of perjury, I declare I have examined this return, including all accompanying schedules and statements, and to the best
of my knowledge and belief it is true, correct, and complete.
Paid Preparer’s
Email Address
I authorize the Department to discuss my return with my
Paid Preparer: Firm’s Name (or yours if self-employed)
personal representative (see instructions).
Y
N
Date _________________________
Paid Preparer’s Name
Personal Representative’s Name (please print)
PTIN
Email
Address
Telephone Number
Signature of
Address
Corporate Officer __________________________________
City
Print or Type Name of Corporate Officer
State
Zip Code+4
Title
Paid Preparer’s Signature ____________________________
Date _____________________________________________
If you do not owe any tax, mail it to IN Department of Revenue,
If you owe tax, please mail your return to IN Department of
Revenue, PO Box 7205, Indianapolis, IN 46207-7205.
PO Box 7147, Indianapolis, IN 46207-7147.
*12216121594*
12216121594

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