Form Fit-20 - Indiana Financial Institution Tax Return - 2004
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5Indiana Department of Revenue
Indiana Financial Institution Tax Return
For Calendar Year Ending December 31, 2004
or Fiscal Year Beginning_______/_______/ 2004 and Ending_____/_____/_____
BB
Form FIT-20
AA
Federal Identification Number
State Form 44623 (8-04)
A
Name of Corporation
Principal Business Activity Code
B
H
Number and Street
County
Indiana Taxpayer Identification Number
D
I
C
City
State
Zip Code
Corporation Telephone Number
J
(
)
E
G
F
K
Check box if this is a state chartered credit union or an investment company registered under the Investment Company Act of 1940.
(Also see instructions for line 18 and FIT-20 Schedule E-U)
Date of incorporation
in the State of
L.
S.
1
Check:
2
State of Commercial Domicile
M.
Initial Return
Final Return
In Bankruptcy
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2
3
Year of initial Indiana return
N.
Location of accounting records if different from above
O.
T.
Is this return filed on a combined basis under the unitary
address:
concept? ..................................................
Yes
No
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2
Accounting method:
Cash
Accrual
P.
U.
Is this a separate return by a member of a unitary group?
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2
Did the corporation make estimated tax payments using a
Q.
(See instructions pages 4 and 10 ) ...........
Yes
No
1
2
different Federal Identification Number?
Yes
No
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2
List any other Federal Identification Numbers on Schedule H.
V.
Is an extension of time to file attached? ...
Yes
No
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2
Is 80% or more of your gross income derived from making,
R.
acquiring, selling, or servicing loans or extensions of
W.
Are you a member of a partnership? ........
Yes
No
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2
credit?
Yes
No
If you answer no, do not file this
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If you answer yes, see instructions page 4.
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return; file Form IT-20.
Schedule A
Income:
1. Federal taxable income (before net operating loss deduction and special federal deduction) . 1
2. Qualifying dividend deduction ................................................................................................ 2
3. Subtotal (Subtract line 2 from line 1) ........................................................................................ 3
Addback: Enter an amount equal to the deduction taken for:
4. Bad debts (IRC Sec. 166) (see instructions) .............................. 4
5. Bad debt reserves for banks (IRC Sec. 585) .............................. 5
2004
6. Bad debt reserves (IRC Sec. 593) .............................................. 6
7. Charitable contributions (IRC Sec. 170) .................................... 7
8. All state and local income taxes ................................................ 8
FIT-20
9. Do not use
10. Amount of interest excluded for state and local obligations
(IRC Sec. 103) minus the associated expenses (IRC Sec. 265). .. 10
11. Other income: Add net bonus depreciation plus excess IRC
Section 179 adjustment Attach explanation. If amount is
negative enter in <brackets> ..................................................... 11
12. Total Addbacks: (Add lines 4 through 11) ..............................................................................
12
13. Subtotal (Add line 3 and line 12) .............................................................................................
13
Deductions:
14. Subtract income that is derived from sources outside the
United States and was included in federal taxable income ........ 14
15. Subtract an amount equal to a debt or portion of a debt that
becomes worthless - net of all recoveries (IRC Sec. 166) ......... 15
16. Subtract an amount equal to any bad debt reserves that are
included in federal income because of accounting method
changes (IRC Sec. 585(c)(3)(a) or Sec. 593) ............................... 16
17. Total Deductions: (Add lines 14 through 16) ..........................................................................
17
18. Total Income Prior to Apportionment: (Subtract line 17 from line 13) ...................................
18
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