Form Fit-20 - Indiana Financial Institution Tax Return - 2004 Page 2
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52004 Indiana Financial Institution Tax Return
Form FIT-20
Page 2
19. Total Income Prior to Apportionment(Amount from line 18) ............................................................. 19
20. Apportionment Percentage (Box number 97 of Schedule E-U) ........................................................... 20
.
%
21. Apportioned income attributable to Indiana
21
(Multiply line 19 by line 20) .............
22. Department use only. Do not write in this space
23. Total as Apportioned Adjusted Gross Income: Amount from line 21. See instructions .................... 23
24. Indiana Net Operating Loss Deduction from Schedule FIT-20 NOL .................................................. 24
25. Indiana Adjusted Gross Income (Subtract line 24 from line 23) .......................................................... 25
26. Financial Institution Tax (Multiply line 25 by .085) ............................................................................. 26
28. Less: Nonresident Taxpayer Credit (Attach Schedule FIT-NRTC) ..................................................... 28
29. Net Financial Institution Tax Due (Subtract line 28 from line 26) ....................................................... 29
30. Sales/Use Tax Due (See instructions) ................................................................................................. 30
31. Subtotal Due (Add lines 29 and 30) .................................................................................................... 31
Credits (Attach schedules):
32. Neighborhood Assistance Tax Credit (NC-20) .......................................... 32
33. Enterprise Zone Employment Expense Credit (EZ 2) ................................. 33
34 Enterprise Zone Loan Interest Tax Credit (LIC) ........................................ 34
35. Teacher Summer Employment Tax Credit (Attach Certification) ............... 35
36. Industrial Recovery Tax Credit .................................................................. 36
37. Other_________________________________ .................................... 37
a
38. Total Credits: (Add lines 32 through 37) ............................................................................................. 38
39. Net Tax Due: (Subtract line 38 from line 31) ........................................................................................ 39
Estimated Tax and OtherPayments
40. Total estimated financial institution tax paid (Itemize quarterly FT-QP
payments below)
1._________ 2.__________ 3.__________ 4.__________ ................ 40
41. Extension payment _________and prior year
a
overpayment credit _________ Enter combined total .............................. 41
b
42. Other payments/EDGE credit (Attach supporting documentation) .......... 42
43. Total Payments (Add lines 40 through 42) .......................................................................................... 43
44. Balance of Tax Due (Subtract line 43 from line 39. If line 43 exceeds line 39 - Enter -0-) .................... 44
45. Penalty for the Underpayment of Tax from Schedule FIT-2220 (Form page 4) ................................... 45
46. If payment is made after the original due date, add interest (See instructions) ................................... 46
47. Late penalty: If paying late enter 10% of line 44: see instructions. If line 31 is zero, enter $10 per day
filed past due date ............................................................................................................................... 47
48. Total Due (Add lines 44 through 47) Payable in U.S. funds to: Indiana Department of Revenue ...... 48
49. Total Overpayment (Subtract lines 39 and 45 from line 43) ....................... 49
50. Refund (Enter portion of line 49) ............................................................... 50
51. Overpayment Credit (Amount of line 49 to be applied to next year's estimated tax account) ............. 51
Certification of Signatures and Authorization Section
Do not write in box below
DD
I authorize the Department to discuss my return with my tax preparer.
Yes
CC
Taxpayer's E-mail address EE
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.
Signature of Officer
Date
Print or Type Name of Officer
Title
LL
MM
Paid Preparer's Name
Preparer's FID, SSN, or PTIN Number
Check One:
OO
1
Federal I.D. Number
2
Social Security Number
FF
NN
PTIN Number
3
Street Address
Preparer's Daytime Telephone Number
GG
PP
City
State
Zip+4
Preparer's Signature
II
JJ
HH
Indiana Department of Revenue, 100 N. Senate Avenue, Indianapolis, IN 46204-2253.
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