Form It-40 Pnr - Indiana Part-Year Or Full-Year Nonresident Individual Income Tax Return - 1998

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Indiana Part-Year or Full-Year Nonresident
Form
1998
IT-40 PNR
Individual Income Tax Return
Due April 15, 1999
Revised 9/98
If you are not filing for the calendar year January 1 through
SF# 273
December 31, 1998, enter period from: _________to: _________
q q
Your Social
Spouse’s Social
Check the box if you are
Security Number
Security Number
married filing separately.
Your First Name
Initial Last Name
If filing a joint return, Spouse’s First Name
Initial
Last Name
Present Address (Number and Street or Rural Route)
School District
Number (see page 30)
City
State
Zip Code + 4
Foreign Country
(if applicable)
If you have a loss (or negative en-
Enter the 2-digit county code numbers (found on page 6 in the instruction booklet)
try), fill in the oval directly to the left
for the county where you lived and worked on January 1, 1998.
of lines 1 and/or 3. Example:
Taxpayer
Spouse
County where
County where
County where
County where
Please round all entries to nearest
you lived
you worked
you lived
you worked
whole dollar (see instructions, pg 5)
Dollars
Cents
1. Complete Indiana Schedule A first. Enter here the amount from line 35B of
.
,
,
1
Section 3 from that schedule (you must attach Indiana Schedule A) ........................
.
2. Indiana Deductions: Enter the amount from line 18, Schedule D
....
(attach schedule)
,
,
2
.
3. Indiana Adjusted Gross Income: Line 1 minus line 2 .......................................
3
,
,
.
0 0
4. Number of exemptions claimed on your federal return
x $1,000 .............
,
,
4
5. Additional exemption for certain dependent children (see instructions on page 15.)
.
0 0
,
,
Enter number claimed in box
x $500 ........................................................
5
6. Check box(es) below for additional exemptions if, by December 31, 1998:
q or blind q . Spouse was: 65 or older q or blind q .
You were: 65 or older
.
0 0
,
,
6
Number of boxes checked
x $1,000 .................................................................
.
0 0
7
,
,
7. Exemption Subtotal: Add Lines 4, 5 and 6 ..........................................................
.
8. Enter amount from Box 8C of the Proration Section located at the bottom of
8
Indiana Schedule A, Section 1 (you must attach this schedule) .. ...........................
.
,
,
9
9. Total Exemptions: Multiply line 7 by the number on line 8 ...............................
.
,
,
10
10. State Taxable Income: Line 3 minus line 9 (if less than zero, leave blank) ......
.
,
,
11
11. State Adjusted Gross Income Tax: Multiply line 10 by 3.4% (.034) ........................
.
,
,
12. County Income Tax: See if you need to complete Schedule CT-40 PNR ...............
12
.
,
,
13
13. Use Tax due on out-of-state purchases ...................................................................
.
,
,
14
14. Household Employment Taxes: Attach Schedule IN-H ...........................................
.
,
,
15. Total Tax: Add lines 11 through 14. Enter here and on line 22 on the back ......
15
16. Indiana State Tax Withheld: Don't include any withholding amounts for other
.
,
,
16
state taxes. Attach W-2s, WH-18s, or 1099s ..........................................................
17. Indiana County Tax Withheld: Don't include other local taxes. Attach W-2s,
.
,
,
WH-18s, or 1099s ...................................................................................................
17
.
,
18. 1998 Estimated Tax Paid: Include any extension payments made on Form IT-9 ...
,
18
19. Unified Tax Credit for the Elderly (You must be age 65 or older and an Indiana
.
,
,
resident for at least 6 months to qualify. See instructions on page 21.) ..................
19
.
20. Indiana Credits: Enter the amount from Schedule E, line 12 (attach schedule) .....
,
,
20
.
21. Total Credits: Add lines 16 through 20. Enter here and on line 23 on the back
,
,
21
Turn the page
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