Form It-20x - Amended Corporation Income Tax Return

Indiana Department of Revenue

Amended Corporation Income Tax Return

For Calendar Year Ending ______

Form IT-20X

or Other Tax Year

SF 438 Revised 9-00

Beginning

Month _____________,

Year ______

and Ending

Month _____________,

Year ______

(Do Not Write Above)

Federal Identification Number

Name of Corporation

Number and Street

County

Indiana Taxpayer Identification Number

City or Post Office

State

Zip Code

Corporate Telephone Number

(

)

a. Is a federal amended return being filed? ................................

Yes

N o

List years and attach copies of federal waivers of the statute of

b. Is the corporation currently under examination by the

limitations and dates on which waivers expire:

___________________________________________

Indiana Department of Revenue? .........................................

Yes

N o

If yes, indicate years ______________

Is the company under examination by the Internal

Yes

N o

c. Is this the first amended return for this tax year? .................

Yes

N o

Revenue Service? .................................................................

d. Date of incorporation _______________ in state of _________

If yes, state years:

e. Are you in a bankruptcy proceeding? ...................................

Yes

N o

Attach corrected state and federal schedules supporting these changes. Explain change in Part IV on reverse side of the form.

Amount of Change

As Reported or

Correct

Explain on Part IV

Last Determined

Amount

Part I

- Summary of Tax Calculations

Gross income tax (attach schedule if corrected) .............................

Adjusted gross income ....................................................................

Adjusted gross income tax - multiply line 2 by the applicable rate..

Subtract the greater of lines 1 or 3 from line 2 and enter difference

Supplemental net income tax - multiply line 4 by the applicable rate

Total income tax - greater of lines 1 or 3, plus line 5 ....................

Sales/use and other taxes ................................................................

Total tax due - add lines 6 and 7 ....................................................

Part II

- Credits and Payments

Amount of estimated tax paid (including extension payment)........

10.

Gross income tax paid on real estate sales (attach additional receipts)

11.

College and University Credit (attach schedule if corrected) .........

12.

Other credits (attach an explanation if changed from original claim)

13.

Amount previously paid with the original return ...........................

14.

Amount paid on prior amended return ...........................................

15.

Amount paid for audit adjustment .................................................

16.

Total credits - add lines 9 through 15 ............................................

LESS:

Amount previously refunded (include amounts credited to IT-6 estimated account) .........................................................

17.

18.

Amount of all penalty and interest previously paid ...........................................................................................................

19.

Net credits - subtract lines 17 and 18 from line 16 column C ..........................................................................................

Part III -

Remittance Due or Refund (see instructions)

20.

Balance due (If line 8 is greater than 19, enter difference) ..........................................................................................

21.

Penalty (10% of line 20 or $5.00, whichever is greater) .............................................................................................

22.

Interest (see instructions) ...........................................................................................................................................

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23.

Total remittance due - add lines 20, 21 and 22 ................................................................ PAY THIS AMOUNT

24.

Total overpayment (If line 19 is greater than line 8, enter the difference)..........

25.

Amount of line 24 to be refunded........................................................................

26.

Amount of line 24 to be applied to the current estimated income tax account for year ending:__________................

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Make checks payable to the Indiana Department of Revenue and mail to: 100 North Senate Avenue, Indianapolis, Indiana 46204-2253.

NOTE: If the corporation is undergoing a bankruptcy proceeding, mail to: Indiana Department of Revenue, Compliance Division, Bankruptcy Section,

Indiana Government Center North, 100 N. Senate Avenue, Indianapolis, Indiana, 46204-2253.

Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and

belief it is true, correct, and complete. I authorize the Department to discuss my return with my tax preparer. Yes

Signature of Corporate Officer

Date

Print or Type Name

Title

Name

Preparer's FID, SSN, or PTIN Number

Check One

Federal I.D. Number

Social Security Number

Street Address

Daytime Telephone Number