Schedule 8-D (State Form 49103) - Schedule Of Indiana Affi Liated Group Members
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1
2State Form 49103
Indiana Department of Revenue
(R5 / 8-11)
Schedule 8-D
Schedule of Indiana Affi liated Group Members
for Period Beginning Month
_______________ Year _______ and Ending Month
_______________ Year ________
BB
AA
This schedule must be enclosed with Form IT-20, Form IT-20S, or Form URT when fi ling on a consolidated basis.
Complete each column listing all members of an affi liated controlled group included in the Indiana consolidated adjusted
gross income tax or utility receipts tax return. All affi liated companies in the consolidated group are required to use the
identical accounting period.
Check column A if the corporation is a new addition to the Indiana affi liated group. Indicate the amount in column E if any
estimated tax was separately paid by the affi liate under its ID number. Indicate in column F the date the corporation quali-
fi ed to do business in Indiana.
Affi liated Entities Filing Consolidated Indiana Return
A
B
C
D
E
F
if
Estimated tax
Qualifying
Date/state
Name/address of each affi liated corporation
Federal ID number
paid by affi liate
date
of incorporation
new
24100000000
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