Form It-41 - Fiduciary Income Tax Return
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INDIANA DEPARTMENT OF REVENUE
IT-41
FIDUCIARY INCOME TAX RETURN
State Form 11458
(R7 / 8-11)
For the calendar year ending
or fiscal year beginning
and ending
Name of Estate or Trust
Address
Name and Title of Fiduciary
City
State
Zip Code
Federal Identification Number
1. Taxable Income of Fiduciary from Federal Form 1041or Unrelated Business Taxable Income
.00
from Federal Form 990T _____________________________________________________
1
INCOME
AND
.00
2. Indiana Additions or Add-backs, see Line 2 instructions _____________________________
2
INDIANA
ADDITIONS
.00
3. Lump Sum Distribution from Federal Form 4972 __________________________________
3
.00
4. Net Operating Loss Deduction from Federal Return ________________________________
4
.00
5. Total Income (Add lines 1 through 4) __________________________________________
5
.00
6. Interest on U.S. Obligations Reported on Federal Return ___________________________
6
INDIANA
.00
7. Non-Indiana Fiduciary Income ________________________________________________
7
DEDUCTIONS
.00
8. Enter Indiana Portion of Net Operating Loss Deduction
8
(Attach Schedule IT-40NOL, see instructions)
.00
9. State Taxable Income (Line 5 minus lines 6 through 8) _____________________________
9
.00
10. State Adjusted Gross Income Tax (3.4% of line 9) __________________________________
10
TAX
COMPUTATIONS
.00
11. Additional Tax, see Line 11 instructions _________________________________________
11
.00
12. Total Tax (Add lines 10 and 11) _______________________________________________
12
.00
13. Fiduciary Estimated Tax Paid _________________________________________________
13
CREDITS
.00
14. Other Credits (You MUST attach verification), see Line 14 instructions _________________
14
.00
15. Total Credits (Add lines 13 and 14.) ___________________________________________
15
.00
16. Balance of Tax Due (If line 12 is greater than line 15, enter the difference) _____________
16
.00
17. Penalty, see Line 17 instructions _______________________________________________
17
.00
18. Interest, see Line 18 instructions ______________________________________________
18
.00
19. Total Amount Due Add lines 16 through 18 _________________________ PAYMENT DUE 19
.00
20. Refund Due (If line 15 is greater than line 12, enter the difference) ____________ REFUND 20
UU
Turn over to the back for Signatures
*24211111694*
24211111694
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