Form In-40sp - Indiana Innocent Spouse Allocation Worksheet Page 2
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1
2Allocation Between Spouses of Items on the Joint Indiana Individual Income Tax Return
Part 2
(a)
(b)
Amount allocated to
(c)
Amount allocated to
Amount shown
Allocated Items
innocent spouse
responsible spouse
on joint federal and
Indiana tax returns
5. Income. Enter the separate income that each spouse
earned. Allocate joint income, such as interest earned on
a joint bank account, as you determine. Be sure to
allocate all income shown on the joint tax return.
a) Wages .......................................................................
b) All other income. Identify the type and amount:
6. Adjustments claimed on your federal tax return.
Enter each spouse’s separate adjustments, such as an
IRA deduction. Allocate other adjustments claimed on
your federal return as you determine ..............................
7. Indiana deductions. Enter each spouse’s share of
deductions, such as renter’s deduction, that was claimed
on the Indiana tax return. Allocate other adjustments
claimed on your Indiana return as you determine ............
8. Number of exemptions. Allocate the exemptions
claimed on the joint Indiana return to the spouse who
would have claimed them if separate returns had been
filed. Enter whole numbers only (for example, you
cannot allocate 3 exemptions by giving 1.5 exemptions to
each spouse). Show the division of exemptions by type,
such as 2 exemptions claimed on Indiana return plus 1
additional exemption for certain dependent child ............
9. Withholding credits. Enter Indiana state and county tax
withheld from each spouse’s income as shown on the
W-2s, 1099-Rs, W-2Gs, etc. Be sure to attach copies of
these forms to this worksheet .........................................
10. Credits. Allocate any child tax credit to the spouse who
was allocated the dependent’s exemption. Allocate all
other Indiana credits based on each spouse’s interest ....
11. Payments. Allocate joint estimated tax payments as you
determine ........................................................................
Note: The Indiana Department of Revenue will figure the amount of any refund due the innocent spouse, if applicable.
Signature Area
Part 3
Under penalties of perjury, I declare that I have examined this form and any accompanying schedules or statements and to the best of my knowledge and
belief, they are true, correct, and complete. Declaration of preparer (other than taxpayer) is based on all information of which preparer has any knowledge.
Keep a copy
Innocent spouse’s signature
Date
Phone number
of this worksheet
(
)
with your records
Preparer’s signature
Date
Preparer’s SSN or PTIN
Check if self-
Paid Preparer’s
employed
Use Only
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