Form It-40ez - Indiana Income Tax Return For Full-Year Indiana Resident Filers With No Dependents - 2013 Page 2

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Indiana Deduction Worksheet

1.Renter’s deduction

Address where rented if different from the one on the front page (enter below)

Total amount of rent paid

Landlord’s name and address (enter below)

. 00

Number of months rented

Enter the lesser of $3,000 OR total amount of rent paid _____

. 00

2. Enter the amount from line 7 of the unemployment compensation worksheet found on page 8 _____

.00

3. Total deductions: Add lines 1 and 2. Carry this total to page 1, line 2 ___________________________

.00

Extension of time to ﬁ le

Place “X” in box if you have ﬁ led a federal extension of time to ﬁ le, Form 4868

Place “X” in box if you have ﬁ led an Indiana extension of time to ﬁ le, Form IT-9, or online via e-Pay.

Date of Death

If any individual listed at the top of the IT-40EZ died during 2013, enter date of death below (MMDD).

Taxpayer's date of death

Spouse’s date of death

2013

Authorization

Under penalty of perjury, I have examined this return and all attachments and to the best of my knowledge and belief, it is true, complete and correct. I

understand that if this is a joint return, any refund will be made payable to us jointly and each of us is liable for all taxes due under this return. Also, my

request for direct deposit of my refund includes my authorization to the Indiana Department of Revenue to furnish my ﬁ nancial institution with my routing

number, account number, account type, and Social Security number to ensure my refund is properly deposited. I give permission to the Department to

contact the Social Security Administration in order to conﬁ rm the Social Security number(s) used on this return are correct.

Your Signature

Date

Daytime telephone number

Spouse’s Signature

Date

Email address where we can reach you

Paid Preparer: Firm’s Name (or yours if self-employed)

I authorize the Department to discuss my return with my personal

representative (see page 10 ).

Yes