Form It-65 - Indiana Partnership Return - 2003
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1Indiana Department of Revenue
Indiana Partnership Return
for Calendar Year Ending December 31, 2003
or
Other Tax Year Beginning
AA
________/________/
2003
and Ending
________/________/ __________
BB
(Please Do not write above)
Form IT-65
Federal Identification Number
State Form 11800 (9-03)
A
Principal Business Activity Code
Name of Partnership
B
H
Indiana Taxpayer Identification Number
Number and Street
Indiana County or O.O.S.
I
C
D
Telephone Number
City
State
Zip Code
F
(
)
E
G
J
K. Date of organization
1
O. Check all boxes
1
Initial Return
2
Final Return
3
In Bankruptcy
In the State of
that apply to entity:
Composite Return
2
4
L. State of commercial domicile
P. Number of non-Indiana resident partners?
M. Year of initial Indiana return
Q. Is an extension of time to file attached?
Yes
No
1
2
N. Accounting method:
R. Are you a limited liability company electing partnership treatment on your
Cash
Accrual
Other
federal return?
Yes
No
1
2
3
1
2
1
2
S. Is this partnership a member of any other partnership(s)?
Yes
No
Aggregate Partnership Distributive Share Income (See worksheet on page 10)
Total net income (loss) from U.S. Partnership return, Form 1065 Schedule K, lines 1 through 7
1.
less lines 9, portion of line 10, and line 14b(2) (see instructions) ......................................................................................
1
2. Add back: a) All state income taxes (taxes based on income deducted on the federal return)
2 a
2003
2b
b) Net bonus depreciation allowance ........................................................................
2c
Deduct:
c) Interest on U.S. Government obligations ...........................................................
IT-65
2d
Deduct:
d) Indiana lottery prize money ................................................................................
2 e
2e.Total state modifications to distributive share of partnership income (line 2a and 2b minus lines 2c and 2d) .............
3. Total partnership income, as adjusted (add lines 1 and 2e) ..................................................................................................
3
Partnerships deriving income from sources within and outside Indiana and having non-Indiana domiciled partners or non-unitary corporate partners
must complete line 4 below. Enter distributive share, as apportioned, on IT-65 Schedule IN K-1 and attach IT-65 Schedule E, Apportionment of Income.
___ ___ . ___ ___ %
4. Enter average percentage for Indiana apportioned adjusted gross income from IT-65 Schedule E line (4c), if applicable
4
CONTINUE BY COMPLETING IT-65 IN K-1 (ON REVERSE SIDE)
Summary of Calculations
5
5. Sales/use tax due on purchases subject to use tax from Sales/Use Tax worksheet (from page 8) ....................................
6
6. Total composite tax from completed Schedule IT-65COMP (D+E). Attach schedule ....................................................
7
7. Total tax (add lines 5 and 6) Caution: If line 7 is zero, see line 12 late file penalty ...................................................
8
8. Total composite tax return credits (attach schedule and WH-18 statement(s) for composite members) ....................
9
9. Other credits belonging to the partnership (attach documentation) ..........................................................................................
10. Subtotal (line 7 minus lines 8 and 9). If total is greater than zero, proceed to lines 11, 12, and 13 .........................................
1 0
11
11. Interest: Enter total interest due; see instructions. (Contact the Department for current interest rate) ...................
12. Penalty:
If paying late enter 10% of line 10. If line 7 is zero, enter $10 per day filed past the due date, see instructions ................
12
13. Total Amount Due (add lines 10, 11 and 12). If less than zero, enter on line 14 .........................
Pay in U.S. Funds
13
Please pay the sum on line 13, make check payable to: Indiana Department of Revenue
14. Overpayment (line 8 plus line 9, minus lines 7, 11, and 12) ...............................................
14
15
15. Refund: Amount from line 14 to be refunded. Enter as a positive figure ............................
Certification of Signatures and Authorization Section
Do not write in line 20 or
20
in Box DD. Reserved for
I authorize the Department to discuss my return with my tax preparer.
Yes
CC
DD
Under penalties of perjury, I declare I have examined this return, including accompanying
Department's use only.
schedules and statements, and to the best of my knowledge and belief it is true, correct and complete.
Partnership's e-mail address
EE
Signature of Partner
Date
Print or Type Name of Partner
Title
LL
MM
Print or Type Paid Preparer's Name
Preparer's FID, SSN, or PTIN Number
Check Box:
1
Federal I.D. Number
FF
NN
OO
2
Social Security Number
Street Address
Daytime Telephone Number of Preparer
3
PTIN Number
GG
PP
City
State
Zip+4
Preparer's Signature
HH
II
JJ
VN
Please mail forms to: Indiana Department of Revenue, 100 N. Senate Avenue, Indianapolis, Indiana 46204-2253
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