State Form 46003 - Schedule It-2440 - Indiana Disability Retirement Deduction - 2011 Page 2
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2Line-by-Line Instructions
Do You Qualify for the Deduction?
Table A - How to fi gure your weekly pay:
If you were paid:
Figure your weekly pay by:
You may qualify for the deduction if you meet both of the
following requirements:
Every 2 weeks ............. Divide your gross pay by 2
•
you retired on disability before December 31 of the tax
Twice a month.............. Multiply your gross pay by 24 and
year for which you are claiming the deduction; and
divide the result by 52
•
you were permanently and totally disabled when you
retired.
Once a month .............. Multiply your gross pay by 12 and
divide the result by 52
If you meet these requirements, you may be eligible to subtract
Any other way .............. Divide your gross yearly pay by
up to $5,200 a year of your disability payments from your gross
52
income. The amount you subtract is limited to the amount of
disability pay you actually received or $100 a week, whichever
Note: If you did not receive disability income for the whole
is less, and may have to be reduced by part of your federal
year, use the actual amount of weeks/months.
adjusted gross income.
Example: Jim received disability income of $130 a week for
Your spouse may also be eligible to subtract up to $5,200 of
six weeks. He should complete the worksheet below, entering
disability payments if you fi le a joint return and your spouse
the $130 amount on line a.
meets all the above requirements.
Note: In no case may the total deduction be more than
Worksheet - How to fi gure the excess over $100 for full
$10,400 on a joint return.
weeks:
a. Weekly disability pay received ......... a __________
General Instructions
b. Maximum weekly deduction ............ b -
100
c. Subtract line b from line a (If line b
Enter your name(s), social security number(s) and, if
is larger than line a, enter 0) ............ c __________
applicable, the date you retired.
d. Number of full weeks for which you
received disability pay ..................... d __________
On a joint return, if both spouses qualify for the disability
e. Multiply the amount on line c by line
retirement deduction, two Physician’s Statements must be
d. Enter here and on line 3A or 3B
attached. Use only one Schedule IT-2440 to calculate the
on the front of this schedule ............ e __________
deduction.
Line 4 - The deduction is further reduced by the excess of
Line 1 - Enter the amount received during the taxable year
the federal adjusted gross income (AGI) over $15,000.
through an accident and health plan for personal injuries or
sickness. Use line 1A for yourself and line 1B for your spouse.
a. Federal AGI (from IT-40 line 1 or from
IT-40PNR Schedule A, line 37A) ..... a __________
Line 3 - The amount you can deduct is limited to the disability
b. Income limit ..................................... b -
15,000
income you received each week or $100 per week, whichever
c. Subtract b from a (if b is larger
is less.
than a, enter 0). Enter here and on
line 4 on the front of this schedule ... c __________
If you did not receive your disability pay each week, you will
have to fi gure your weekly pay (see Table A).
Instructions for Physician’s Statement
A person is permanently and totally disabled when:
•
He or she cannot engage in any substantial gainful
activity because of a physical or mental condition; and
•
A physician determines that the disability
(a) has lasted or can be expected to last continuously
for at least a year, or
(b) can be expected to result in death.
24100000000
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