Form Fit-20 - Indiana Financial Institution Tax Return - 2012 Page 2

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Form FIT-20
2012 Indiana Financial Institution Tax Return
Round all entries
00
20. Total Income Prior to Apportionment (amount from line 19) ................................................................................... 20
.
%
21. Apportionment Percentage (line 15 of Schedule E-U) ........................................................................................... 21
00
22. Current Year Apportioned Adjusted Gross Income attributed to Indiana (multiply line 20 by line 21) ................. 22
00
23. Indiana Net Capital Loss Adjustment from attached worksheet. Line 23 may not exceed amount on line 22 . .......... 23
00
24. Subtotal of line 22 minus line 23. Do not enter an amount less than zero ............................................................. 24
00
25. Indiana Net Operating Loss Deduction from Schedule FIT-20 NOL. Line 25 may not exceed amount on line 24 .... 25
00
26. Total Indiana Adjusted Gross Income subject to tax (subtract line 25 from line 24) ................................................ 26
00
27. Financial Institution Tax (multiply line 26 by tax rate; see instructions) ................................................................... 27
00
28. Less: Nonresident Taxpayer Credit (attach Schedule FIT-NRTC) . ................................................................. (816) 28
00
29. Net Financial Institution Tax Due (subtract line 28 from line 27) ............................................................................. 29
00
30. Sales/Use Tax Due (see instructions) ..................................................................................................................... 30
00
31. Subtotal Due (add lines 29 and 30) . ........................................................................................................................ 31
Tax Liability Credits (attach schedules):
00
32. Neighborhood Assistance Tax Credit (NC-20) . ...............................................................................................(828) 32
00
33. Enterprise Zone Employment Expense Credit (EZ 2) .................................................................................... (812) 33
00
34 Enterprise Zone Loan Interest Tax Credit (LIC) . .............................................................................................(814) 34
00
35. Enter name of other credit________________ Code No. a _ _ _ 35b....................................................... ........ 35b
00
36. Enter name of other credit________________ Code No. a _ _ _ 36b................................................................ 36b
00
37. Total Credits (add lines 32 through 36b) ................................................................................................................. 37
00
38. Net Tax Due (subtract line 37 from line 31) ............................................................................................................. 38
Estimated Tax and Other Payments:
39. Total estimated financial institution tax paid (itemize quarterly FT-QP payments below)
1._________ 2.__________ 3.__________ 4.__________ .............................................................................. 39
00
40. Extension payment _______and prior year and overpayment credit _______ Enter combined total ............... 40c
00
41. Other payments/EDGE credit (attach supporting documentation) .......................................................................... 41
00
42. Total Payments (add lines 39 through 41) . .............................................................................................................. 42
00
43. Balance of Tax Due (subtract line 42 from line 38. If line 42 exceeds line 38, enter -0-) . ..................................... 43
00
44. Penalty for the Underpayment of Tax from Schedule FIT-2220 (Form page 4) . ...................................................... 44
00
45. If payment is made after the original due date, add interest (see instructions) ....................................................... 45
46. Late penalty: If paying late, enter 10% of line 43: see instructions. If line 31 is zero, enter $10 per day filed past
00
due date................................................................................................................................................................... 46
00
47. Total Due (add lines 43 through 46) Payable in U.S. funds to: Indiana Department of Revenue .......................... 47
00
48. Total Overpayment (subtract lines 38, 44, 45, and 46 from line 42) . ....................................................................... 48
00
49. Refund (enter portion of line 48 to be refunded) .................................................. .................................................. 49
00
50. Overpayment Credit (amount of line 48 to be applied to next year's estimated tax account) ................................. 50
Certification of Signatures and Authorization Section
Under penalties of perjury, I declare I have examined this return, including all accompanying schedules and statements, and to the best
of my knowledge and belief it is true, correct and complete.
I authorize the Department to discuss my return with my personal
representative (see page 16)
Yes
No
Company's E-mail address EE
Signature of Corporate Officer
Date
Paid Preparer: Firm’s Name (or yours if self-employed)
PTIN
Print or Type Name of Corporate Officer
Title
Telephone Number
Personal Representative’s Name (Print or Type)
Address
City
Telephone Number
State
Zip Code + 4
Address
Paid Preparer's Signature
Date
City
State Zip Code + 4
Please mail your return to: Indiana Department of Revenue, PO Box 7228, Indianapolis, IN 46207-7228.
*20612121594*
20612121594

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