Form In-111 - Schedule In-153 - Capital Gain Exclusion Calculation - 2017 Page 2

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Taxpayer’s Last Name

Social Security Number

*171531200*

* 1 7 1 5 3 1 2 0 0 *

PART II.

PERCENTAGE EXCLUSION

(Use this section only if you have eligible gains. See Technical Bulletin 60 for more information or continue

on to Part III.)

.0 0

10. Enter the amount from Part I, Line 4 . . . . . . . . . . . . . . . . . . 10. ________________________________

11. Enter amount of adjusted net capital gain from the sale

.0 0

of assets held for three years or less . . . . . . . . . . . . . . . . . . 11. ________________________________

12. Assets held for more than three years. Subtract Line 11

.0 0

from Line 10. Entry cannot be less than zero . . . . . . . . . . . 12. ________________________________

Enter the amount of net adjusted capital gain from the sale of the following assets held for more than three years

13a. Real estate or portion of real estate used

.0 0

as a primary or nonprimary home . . . . . . . . . . . . . . . 13a. ________________________________

13b. Depreciable personal property (except

.0 0

for farm property or standing timber) . . . . . . . . . . 13b. ________________________________

13c. Stocks or bonds publicly traded or

traded on an exchange or any other

.0 0

financial instruments. . . . . . . . . . . . . . . . . . . . . . . . . 13c. ________________________________

.0 0

14. Add Lines 13a through 13c . . . . . . . . . . . . . . . . . . . . . . . . . 14. ________________________________

15. Subtract Line 14 from Line 12; enter result here.

Entry cannot be less than zero. This is the amount

.0 0

of net adjusted capital gain eligible for exclusion. . . . . . . . 15. ________________________________

Line 16 Federal Form 4952 information. If no investment interest expense for ineligible assets was reported on Federal Form 4952, enter Line 7

from Part I of this form. Otherwise, you may need to recompute Federal Form 4952 to reflect only investment interest income for assets eligible for

the capital gain exclusion.

16. Enter amount from Part I, Line 7 or recomputed

.0 0

Federal Form 4952. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16. ________________________________

.0 0

17. Subtract Line 16 from Line 15 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17. _______________________________

.0 0

18. Multiply Line 17 by 40%; enter result here . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18. _______________________________

PART III.

CAPITAL GAIN EXCLUSION

.0 0

19. Enter the greater of Line 9 or Line 18 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19. _______________________________

.0 0

20. Multiply ______________________________ x 40%; enter result here . . . . . . . . . . . . . . . . . . . . . . . . 20. _______________________________

Federal Taxable Income from Form IN-111, Line 11

21. Enter the smaller of Line 19 or Line 20. This is your capital gain exclusion.

.0 0

Enter on Form IN-111, Line 14b. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21. _______________________________

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Schedule IN-153

Page 2 of 2

5454

Rev. 10/17