Form It-65 - Schedule In K-1 -Partner'S Share Of Indiana Adjusted Gross Income, Deductions, Modifications, And Credits - 2013

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IT-65
2013 Schedule IN K-1
Indiana Department of Revenue
State Form 49181 (R13 / 8-13)
Partner’s Share of Indiana Adjusted Gross Income, Deductions, Modifications, and Credits
Tax Year Beginning
2013 and Ending
Name of Partnership
Federal Identification Number
Distributions - Provide IN K-1 to each partner. Enclose IN K-1 with IT-65 return. For information on the
acceptable electronic data file format, visit the Department’s website at Pro rata
amounts for lines 1 through 26 of any nonresident partner must be multiplied by the Indiana apportionment
percent, if applicable, from IT-65, line 4.
Part 1 – Partner’s Identification Section
(a) If Partner Is an Individual (please print clearly)
Social Security Number:
Last Name:
First Name:
a1 ___________________________________
a2 ___________________________
a3
(b) If Partner Is an Other Entity (please print clearly)
Federal Identification Number:
Name:
b1 ___________________________________________________________________
b2
(c) Partner’s State of Residence or Commercial Domicile ............................................................c1
(d) Indiana Tax Withheld for Nonresident Partner (on WH-18) ...................................................... d
00
Enter federal ID number from pass-through WH-18 _________________________________
.
%
(e) Partner’s Federal Pro Rata Percentage .................................................................................. e
00
(f) Partner’s Tax as Computed on IT-65COMP Column G .......................................................... f
Part 2 - Distributive Share Amount
(use apportioned figures for nonresident partners)
00
1. Ordinary business income (loss) ....................................................................................................
00
2. Net rental real estate income (loss) ...............................................................................................
00
3. Other net rental income (loss) ........................................................................................................
00
4. Guaranteed payments....................................................................................................................
00
5. Interest income ...............................................................................................................................
00
6. Ordinary dividends .........................................................................................................................
00
7. Royalties ......................................................................................................................................
00
8. Net short-term capital gain (loss) ..................................................................................................
00
9. Net long-term capital gain (loss) ....................................................................................................
00
10. Net IRC Section 1231 gain (loss) ..................................................................................................
00
11. Other income (loss) .......................................................................................................................
00
12. IRC Section 179 expense deduction ..............................................................................................
13a. Portion of expenses related to investment portfolio income, including investment interest
00
expense and other (federal nonitemized) deductions ..................................................................
13b.Other information from line 20 of federal K-1 related to investment interest and expenses
00
not listed elsewhere .....................................................................................................................
14. Total pro rata distributions (Add lines 1 through 11; subtract lines 12, 13a, and 13b
00
when applicable.) ...........................................................................................................................
Continued on next page
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