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Schedule 1                            Schedule 1: Add-Backs                                                Enclosure 
Form IT-40, State Form 53995                                                                        Sequence No. 01
(R13 / 9-22)                                                                    2022

Name(s) shown on Form IT-40                                                     Your Social Security Number

                                                                                                    Round all entries

1. Tax add-back: certain taxes deducted from federal Schedules C, C-EZ, E and/or F ____________  1                   .00

2. Net operating loss carryforward from federal Form 1040, “Other income” line  ________________ 2                   .00

3. OOS municipal obligation interest add-back  __________________________________________        3                   .00

4. Bonus depreciation add-back ______________________________________________________            4                   .00

5. Section 179 expense excess add-back ______________________________________________            5                   .00

6. Other Add-Backs: See instructions.

a. Enter add-back name                                                 code no.                  6a                  .00

b. Enter add-back name                                                 code no.                  6b                  .00

c.  Enter add-back name                                                code no.                  6c                  .00

d. Enter add-back name                                                 code no.                  6d                  .00

e. Enter add-back name                                                 code no.                  6e                  .00

f.  Enter add-back name                                                code no.                  6f                  .00

g. Enter add-back name                                                 code no.                  6g                  .00

h. Enter add-back name                                                 code no.                  6h                  .00

i.  Enter add-back name                                                code no.                  6i                  .00

j.  Enter add-back name                                                code no.                  6j                  .00

k.  Enter add-back name                                                code no.                  6k                  .00

l.  Enter add-back name                                                code no.                  6l                  .00

m. Enter add-back name                                                 code no.                  6m                  .00

n. Enter add-back name                                                 code no.                  6n                  .00

o. Enter add-back name                                                 code no.                  6o                  .00

7.  Add lines 1 through 6. Enter total here and on Form IT-40, line 2  Total Indiana Add-Backs   7                   .00

                                     *22822111694*
                                       22822111694






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