Schedule              Indiana Department of Revenue                                                            Enclosure 
IN-PAT                Qualified Patents Exemption Schedule                              2022    Sequence No. 22
State Form 54084
(R15 / 9-22)

Part 1
Name of Corporation, Nonprofit Organization, or Individual            Check one
                                                                                     □ SSN     □ FEIN     □ PTIN
Enter NAICS Code*                                                     Enter ID Number

*Visit www.naics.com for a complete listing of business codes.

Part 2
Name of Patent                                                        Patent Filing Date

Description of Patent                                                 Number of Employees on Patent Filing Date

Part 3
(Column 1)            (Column 2)                                      (Column 3)               (Column 4)
Claiming Exemp-       Amount of Income from                           Multiply by       Amount of Exemption Claimed
tion for (List Tax    a Qualified Patent                           Percentage Allowed
Period Ending)
1st year  ______                                                      x 0.50
2nd year  ______                                                      x 0.50
3rd year  ______                                                      x 0.50
4th year  ______                                                      x 0.50
5th year  ______                                                      x 0.50
6th year  ______                                                      x 0.40
7th year  ______                                                      x 0.30
8th year  ______                                                      x 0.20
9th year  ______                                                      x 0.10
10th year  ______                                                     x 0.10

Enclose this schedule with Form IT-20, IT-20NP, IT-40, or IT-40PNR.

                      *24100000000*
                                                           24100000000

                                     Instructions for Completing Schedule IN-PAT

Qualified Patents Exemption                                         This exemption applies only to utility patents issued under 35 
Public Law 223-2007 SECTIONS 1, 2, and 11 amended Indiana           U.S.C. 101 and plant patents issued under 35 U.S.C. 161 for 
Code (IC) 6-3-1-3.5 and adds IC 6-3-2-21.7, effective Jan. 1,       inventions resulting from development processes conducted in 
2008. Income from qualified patents included in federal taxable     Indiana. The exemption does not include design patents issued 
income is exempt from the adjusted gross income of individuals,     under 35 U.S.C. 171.
corporations, and insurance companies for taxable years 
beginning after Dec. 31, 2007.                                      Part 2
                                                                    Enter the name and filing date of the patent. Enter a description of 
•  A qualified patent is a utility patent or a plant patent         the patent. Enter the number of employees the entity had on the 
   issued after Dec. 31, 2007, for an invention resulting from a    patent filing date. To qualify for this exemption, the entity must 
   development process conducted in Indiana. The term does          have fewer than 500 employees. 
   not include a design patent.  
                                                                    Part 3
•  The exemption from income includes licensing fees or other       Column 1. Fill in the tax years for which you are taking the 
   income received for the use of the patent, royalties received    qualified patents income exemption. The exemption can be 
   for the infringement, receipts from the sale of a qualified      claimed for up to 10 years. 
   patent, or income from the taxpayer’s own use of the patent 
   to produce the claimed invention.                                Column 2. Enter the amount of income earned from the patent. 

Who Should File Schedule IN-PAT?                                    Column 3. Multiply the amount of income earned from the 
Any individual Indiana resident, any corporation (including         patent by the corresponding percentage. For the first 5 years, 50% 
affiliates) that has fewer than 500 employees and is domiciled      of the amount of income received from the patent is exempt; the 
in Indiana, and any nonprofit organization that is domiciled in     percentage declines by 10% each year starting in the sixth year 
Indiana should complete Schedule IN-PAT if they are subject         that the exemption is claimed. 
to the adjusted gross income tax and they have income from a 
qualified patent. Schedule IN-PAT should be enclosed with your      Column 4. Enter the amount of the exemption you are claiming 
Indiana tax return (Form IT-40, Form IT-20, or Form IT-20NP).       (Column 2 multiplied by Column 3). Enter this amount on Form 
                                                                    IT-20 (line 10), Form IT-20NP (line 4), Form IT-40 Schedule 2 
Carryforward Years                                                  (under line 11), or Form IT-40PNR Schedule C (under line 11). 
The exemption may not be claimed for more than 10 years. For        The total amount of exemptions claimed in a taxable year may not 
the first 5 years, 50% of the amount of income received from        exceed $5 million.
the patent is exempt; the percentage declines by 10% each year 
starting in the sixth year that the exemption is claimed. The total Enclose this schedule with your Indiana tax return. 
amount of exemptions a taxpayer can claim in a taxable year may 
not exceed $5 million. 

For more information, get Income Tax Information Bulletin #104 
at www.in.gov/dor/files/reference/ib104.pdf.

Part 1
Enter the name of the individual, corporation, or nonprofit 
organization claiming the exemption. 

Enter the Social Security number, Federal Employer Identification 
Number, or Individual Taxpayer identification number.

Enter the North American Industry Classification System 
(NAICS) business code for the patent. You can find a listing of all 
the NAICS codes at www.naics.com.

                                            *24100000000*
                                                                 24100000000