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Schedule LIC                            Indiana Department of Revenue                                                                       814
State Form 21926
(R14 / 8-19)                                Enterprise Zone
                                        Loan Interest Tax Credit
                                    For Tax Year Ending:  Month_________ Year _______
(Enclose completed schedule with annual state tax liability return.)                                                                  Enclosure Sequence No. 28
Section A - Taxpayer Information
Name of Taxpayer (lender)                                                          Social Security Number or FEIN

Street Address                                                                     County

City or Town, State, and ZIP Code                                                  Taxpayer’s Telephone Number

Section B - Qualified Loan Information  (attach list of all borrowers) Section B continued on reverse side.
Name of Borrower (A)                                                               Borrower’s Social Security Number or FEIN

Street Address                                                                     Borrower’s Telephone Number

City or Town, State, and ZIP Code

Use of Loan (check one):             Date of Loan Origination:                     Location Name of Borrower’s Enterprise Zone
 Business     Personal
Section C - Report of Qualified Loans to Businesses by Enterprise Zone Locations 
Summarize the number of qualified loans to businesses in each enterprise zone and the amount of interest received during the taxable year.
Enterprise Zone       (a)               (b)                          Enterprise Zone        (C)                                          (d)
                  Number of          Interest Income                                        Number of                                    Interest Income
                      Loans                                                                 Loans
Bedford                           $                                  Lafayette                                                        $
                                                     00                                                                                                 00
Bloomington                       $                                  La Porte                                                         $
                                                     00                                                                                                 00
Connersville                      $                                  Michigan City                                                    $
                                                     00                                                                                                 00
East Chicago                      $                                  Mitchell                                                         $
                                                     00                                                                                                 00
Elkhart                           $                                  New Albany                                                       $
                                                     00                                                                                                 00
Evansville                        $                                  Portage                                                          $
                                                     00                                                                                                 00
Ft. Harrison                      $                                  Richmond                                                         $
                                                     00                                                                                                 00
Ft. Wayne                         $                                  River Ridge                                                      $
                                                     00                                                                                                 00
Frankfort                         $                                  Salem                                                            $
                                                     00                                                                                                 00
Hammond                           $                                  South Bend                                                       $
                                                     00                                                                                                 00
Jeffersonville                    $                                  Vincennes                                                        $
                                                     00                                                                                                 00
Subtotal                          $                                  Subtotal                                                         $
                                                     00                                                                                                 00
Section D - Credit for Qualified Loans for the Taxable Year
1. Grand total of all qualified loans to businesses listed in Section C, columns (a) and (c) ....................                     1 $
                                                                                                                                                        00
2. Total amount of loan interest income received from qualified loans in Section C, columns (b) and (d) .                             2 $
                                                                                                                                                        00
3. Amount of loan interest income received from other qualified nonbusiness loans made for home 
 improvements within all enterprise zones ........................................................................................... 3 $
                                                                                                                                                        00
4. Total Loan Interest Credit - add amounts on lines 2 and 3; multiply result by 5 percent (.05) ............                         4 $
                                                                                                                                                        00
5. Indicate for which tax type you are applying this credit. Enter net amount of tax you are offsetting: 
 a  Adjusted Gross Income Tax     b  Insurance Premium Tax     c  Financial Institutions Tax                                       5 $
                                                                                                                                                        00
 The tax offset may not exceed the amount of available credit from line 4.  
 Carry amount on line 5 to other credit line of your return.
6. Unused amount of credit available for carryover - subtract line 5 from line 4 and complete Section E ..                            6 $
                                                                                                                                                        00

                                        *24100000000*
                                                     24100000000



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Section B - Qualified Loan Information Continued  (Attach additional sheets if necessary.)
Name of Borrower (B)                                             Borrower’s Social Security Number or FEIN

Street Address                                                   Borrower’s Telephone Number

City or Town, State, and ZIP Code

Use of Loan (Business or         Date of Loan Origination        Location Name of Borrower’s Enterprise Zone
Personal)

Name of Borrower (C)                                             Borrower’s Social Security Number or FEIN

Street Address                                                   Borrower’s Telephone Number

City or Town, State, and ZIP Code

Use of Loan (Business or         Date of Loan Origination        Location Name of Borrower’s Enterprise Zone
Personal)

Name of Borrower (C)                                             Borrower’s Social Security Number or FEIN

Street Address                                                   Borrower’s Telephone Number

City or Town, State, and ZIP Code

Use of Loan (Business or         Date of Loan Origination        Location Name of Borrower’s Enterprise Zone
Personal)

Section E - Enterprise Zone Interest Credit Carryover (814)
                      Enter the initial tax period in which the Enterprise Zone Loan Interest Credit was claimed.
                            Enter the remaining unused amount of credit from Section D, line 6.
Initial Tax Year Ending:                          Enterprise Zone Loan Interest Credit Available 
Month ________________   Year_________            for Carryforward from Section D, Line 6:    $_______________________
                                 Show how the unused credit is applied during the carryover period.
                            Unused Credit (column (5)) is to be placed on your return for the next tax year.
               (1)                                (2)            (3)                               (4)           (5)
                                       Total               Type of Tax
         Credit Carryforward           Amount of Tax       Liability Reduced Amount Applied                      Unused Credit
1st Following Tax Year    __________
2nd Following Tax Year   __________
3rd Following Tax Year    __________
4th Following Tax Year    __________
5th Following Tax Year    __________
6th Following Tax Year    __________
7th Following Tax Year    __________
8th Following Tax Year    __________
9th Following Tax Year    __________
10th Following Tax Year  __________
Section F - Signature

I certify I have examined this schedule and, to the best of my knowledge and belief, the information contained in this schedule is true, 
correct, and complete.
Signature of Taxpayer: ____________________________  Title _____________________                   Date Signed: _________________

                                    *24100000000*
                                                      24100000000



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                            Instructions for Completing Schedule LIC

Indiana Code (IC) 6-3.1-7-2 provides that a taxpayer who is 
                                                                Section B - Qualified Loan Information
in good standing with the Indiana Economic Development 
Corporation is entitled to a state income tax credit of 5%      Enter the following information for each qualified loan, 
of the interest income received from qualified loans made       or provide a combined listing of borrowers within every 
before January 1, 2018. To qualify, the loan proceeds must      enterprise zone. Attach additional sheets as necessary: 
be for purposes directly related to businesses located in 
an enterprise zone or for improvements increasing the           1)  Enter the borrower’s name and location address 
assessed value of real property located in an enterprise        within the enterprise zone.
zone.* A qualified loan also means a loan made to an            2)  Enter the borrower’s Social Security Number or 
individual or business that uses the loan proceeds toward       Federal Employer Identification Number.
the rehabilitation, repair, or improvement of a residence       3)  Enter the borrower’s telephone number.
within an enterprise zone.                                      4)  Indicate the purpose of the loan (business or 
                                                                personal home improvement) and the date of loan 
*An enterprise zone created under IC 5-28-15 or an air-         origination.
port development zone (code # 802) designated under             5)  Enter the name of the borrower’s enterprise zone 
IC 8-22-3.5-14.                                                 location.

                                                                Section C – Report of Qualified Loans to Businesses 
              Who May File for This Credit?                     
                                                                by Enterprise Zone Locations
For the purposes of eligibility, for the Loan Interest Credit, 
a taxpayer in good standing is defined as an entity             Summarize the number of qualified loans on which you 
conducting business operations within an enterprise zone        received interest during the taxable year according to the 
that:                                                           enterprise zone in which the loan proceeds are used by the 
1)     Receives interest on a qualified loan made during        business borrower(s) (listed in Section B). 
       the tax year;
2)  Pays the registration fee charged to zone                   Enter the total amount of interest income received 
       businesses under IC 5-28-15-5;                           from qualified loans to businesses during the taxable 
3)  Provides the assistance to urban enterprise                 year attributed to the enterprise zone location of  the 
       associations required from zone businesses under         borrower(s), columns (a) and (c).  
       IC 5-28-15-5(b); and
4)  Complies with any requirements adopted by the               For purposes of the Loan Interest Credit, interest includes 
       board of the Indiana Economic Development                service charges, time-price differentials, and all other 
       Corporation for taxpayers claiming the Enterprise        charges for the use of money. Interest received from 
       Zone Loan Interest Credit.                               loans and lines of credit existing at the time an enterprise 
                                                                zone was designated qualify for the credit if the proceeds 
Note: If the taxpayer is located outside an enterprise zone,    are used for a qualified purpose. Interest from mortgage 
the taxpayer is not required to reinvest its incentives within  loans to acquire property does not qualify unless the 
the enterprise zone, other than complying with 2) and 3)        property is used for business purposes (including renting 
above.                                                          or leasing). If the proceeds of a loan are used to both 
                                                                acquire and improve real property and the acquisition is 
       How Often Can I Claim a Credit?                          not for a business purpose, only that portion of the interest 
                                                                attributable to the improvement of the property would 
A claim for credit is filed annually for each qualified loan    qualify for the Loan Interest Credit. If the loan proceeds are 
or in combination with all qualified loans made during the      used to acquire business property which is subsequently 
taxable year.                                                   removed from an enterprise zone, only the interest received 
                                                                while the property was used for a business purpose within 
       Section A - Taxpayer Information                         the enterprise zone would qualify for the credit.

1)  Type or print lender’s name and address.                    Section D – Credit for Qualified Loans for
2)  Enter lender’s Social Security Number or Federal                        the Taxable Year
       Employer Identification Number.
3)  Enter Indiana county or O.O.S. (out-of-state).              Line 1. Enter the grand total of all qualified loans to 
4)  Enter telephone number.                                     businesses listed in Section C, columns (a) and (c).

                                                                Line 2. Enter the amount of loan interest income received 
                                                                from businesses during the taxable year from qualified 
                                                                loans listed in Section C, columns (b) and (d).



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Line 3. Enter the total other loan interest income received 
                                                                What if I Do Not Use All of My Credit?
from nonbusiness loans made for the purposes of 
rehabilitation, repair, or improvement of a residence or for    Any unused credit may be carried over to the next eligible 
improvements that increase the assessed value of real           tax return to be filed up to 10 years from the date of the 
property located in any enterprise zone.                        loan until all credit has been used or the enterprise zone 
                                                                terminates. 
Line 4. Add the amount of business and nonbusiness 
interest income and multiply the result by 5%.                  Note: A taxpayer is not entitled to a carryback or refund of 
                                                                any unused credit. The statute does allow the taxpayer to 
Line 5. Indicate the state tax liability you wish to offset by  carry forward any unused credit.
checking the appropriate tax type box and by entering the 
net amount of your state tax liability. Note: The net amount    What if I Am an Entity Exempt from
of tax entered on line 5 must be reduced by all other                       Adjusted Gross Income Tax?
applicable tax liability credits and may not be greater than    Entities exempt from adjusted gross income tax under 
the amount on line 4. Carry the net amount of credit to be      IC 6-3-2-2.8(2) may “pass through” the credit to 
used to your tax type return.                                   shareholders, partners, beneficiaries, or members of 
                                                                the pass-through entity. A pass-through entity is an 
Line 6. Subtract line 5 from line 4. The result may not be      S corporation, a partnership, a trust, a limited liability 
less than 0. If it’s greater than 0, carry the excess unused    company, or a limited liability partnership. Each member’s 
amount of credit to Section E.                                  tax credit is calculated by multiplying the total credit 
                                                                available by the percentage of the entity’s distributive 
Section E – Enterprise Zone Loan Interest Carryover             income to which the shareholder, partner, beneficiary, or 
Complete this section whenever there is a carryover             member is entitled. The pro rata share of the calculated 
of unused Loan Interest Credit. The amount of credit            credit is reported by the entity on each unit-holder’s 
carryover from a taxable year shall be reduced to the extent  Schedule IN K-1. A copy of Schedule LIC or IN K-1 must be 
that the carryover is used by the taxpayer to obtain credit     enclosed with the return to claim your share of the credit.
against allowable state tax liabilities for any subsequent 
taxable year. Carryover is allowed up to 10 years following     Whom Do I Contact if I Have Questions 
the date on which a qualified loan credit is claimed but not    About the Enterprise Zone Loan Interest Credit?
beyond the phase-out period that terminates the enterprise 
                                                                Questions concerning enterprise zone income tax 
zone from which a qualified loan had originated.
                                                                provisions should be directed to:
Enter in each column the applicable date or amounts for 
                                                                            Indiana Department of Revenue
every succeeding taxable year in which a credit carryover 
                                                                            Returns Processing Center
is used.
                                                                            Corporate Income Tax Section
                                                                            P.O. Box 7206
          Section F – Signature                                             Indianapolis, IN 46207
The taxpayer or an authorized agent must sign this                          (317) 232-0129
schedule.                                                                   www.in.gov/dor

          Where Can I Claim This Credit?                        For questions concerning other provisions related 
                                                                to enterprise zones and current locations within the 
The Loan Interest Credit can be applied as a credit against     designated cities, contact:
the taxpayer’s adjusted gross income tax (IC 6-3-1 through 
6-3-7), insurance premium tax (IC 27-1-18-2), and financial     Indiana Economic Development Corporation
institution tax (IC 6-5.5). A copy of Schedule LIC must                     1 N. Capitol Ave., Suite 700
be enclosed with the return; otherwise, the credit will be                  Indianapolis, IN 46204
disallowed. The credit amount calculated on the LIC is to                   (317) 232-8800
be taken as a credit against your tax liability on the return               www.iedc.in.gov
in the order listed above after first applying other credits 
allowed under IC 6-3.1-1-2. 

Refer to Income Tax Information Bulletin #66 at 
www.in.gov/dor/3650.htm for additional information. Please 
see the instructions for your tax return to determine where 
the credit should be entered on the various tax forms.






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