PDF document
- 1 -
             Form               Indiana Amended Individual Income Tax Return  
                                                                                                                              Tax
        IT-40X            If you are not filing for the calendar year January 1 through December 31, enter period from:       Year
        State Form 44405
        (R18 / 9-19)                                                                                                                          DF
                                                                                        to:

   Your Social                                                                            Spouse’s Social 
   Security Number A                                                                      Security Number  B
   Your first name                                     Initial                            Last name                                           Suffix

E                                                    F                                  G                                                   DU
   If filing a joint return, spouse’s first name       Initial                            Last name                                           Suffix

H                                                    I                                  J                                                   DV
   Present address (number and street or rural route) 
                                                                                                                      Place “X” in box if you are 
K                                                                                                                     married filing separately.    L
   City                                                                                            State       Zip/Postal code

M                                                                                          N                  O
   Foreign country 2-character code     Place “X” in box                                   Enter loss year
                                        if amendment                                                        For department 
P                                       due to an NOL.                                                          use only
DI Are you filing an amended federal return?  Yes        No                                If yes, attach a copy of your federal Form 1040X.
   Enter the 2-digit county code numbers for the county where you lived and worked on January 1 of the tax year.
   County where                      County where                                          County where               County where 
   you lived                         you worked                                            spouse lived               spouse worked
                        R                              S                                                    T                                      U
                                                                                           A                  B                             C
                                                                                           As Shown on      Amount of                       Correct
   Complete Part 1 on the back to explain any changes.                                     Original Return  Change                          Amount
1.  Amount from line 1 of Form IT-40/IT-40EZ/IT-40PNR ......                                                             1
                                                                                    00 00                                     00
2.  Indiana add-backs from Schedule 1 (or Schedule B) .......
                                                                                    00 00                                     00
3.  Add lines 1 and 2..............................................................
                                                                                    00 00                                     00
4.  Indiana deductions from Schedule 2 (or Schedule C) ......                                                            4
                                                                                    00 00                                     00
5.  Subtract line 4 from line 3.................................................                                         5
                                                                                    00 00                                     00
6.  Exemptions from Schedule 3 (or Schedule D) .................                                                         6
                                                                                    00 00                                     00
7.  Subtract line 6 from line 5.................................................                                         7
                                                                                    00 00                                     00
8.  State adjusted gross income tax: see instructions ...........                                                        8
                                                                                    00 00                                     00
9.  County tax ........................................................................                                  9
                                                                                    00 00                                     00
10.  Other taxes from Schedule 4 (or Schedule E)..................                                                       10
                                                                                    00 00                                     00
11.  Add lines 8, 9 and 10 (tax) (if less than zero, enter zero)                                                         11
                                                                                    00 00                                     00
12.  Credits from Schedule 5 (or Schedule F) ......................                                      00           00  12  00
13.  Offset credits from Schedule 6 (or Schedule G) ...............                                                       13
                                                                                    00  00                                    00
14.  Amount previously paid ....................................................                                       14
                                                                                    00                                        00
15.  Add lines 12, 13 and 14 (net credits)................................                                               15
                                                                                    00  00                                    00
16.  Donations (see instructions) .............................................                                        16
                                                                                                         00                   00
17.  Amount applied to the next year’s estimated tax account                                                             17
                                                                                                         00           00      00
18.  Amount previously refunded.............................................                                           18
                                                                                                         00                   00
19.  Penalty for the underpayment of estimated tax ................                                      00           00   19
                                                                                                                              00
20.  Add lines 11, 16, 17, 18 and 19 (tentative amount due) ...                                                           20 
                                                                                                         00           00                             00

                                        *16119111694*
                                                                                        16119111694



- 2 -
21.  Refund: If line 15C is greater than line 20C, enter the difference here and stop. This is your refund. If  
      line 20C is greater than line 15C, continue to line 22 ........................................................... Your Refund 21
                                                                                                                                                                  00
22.  Amount Due: If line 20C is greater than line 15C, enter the difference here .............................................  22
                                                                                                                                                                  00
23.  Penalty (see instructions) ............................................................................................................................  23
                                                                                                                                                                  00
24.  Interest (see instructions) ............................................................................................................................  24
                                                                                                                                                                  00
25.  Total Amount Due (see instructions for information on how to make your payment) . Pay This Amount                               25
                                                                                                                                                                  00
Authorization
Under penalty of perjury, I have examined this return and all attachments and to the best of my knowledge and belief, it is true, complete and 
correct. I understand that if this is a joint return, any refund will be made payable to us jointly and each of us is liable for all taxes due under this 
return. Also, my request for direct deposit of my refund includes my authorization to the Indiana Department of Revenue (Department) to furnish my 
financial institution with my routing number, account number, account type, and Social Security number to ensure my refund is properly deposited. 
I give permission to the Department to contact the Social Security Administration to confirm that the Social Security number(s) used on this return 
is correct.                                                                      Daytime telephone number

Your Signature ______________________________________       Date _____________                                                                                   BV
                                                                                 Email address where we can reach you                                              BW
Spouse’s Signature __________________________________       Date _____________

AG
I authorize the Department to discuss my return with my personal        Paid Preparer: Firm’s Name (or yours if self-employed)
representative.                                                      AN
 Yes        No    If yes, complete the information below. 
Personal Representative’s Name (please print) AH                     AQ PTIN
                                                                            AR
                                                                        Address
Telephone                                        AI                     AS
number                                                                  City
       AJ                                                               AT                                                           AU
Address
                                                                        State                                            Zip Code
  AK
City
                                                                        Preparer’s 
  AL                            AM                                      signature ______________________________________________
State                         Zip Code 

Part 1    Explanation of changes

Check all that apply. Make sure to enclose copies of W-2s, federal and/or other state tax returns, state schedules (such as CC-40 if 
claiming a college credit), etc., to support your amendment.
 Add W-2 (s) __________________________________________________________________________________________
 Add/change Credit: name of credit(s) ______________________________________________________________________
 Add/change Deduction: name of deduction(s) ________________________________________________________________
 Add/change Exemption: which exemption(s) _________________________________________________________________
 Change in filing status: _________________________________________________________________________________
 Amending for tax year 2016 or before? If yes, and you are decreasing the amount reported on Line 1, Column C, check the box        
       and attach a federal Tax Account Transcript (see instructions)
 Other: Explain

Mailing Address:
If enclosing payment mail to: Indiana Department of Revenue, P.O. Box 7224, Indianapolis, IN  46207-7224. 
Mail all other returns to: Indiana Department of Revenue, P.O. Box 40, Indianapolis, IN 46206-0040.

                                       *24100000000*
                                                            24100000000



- 3 -
                             Instructions for Completing Form IT-40X
Who should file Form IT-40X                                           Line 1 – Amount from Line 1 of IT-40/IT-40EZ/IT-40PNR
Use this form to correct/update a previously filed Indiana indi-      Enter in Column A the amount reported on line 1 of your Indiana 
vidual income tax return.                                             individual income tax return. Enter any change to that amount 
                                                                      in Column B, and the corrected total in Column C. If amending 
Additional Information                                                Form IT-40RNR, enter the Indiana AGI from line 3.
If you have any questions concerning the types of income to be 
reported, what adjustments are allowable, how to figure and claim     Important. If you are reducing the amount in Column C for 
various credits, etc., you should refer to the instructions for the   tax year 2016 or before, you must attach a federal Tax Account 
individual income tax return for the year you are amending. Cur-      Transcript. After the Internal Revenue Service completes the 
rent year instructions may be accessed online at                      processing of any federal Form 1040X, you may obtain a copy of 
www.in.gov/dor/6524.htm; instructions for previous years may be  the transcript at www.irs.gov/individuals/get-transcript.
accessed at www.in.gov/dor/3488.htm.
                                                                      Line 2 – Indiana Add-Backs
Part 1 Explanation of Changes (Located on Page 2)                     For tax year 2009 and beyond, enter in Column A the total add-
You must provide a complete explanation of the changes you are        backs reported on Schedule 1 from IT-40 (from Schedule B if 
making to your previously filed return. While some of the most        filing IT-40PNR). If filing Form IT-40EZ for 2009, add-back any 
common reasons to amend are listed, if you are amending for any       unemployment compensation reported on line 2 of that form.
other reason(s), enter a detailed explanation in the “Other” area.
                                                                      For tax years 2005 through 2008, enter the total of add-backs 
Make sure to enclose documents to support your amended claim.         reported on lines 2 through 6 from IT-40 (from Schedule A, lines 
These documents can include:                                          23 and 24 if filing IT-40PNR). 
W-2s, 1099s, WH-18s, etc.
A copy of your amended federal return, if one was filed, and        For tax years 2003 and 2004, enter the total of add-backs reported 
  any federal schedules/forms that support the changes listed in  on lines 2 through 5 from IT-40 (from Schedule A, lines 23 and 
  Column B.                                                           24 if filing IT-40PNR). 
Schedule IT-40NOL and federal Schedule A (from Form 
  1045) if claiming a net operating loss carryforward deduc-          For tax years before 2003, enter the net of any reported tax add-
  tion.                                                               back, net operating loss carryforward, and/or income taxed on 
Other state(s) returns if claiming a credit for taxes paid to       federal Form 4972 (enter the net of any reported tax add-back and 
  other states                                                        income taxed on federal Form 4972 if filing IT-40PNR). Enter 
State forms/schedules, such as Schedule CC-40 if claiming a         any change in Column B and the corrected total in Column C.
  college credit.                                                      
Federal Tax Account Transcript (see Line 1 instructions).           Line 4 – Indiana Deductions
                                                                      Enter in Column A the deductions reported on your Indiana indi-
Failure to submit a complete explanation and the appropriate          vidual income tax return. Enter any change in Column B and the 
state and federal schedules and forms could result in a delay in      corrected total in Column C.
processing your claim.
                                                                      Line 6 – Exemptions
Note. You may not change your filing status (from a joint to a sin-   Enter in Column A the total amount of exemptions reported on 
gle return) after the due date of the original tax return has passed. your Indiana individual income tax return. Enter any change 
                                                                      in Column B and the corrected total in Column C. If amending 
Column A – Enter the amount shown on your original return or          Form IT-40RNR, enter the exemptions from line 4. 
previously amended return, or as last determined by the depart-
ment.                                                                 Note. If amending Form IT-40PNR, read the proration instruc-
                                                                      tions for that tax year; use the corrected totals from the IT-40X to 
Column B – Enter the amount of change in the items reported           arrive at the adjusted amount to enter here.
on your original return.
                                                                      Line 8 – State Adjusted Gross Income Tax
Column C – Enter the correct amounts after taking into account        For tax years beginning before Jan. 1, 2015, multiply the amount
the increases or decreases shown in Column B. If there are no         on line 7 by .034. For the 2015 and 2016 tax years, multiply the 
changes, enter the same amount in Column A and Column C,              amount on line 7 by .033. For tax years 2017 and beyond, multi-
leaving Column B blank.                                               ply the amount on line 7 by .0323.

Important. You must round all entries.                                Line 9 – County Tax
                                                                      Complete Schedule CT-40/CT-40PNR (or IT-40RNR, if applica-
                                                                      ble) for the tax year in question to figure the corrected county tax.



- 4 -
Line 10 – Other Taxes                                               Find your interest rate from the chart below:
Enter the total of any use tax, household employment tax, recap-
ture of certain offset credits and/or nonresident professional team Tax         Annual         Monthly
member’s county tax.                                                Year        Rate           Rate
                                                                    2010        4% (.04)       .0033
Line 12 – Credits
Enter the total of your Indiana state and county withholding        2011        9% (.09)       .0075
taxes, estimated tax paid, extension payment, unified tax credit    2012        4% (.04)       .0033
for the elderly, earned income credit, Lake County residential      2013 – 2015 3% (.03)       .0025
income tax credit, economic development for a growing economy 
                                                                    2016        2% (.02)       .0017
credit and automatic taxpayer refund credit.
                                                                    2017        3% (.03)       .0025
Line 13 – Offset Credits
Enter all other credits not included on line 12.                    If filing for years other than those listed above, visit our website 
                                                                    at www.in.gov/dor/3618.htm to get Departmental Notice # 3.
Line 16 – Donations
Enter any amount contributed to the Indiana Nongame and             Line 25 – Total Amount Due – Payment Options 
Wildlife Fund, the Military Family Relief Fund, and/or the Public   There are several ways to pay the amount you owe. 
K-12 Education Fund with the filing of your original return.
                                                                    Make your check, money order or cashiers check payable to: 
Note. You cannot increase or decrease this amount once a            Indiana Department of Revenue. 
contribution has been made. Also, you cannot make a first-time 
contribution with the filing of this return.                        You may also pay using the eCheck payment method. This 
                                                                    service uses a paperless check and may be used to pay the tax 
Line 17 – Amount Applied to the Next Year’s Estimated               due with your Indiana individual income tax return, as well as 
     Tax Account                                                    any billings issued by the Indiana Department of Revenue for 
This line cannot be changed unless the amended return is filed by   any tax type. Go to www.in.gov/dor/4340.htm and follow the 
the first installment payment due date.                             step-by-step instructions to make your payment. You will receive 
                                                                    a confirmation number and should keep this with your tax filing 
Line 19 – Penalty for the Underpayment of Estimated                 records. The fee for using this service is $1.
 Tax 
This penalty is based on the tax that was due by your original fil- Important. All payments made to the Indiana Department of 
ing due date. Any increase or decrease in tax due will change the   Revenue must be made with U.S. funds.
penalty amount. Attach Schedule IT-2210 to support any changes.
                                                                    You may also pay by using your MasterCard® or VISA® by call-
Line 21 – Refund                                                    ing 1-800-2-PAY TAX (1-800-272-9829). Or, log on to 
Enter the amount of refund you are claiming. The processing of      www.in.gov/dor/4340.htm and use your MasterCard® or VISA® 
amended tax returns takes approximately 20 weeks. In general, an  to make a payment.
amended claim for refund must be made within three years from 
the due date of the original return (including extensions) or the   A convenience fee will be charged by the credit card processor 
date of overpayment, whichever is later.                            based on the amount you are paying. You will be told what the 
                                                                    fee is and you will have the option to either cancel or continue the 
Lines 23 and 24 – Penalty and Interest                              credit card transaction. 
If you have an amount due on line 22 and this amended return is 
submitted after the due date for filing your original return, you   Mailing Address
must include penalty and interest (calculated from the due date).   If enclosing payment mail to: Indiana Department of Revenue, 
Figure both penalty and interest on the amount on line 22 minus       P.O. Box 7224, Indianapolis, IN 46207-7224.  
any amount on line 19C. Penalty is 10 percent (.10) of the remit-
tance due or $5.00, whichever is greater.                           Mail all other returns to: Indiana Department of Revenue, P.O. 
                                                                      Box 40, Indianapolis, IN 46206-0040






PDF file checksum: 1576665576

(Plugin #1/8.13/12.0)