Enlarge image | 01 0000000000111111111122222222223333333333444444444455555555556666666666777777777788888 1234567890123456789012345678901234567890123456789012345678901234567890123456789012345 04 Schedule Indiana Withholding and Composite IN-COMPA 05 State Form 52826 Filing Opt-Out Affidavit 06 (R3 / 8-23) 07 08 09 10 Pass-Through Entity Information 11 Name of Entity FEIN 12 13 14 Address 15 16 City, State, ZIP Code 17 18 19 20 Type of Pass-Through Entity: 21 22 23 Partnership S Corporation Estate Trust □ □ □ □ 24 25 Nonresident Information 26 Name FEIN/SSN 27 28 29 Address 30 31 City, State, ZIP Code 32 33 34 Type of Entity 35 36 Year(s) (see instructions) 37 38 39 40 41 Please check the reason(s) for claiming an exemption for, or reduction in the amount of withholding: 42 The entity is an employee stock ownership plan. (03) 43 □ 44 The entity is an insurance company not subject to adjusted gross income tax or financial institutions tax. (05) 45 □ 46 The entity is a nonprofit (including IRAs and other retirement plans) and the income is not unrelated business 47 □ 48 income to the entity. (06) 49 The entity is a real estate investment trust. Do not claim this exemption if the entity is a captive real estate 50 □ 51 investment trust. (07) 52 The entity is a real estate mortgage investment conduit. (08) 53 □ 54 The entity is permitted a treaty-based exemption from income tax. Please list the country and the relevant 55 □ 56 provision of the treaty (if known). (09) ____________________________ 57 58 59 60 61 62 *24100000000* 63 24100000000 64 65 66 |
Enlarge image | 01 0000000000111111111122222222223333333333444444444455555555556666666666777777777788888 1234567890123456789012345678901234567890123456789012345678901234567890123456789012345 04 05 06 07 The income is subject to reduction because the entity claiming ownership has an allowable loss to be 08 □ applied against the income. 09 10 Suspended losses (list amount allowable) (04) ______________ 11 □ 12 Claimed ______________ 13 14 Passive activity losses (list amount allowable) (10) ______________ 15 □ 16 Claimed ______________ 17 18 Indiana net operating losses (list amount allowable) (11) ______________ 19 □ 20 Claimed ______________ 21 22 The tax owed by the entity is reduced by either Indiana credit carryforwards or Indiana credits from other 23 □ sources. List the credit, amount, the year in which the credit was earned, and the FEIN or Social Security 24 number of the source. (12) 25 26 Credit Year FID of 27 Amount (3-digit code) Earned Source 28 29 30 31 32 33 34 35 36 37 The entity is a corporation or financial institution that is registered with the Indiana Secretary of State to □ 38 do business in Indiana and is remitting estimated payments on the income from the pass-through entity. 39 List the FID if the corporation otherwise subject to withholding is different than the corporation reporting 40 the tax for Indiana purposes. (13) _________________________ 41 42 43 Under penalties of perjury, I understand that I am responsible for filing any Indiana tax returns and remitting 44 any tax due as a result of the pass-through entity’s income derived from Indiana sources. I further agree 45 that I consent to the jurisdiction of the state of Indiana with regard to any income, return filing, assessment, 46 and rights of appeal. I further agree that this waiver of withholding does not apply if a partnership is subject 47 to adjustments resulting from Indiana or federal adjustments, including audits, administrative adjustment 48 requests, and amended returns. This agreement may be revoked at any time by the Indiana Department of 49 State Revenue (“Department”), and the Department may notify the pass-through entity listed above of the 50 revocation and any disallowance of waivers. 51 52 Name: _________________________________ Name (printed): _________________________ 53 54 Title (if applicable): _______________________ Date: ________________________________ 55 56 57 58 59 60 61 62 *24100000000* 63 24100000000 64 65 66 |
Enlarge image | Instructions for Indiana Withholding and Composite Filing Opt-Out Affidavit The Schedule IN-COMPA is intended as a schedule to Nonresident Information permit a shareholder, partner, or beneficiary to have nonresident tax withholding reduced or eliminated in Enter all fields for the affected nonresident. For type certain cases. These cases are intended to be those of entity, use a common description (e.g., individual, S circumstances where an ultimate taxpayer would have an corporation, C corporation, etc.). Indiana income tax liability that is significantly lower than the amount required to be withheld or withholding would For the year, enter the first year and last year of the result in duplicate collection of the same tax. election (for instance, 2022-2026 or 2022-forward) only for the first five reasons listed in the affidavit or for the reason This affidavit may not be used to claim a reduction or associated with corporations registered in Indiana and waiver of pass through entity tax ("PTET"). Any tax required remitting estimated payments. For all other listed reasons, to be withheld will be reduced by the PTET even if this enter only the current taxable year. affidavit is not completed. If multiple tax years are entered appropriately, the affidavit A pass-through entity is not required to accept the affidavit. generally is required to be completed only once for the If a pass-through entity does not accept this affidavit, entire period specified unless the department specifically withholding is required in the same manner as if no affidavit voids the affidavit. However, if there is a material change had been completed. In addition, the department may void in law (as published in the Indiana Register) or material any affidavit and may require a pass-through entity to not change in fact, the listing of multiple years is void upon accept an affidavit upon notification by the department. such material change. For a pass-through entity, any completed affidavits are Reasons for Claiming Exemption or Reduction in required to be attached to the pass-through entity’s return Withholding each year for which the affidavit applies. Failure to attach an affidavit shall be treated as if the affidavit had not Please check at least one box specifying a reason for been completed for that taxable year and composite reduced or eliminated withholding. More than one box can tax will be assessed. be checked. For a partner, shareholder, or beneficiary, the affidavit Each box has a number in parentheses after the may be attached to the return. However, attachment is not explanation. The pass-through entity is required to list the required. The partner, shareholder, or beneficiary must code in Column A on the line of Schedule Composite or provide a completed copy of the affidavit upon department Schedule Composite-COR associated with the nonresident request. completing this affidavit. If more than one box is checked, the pass-through entity is required to list one of the The affidavit must be completed by the nonresident before allowable codes in Column A of the Schedule Composite or the 15th day of the fourth month following the end of the Schedule Composite-COR. pass-through entity’s tax year. In the case of an affidavit covering multiple years, failure to complete the affidavit in If you are claiming an exemption because of an allowable a timely manner will result in the affidavit being treated as loss, you are required to specify each amount of loss that void for that taxable year. is potentially applicable against the income from the pass- through entity. IMPORTANT: In the event of an amended return by the pass-through entity or a department adjustment to If you are claiming that you have a credit that (1) is from the pass-through entity, this affidavit will not relieve another entity or (2) is a carryforward from a previous year, the pass-through entity of withholding based on the regardless of whether the credit was generated by this amended return. Further, this affidavit cannot be used pass-through entity, list each credit separately. Use the to relieve a partnership of any tax otherwise due as three-digit code assigned to the credit by the department. a result of adjustments if the partnership elects to be A list of available credits for a nonresident can be found in taxed at the partnership level. the relevant instruction booklet for the nonresident’s normal return filing. *24100000000* 24100000000 |