01
0000000000111111111122222222223333333333444444444455555555556666666666777777777788888
1234567890123456789012345678901234567890123456789012345678901234567890123456789012345
04       Schedule IN-EIC                 Schedule IN-EIC: Indiana’s Earned Income Credit                                       Enclosure 
05       Form IT-40/IT-40PNR             You must enclose if claiming this credit on Forms IT-40 or IT-40PNR.                 Sequence No. 9
         State Form 49469
06       (R23 / 9-23)                                                                                              2023
07
08  Name(s) shown on Form IT-40/IT-40PNR                                                           Your Social Security Number
09
10 XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX                                                 999             99   9999
11
12 Section A: Figure Your Indiana Earned Income Credit
13
14  A-1 Enter the earned income credit from your federal income tax return  _______________________                A-1  99999999999.00
15
16  A-2 Enter your earned income. (see instructions)  _________________________________________                    A-2  99999999999.00
17  A-3 Enter your Indiana earned income credit (Multiply Line A-1 by 10%). 
18     Carry this total to Form IT-40, Schedule 5, line 6, or  
19     Form IT-40PNR, Schedule F, line 6, Box A _________________ Indiana Earned Income Credit                     A-3  99999999999.00
20
21 Section B: Complete if you claimed one or more children on your federal Schedule EIC. See instructions.
22
23 Enter each child’s information
24
25                                       Child 1                                 Child 2                                Child 3
26 First name
27                        XXXXXXXXXXXXXXXXX                         XXXXXXXXXXXXXXXXX                              XXXXXXXXXXXXXXXXX
28 Last name
29                        XXXXXXXXXXXXXXXXX                         XXXXXXXXXXXXXXXXX                              XXXXXXXXXXXXXXXXX
30 Child’s Social 
31 Security Number(s)          999       99      9999                    999     99            9999                999  99     9999
32
33 Enter letter (e.g., A, B,  ,Cetc.) in boxes below that describes each child’s relationship, age and location to you. 
34
35                                                                  Child 1                        Child 2              Child 3
36  B-1 Relationship: 
37  A Your Child
38  B Grandchild
39  C Stepchild
40  D Foster Child (not related)                                         X                         X                    X
41  E Other (related foster child, or other  
42    related child - see instructions)
43
44  B-2 Age:
45  A Under age 18
46  B Age 18
47  C Age 19 - 24 and full-time student
48  D Age 19 or older and totally                                        X                         X                    X
49    disabled
50
51  B-3 Location:
52  A Child lived with you at 
53    least ½ of the year
54  B Child was born or died 
55    in 2023, and lived with                                            X                         X                    X
56    you while alive in 2023.
57
58  Important: You must complete and attach this schedule to your Form IT-40 or IT-40PNR when claiming the earned income credit. 
59
60
61
62                                               *17223111694*
63                                                                  17223111694
64
65
66

                                               Instructions for Schedule IN-EIC

Here are some important things to know when figuring this credit:    Social Security Number. Your qualifying child must have a valid 
• You must be eligible for and have claimed an EIC on your           Social Security number (SSN) unless the child was born and died 
  federal tax return. If not, STOP. You are not eligible to claim    in 2023.*
  Indiana’s EIC.
• Your income on Form IT-40, line 1 (or Indiana’s Schedule A,        Important: Enter information for the same child (or children) you 
  line 36A), must be less than $63,398. If it is the same amount     entered on your federal Schedule EIC wherever possible.
  or more, STOP. You are not eligible to claim Indiana’s EIC.
• Schedule IN-EIC must be completed and enclosed by all filers       Example. Marie has four children, three of whom she claimed for 
  claiming the EIC.                                                  federal EIC purposes. All three children meet the requirements to be 
• Indiana’s Publication EIC is retired beginning with tax year 2023. a qualified child within Indiana. Since Marie may claim up to three 
                                                                     qualified children on this schedule, she should list the three qualified 
                                                                     children she claimed for federal EIC purposes.

Caution:  You must know what your federal earned income credit       In Section B-1, the ‘Foster Child (not related)’ box (line D) is an 
is before you can figure your Indiana EIC. If you don’t know what    unrelated child who was placed with you by an authorized placement 
your federal EIC is by Indiana’s filing due date, go ahead and file  agency. 
your Indiana return without claiming the EIC. Then, when you find 
out what your federal EIC is, file an amended (corrected) Indiana    In Section B-1, the ‘Other’ box (line E) includes a related foster child,  
tax return to claim your Indiana EIC.                                or your brother, sister, stepbrother, stepsister, or a descendant of 
                                                                     your brother and/or sister, etc. (for example, your niece or nephew), 
                                                                     whom you cared for as your own child.

If, during 2023:                                                     *Exception. If your qualified dependent child was born and died in 
• you were an Indiana resident, and/or                               2023 and you do not have a SSN for the child, enter the word “Died” 
• had income from Indiana sources, and                               in the third (largest) Social Security Number box associated with your 
• you claimed the EIC on your federal                                child’s name. You must keep a copy of the child’s birth certificate, 
  income tax return, Form 1040,                                      death certificate and/or hospital records with your records as the 
then you may be eligible to claim Indiana’s EIC.                     Indiana Department of Revenue (DOR) may request this information 
                                                                     at a later date. The documents must show the child was born alive.
Caution: Schedule IN-EIC must be filed with your tax return in order 
for you to be eligible to claim Indiana’s EIC.                       Exception Example                             Died
Section A – Figure Your Indiana Earned Income Credit
Line A-1. Enter the amount of earned income credit from your federal 
income tax return.

Line A-2. Enter your earned income that you used to determine your 
federal earned income tax credit.

Line A-3. Multiply Line A-1 by 10% (.10).

Section B – Qualifying Child (Children)
You must complete Section B if you are claiming one, two, or three 
children when figuring Indiana’s EIC. 

                                               *24100000000*
                                                    24100000000