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04 Schedule 1                            Schedule 1: Add-Backs                                                Enclosure 
05 Form IT-40, State Form 53995                                                                        Sequence No. 01
   (R14 / 9-23)                                                                    2023
06
07 Name(s) shown on Form IT-40                                                     Your Social Security Number
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09 XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX                                 999              99 9999
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11                                                                                                     Round all entries
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13 1. Tax add-back: certain taxes deducted from federal Schedules C, C-EZ, E and/or F ____________  1  99999999999.00
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15 2. Net operating loss carryforward from federal Form 1040, “Other income” line  ________________ 2  99999999999.00
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17 3. OOS municipal obligation interest add-back  __________________________________________        3  99999999999.00
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19 4. Bonus depreciation add-back ______________________________________________________            4  99999999999.00
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21 5. Section 179 expense excess add-back ______________________________________________            5  99999999999.00
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23 6. Other Add-Backs: See instructions.
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25 a. Enter add-back name  XXXXXXXXXXXXXXXXXXXXXXXXXX                     code no. 999              6a 99999999999.00
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27 b. Enter add-back name  XXXXXXXXXXXXXXXXXXXXXXXXXX                     code no. 999              6b 99999999999.00
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29 c.  Enter add-back name XXXXXXXXXXXXXXXXXXXXXXXXXX                     code no. 999              6c 99999999999.00
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31 d. Enter add-back name  XXXXXXXXXXXXXXXXXXXXXXXXXX                     code no. 999              6d 99999999999.00
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33 e. Enter add-back name  XXXXXXXXXXXXXXXXXXXXXXXXXX                     code no. 999              6e 99999999999.00
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35 f.  Enter add-back name XXXXXXXXXXXXXXXXXXXXXXXXXX                     code no. 999              6f 99999999999.00
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37 g. Enter add-back name  XXXXXXXXXXXXXXXXXXXXXXXXXX                     code no. 999              6g 99999999999.00
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39 h. Enter add-back name  XXXXXXXXXXXXXXXXXXXXXXXXXX                     code no. 999              6h 99999999999.00
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41 i.  Enter add-back name XXXXXXXXXXXXXXXXXXXXXXXXXX                     code no. 999              6i 99999999999.00
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43 j.  Enter add-back name XXXXXXXXXXXXXXXXXXXXXXXXXX                     code no. 999              6j 99999999999.00
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45 k.  Enter add-back name XXXXXXXXXXXXXXXXXXXXXXXXXX                     code no. 999              6k 99999999999.00
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47 l.  Enter add-back name XXXXXXXXXXXXXXXXXXXXXXXXXX                     code no. 999              6l 99999999999.00
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49 m. Enter add-back name  XXXXXXXXXXXXXXXXXXXXXXXXXX                     code no. 999              6m 99999999999.00
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51 n. Enter add-back name  XXXXXXXXXXXXXXXXXXXXXXXXXX                     code no. 999              6n 99999999999.00
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53 o. Enter add-back name  XXXXXXXXXXXXXXXXXXXXXXXXXX                     code no. 999              6o 99999999999.00
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55 7.  Add lines 1 through 6. Enter total here and on Form IT-40, line 2  Total Indiana Add-Backs   7  99999999999.00
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62                                      *22823111694*
63                                        22823111694
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