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04     Schedule E / Schedule IN-PRO      Schedule E: Other Taxes                                                    Enclosure 
05     Form IT-40PNR, State Form 56541                                                                 Sequence No. 04B
       (R5 / 9-23)                                                                          2023
06
07 Name(s) shown on Form IT-40PNR                                                        Your Social Security Number
08
09 XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX                                       999        99 9999
10
11
12 1. Use tax on out-of-state purchases from line 4 of Sales/Use Tax Worksheet __________________   1 99999999999.00
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14 2. Household employment taxes. Enclose Schedule IN-H __________________________________          2 99999999999.00
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16 3. Recapture of certain Indiana offset credits. Enclose Schedule IN-CR _______________           3 99999999999.00
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18 4. Nonresident professional team member’s county tax from Schedule IN-PRO, line 11  __________   4 99999999999.00
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20 5. Add lines 1 through 4. Enter here and on Form IT-40PNR, line 10 __________  Total Other Taxes 5 99999999999.00
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26                                          Schedule IN-PRO
27
28 Nonresident professional team members, including nonresident race team members, should complete this schedule to figure the 
29 Indiana county tax due on modified wage income (see instructions).
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31
32
33 Column A           Column B                                           Column C                   Column D 
34 County Code        Modified Wage Income                               County Tax Rate            County Tax
35                                                                                          (Column B X Column C)
36
37 1.  99          99999999999999999999    .00                           99999999        1          999999999.00
38
39 2.  99          99999999999999999999    .00                           99999999        2          999999999.00
40
41 3.  99          99999999999999999999    .00                           99999999        3          999999999.00
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43 4.  99          99999999999999999999    .00                           99999999        4          999999999.00
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45 5.  99          99999999999999999999    .00                           99999999        5          999999999.00
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47 6.  99          99999999999999999999    .00                           99999999        6          999999999.00
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49 7.  99          99999999999999999999    .00                           99999999        7          999999999.00
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51 8.  99          99999999999999999999    .00                           99999999        8          999999999.00
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53 9.  99          99999999999999999999    .00                           99999999        9          999999999.00
54
55 10. 99          99999999999999999999    .00                           99999999        10         999999999.00
56
57 11. Total county tax. Add lines D-1 through D-10; carry this total to 
58 Schedule E, line 4  _______________________________________ Total County Tax  11                 999999999.00
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62                                      *26023111694*
63                                             26023111694
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