Enlarge image | Schedule 5 / Schedule IN-DONATE Schedule 5: Credits Enclosure Form IT-40, State Form 53998 Sequence No. 04 (R14 / 9-23) 2023 Name(s) shown on Form IT-40 Your Social Security Number Round all entries 1. Indiana state tax withheld: See instructions ___________________________________________ 1 .00 2. Indiana county tax withheld: See instructions _________________________________________ 2 .00 3. Pass Through Entity Tax Credit ____________________________________________________ 3 .00 4. Estimated tax paid for 2023: include any extension payment made with Form IT-9 ____________ 4 .00 5. Unified tax credit for the elderly ____________________________________________________ 5 .00 6. Earned income credit: enclose Schedule IN-EIC and enter amount from line A-3 _____________ 6 .00 7. Lake County residential income tax credit ____________________________________________ 7 .00 8. Economic development for a growing economy credit. Enter amount from Schedule IN-EDGE, line 19 (enclose schedule) ________________________________________________________ 8 .00 9. Economic development for a growing economy retention credit. Enter amount from Schedule IN-EDGE-R, line 19 (enclose schedule) ______________________________________ 9 .00 10. Headquarters relocation credit (refundable portion - see instructions) ______________________ 10 .00 11. Adoption Credit ________________________________________________________________ 11 .00 12. Reserved for future use __________________________________________________________ 12 .00 13. Add lines 1 through 12. Enter total here and on Form IT-40, line 12 _____________Total Credits 13 .00 Schedule IN-DONATE Important: The amount on line 2 cannot exceed the amount on Form IT-40, line 16. 1. Donations: List fund name, 3-digit code and amount to be donated (see instructions) a. Enter fund name code no. 1a .00 b. Enter fund name code no. 1b .00 c. Enter fund name code no. 1c .00 2. Add lines 1a through 1c. Enter total here and on Form IT-40, line 17 Total Donations 2 .00 *23123111694* 23123111694 |