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Schedule IT-40QEC Indiana Department of Revenue Enclosure
State Form 21928
(R19 / 9-23) Enterprise Zone Sequence No. 18
2023
Qualified Employee Deduction
Certificate
Name of employee Social Security Number Name of Enterprise Zone ___________
Date of residence in Enterprise Zone:
From ____________ To ____________
Employee’s street address Amount of compensation for tax year
during the period of residence in the
Enterprise Zone: $_________________
City of residence Caution: Limitation of Deduction
Enter ½ of the above amount or $7,500,
whichever is less: $________________
Employer Address Federal Employer
Identification Number
I certify that the above-named employee was paid the amount indicated as compensation for services rendered, and that he/she is a
qualified employee as defined in IC 6-3-2-8.
Signature of employer Title Telephone number Date
Instructions for completing Schedule IT-40QEC
Schedule IT-40QEC is to be completed by the enterprise zone employer and distributed to its qualified employee(s). The qualified
employee should claim this deduction on IT-40 Schedule 2 or IT-40PNR Schedule C. The employee must enclose the IT-40QEC with
the state individual income tax return to support any claimed deduction of earned enterprise zone income.
Indiana Code IC 6-3-2-8 defines a “qualified employee” as an individual who:
1. Has a principal place of residency in the enterprise zone where employed;
2. Performs services for the employer 90 percent of which are directly related to the conduct of the employer’s trade or business
located in an enterprise zone;
3. Performs services for the employer at least 50 percent of the time during the taxable year within an Indiana state enterprise
zone; and
4. Is employed by a business that remains eligible to receive benefits and incentives as provided by enterprise zone legislation.
Portions of certain Indiana cities are designated as state enterprise zones. A qualified employee living and working in a designated
enterprise zone may be entitled to deduct from state adjusted gross income one-half of the enterprise zone income earned
for services or $7,500, whichever is less. Enterprise zone income means wages, salaries, commissions and any other forms of
remuneration paid to qualified employees for services by an enterprise zone employer, minus any IRA deductions directly related to that
earned income.
For a listing of all current enterprise zones and contact information for each zone please visit www.aiez.org/directory.html.
Privacy Notice: The records in this series are CONFIDENTIAL according to the provisions of IC 6-8.1-7-1 and IC 5-28-15-8
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