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04 Schedule E                                    Indiana Department of Revenue
05 Form IT-20/20S/20NP/IT-65             Apportionment of Income for Indiana
   State Form 49105 
06 (R23 / 8-24)
07                        for Tax Year Beginning 99 99           2024 and Ending 99 99         9999
08
09 Name as shown on return                                                          Federal Employer Identification Number
10
11 XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX                                          9999999999
12 Each filing entity having income from sources both within and outside Indiana must complete an apportionment schedule except 
13 financial institutions and certain insurance companies that use a single receipts factor. Interstate transportation entities must use 
14 Schedule E-7. Combined unitary filers must use the apportioning method (relative formula percentage) as outlined in Information 
15 Bulletin #12 and Tax Policy Directive #6. Omit cents; percents should be rounded two decimal places; read apportionment instructions.
16
17 Part I - Indiana Apportionment of Adjusted Gross Income
18 Sales / Receipts (less returns and allowances)
19 Include all non-exempt apportioned gross business income. Do not use non-unitary partnership income of previously apportioned 
20 income that must be separately reported as allocated income.
21
22                                               Column A                        Column B             Column C 
23                                          Total Within Indiana             Total Within and         Indiana  
24                                                                           Outside Indiana          Percentage
25 Sales delivered or shipped  
26 to Indiana:
27 1. Shipped from within  
28    Indiana                            1A 99999999999.00 
29
30 2. Shipped from outside  
31    Indiana                            2A 99999999999.00
32
33 Sales shipped from Indiana to:
34 3. The United States  
35    government                         3A 99999999999.00
36 4.  Purchasers in a state where  
37    the taxpayer is not subject to  
38    income tax (under P.L. 86-272) 
39    (for years beginning prior to 
40    Jan. 1, 2016 only)                 4A 99999999999.00
41 Other:
42 5.  Interest and other receipts from  
43    extending credit attributed to  
44    Indiana                            5A 99999999999.00
45 6.  Other gross business receipts  
46    not previously apportioned         6A 99999999999.00
47 7.  Direct premiums and annuities  
48    received for insurance upon  
49    property or risks in Indiana       7A 99999999999.00
50 8.  Total Receipts: Add column A  
51    receipts lines on 1A through  
52    7A and enter in line 8A. Enter  
53    all receipts on line 8B            8A 99999999999.00                8B 99999999999.00
54
55 Apportionment of income for  
56 Indiana:
57 9.  Apportionment Percentage:  
58    Divide line 8A by line 8B  
59    (insert as percent, not decimal)                                                             9C 999.99                             %
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04 Schedule E                                                                                                            Page 2
05 Part II - Business/Other Income Questionnaire
06 1.  List all business locations where the taxpayer has operations or partnership interests and indicate type of activities.  
07 This section must be completed; attach additional sheets if necessary.
08
09 City                                                       State           Nature of Business Activity
10
11             XXXXXXXXXXXXXXXXXXXX                                 XX        XXXXXXXXXXXXXXXXXXXXXXXXXXXX
12 Accepts                               Registered to                        Files Returns 
13 Orders?     X Yes X   No              Do Business?  X      Yes   X    No   in State?                    X     Yes X   No
14 Property in                                    Property in 
15 State Leased? X   Yes X  No                    State Owned?    X Yes     X No
16
17 City                                                       State           Nature of Business Activity
18
19             XXXXXXXXXXXXXXXXXXXX                                 XX        XXXXXXXXXXXXXXXXXXXXXXXXXXXX
20 Accepts                               Registered to                        Files Returns 
21 Orders?     X Yes X   No              Do Business?  X      Yes   X    No   in State?                    X     Yes X   No
22 Property in                                    Property in 
23 State Leased? X   Yes X  No                    State Owned?    X Yes     X No
24
25 City                                                       State           Nature of Business Activity
26
27             XXXXXXXXXXXXXXXXXXXX                                 XX        XXXXXXXXXXXXXXXXXXXXXXXXXXXX
28 Accepts                               Registered to                        Files Returns 
29 Orders?     X Yes X   No              Do Business?  X      Yes   X    No   in State?                    X     Yes X   No
30 Property in                                    Property in 
31 State Leased? X   Yes X  No                    State Owned?    X Yes     X No
32
33 City                                                       State           Nature of Business Activity
34
35             XXXXXXXXXXXXXXXXXXXX                                 XX        XXXXXXXXXXXXXXXXXXXXXXXXXXXX
36 Accepts                               Registered to                        Files Returns 
37 Orders?     X Yes X   No              Do Business?  X      Yes   X    No   in State?                    X     Yes X   No
38 Property in                                    Property in 
39 State Leased? X   Yes X  No                    State Owned?    X Yes     X No
40
41 2.  Briefly describe the nature of Indiana business activities, including the exact title and principal business activity of any partnership 
42 in which the taxpayer has an interest:
43
44 XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
45 3.  Indicate any partnership in which you have a unitary or general partnership relationship:
46
47 XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
48 4.  Briefly describe the nature of activities of sales personnel operating and soliciting business in Indiana:
49
50 XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
51 5.  Do Indiana receipts for line 3A include all sales shipped from Indiana to (1) the U.S. government;  
52 or (2) locations where this taxpayer’s only activity in the state of the purchaser consists of the mere  
53 solicitation of orders? If no, please explain.                                                                X   Yes       X No
54
55 XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
56 6.  List the source of any directly allocated income from partnerships, estates, and trusts not in the taxpayer’s apportioned tax base:
57
58 XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
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