Schedule E                                    Indiana Department of Revenue
Form IT-20/20S/20NP/IT-65             Apportionment of Income for Indiana
State Form 49105 
(R23 / 8-24)
                      for Tax Year Beginning                  2024 and Ending

Name as shown on return                                                      Federal Employer Identification Number

Each filing entity having income from sources both within and outside Indiana must complete an apportionment schedule except 
financial institutions and certain insurance companies that use a single receipts factor. Interstate transportation entities must use 
Schedule E-7. Combined unitary filers must use the apportioning method (relative formula percentage) as outlined in Information 
Bulletin #12 and Tax Policy Directive #6. Omit cents; percents should be rounded two decimal places; read apportionment instructions.

Part I - Indiana Apportionment of Adjusted Gross Income
Sales / Receipts (less returns and allowances)
Include all non-exempt apportioned gross business income. Do not use non-unitary partnership income of previously apportioned 
income that must be separately reported as allocated income.

                                              Column A                       Column B           Column C 
                                         Total Within Indiana             Total Within and      Indiana  
                                                                          Outside Indiana       Percentage
Sales delivered or shipped  
to Indiana:
1. Shipped from within  
   Indiana                            1A                    .00 

2. Shipped from outside  
   Indiana                            2A                    .00

Sales shipped from Indiana to:
3. The United States  
   government                         3A                    .00
4.  Purchasers in a state where  
   the taxpayer is not subject to  
   income tax (under P.L. 86-272) 
   (for years beginning prior to 
   Jan. 1, 2016 only)                 4A                    .00
Other:
5.  Interest and other receipts from  
   extending credit attributed to  
   Indiana                            5A                    .00
6.  Other gross business receipts  
   not previously apportioned         6A                    .00
7.  Direct premiums and annuities  
   received for insurance upon  
   property or risks in Indiana       7A                    .00
8.  Total Receipts: Add column A  
   receipts lines on 1A through  
   7A and enter in line 8A. Enter  
   all receipts on line 8B            8A                    .00        8B                 .00

Apportionment of income for  
Indiana:
9.  Apportionment Percentage:  
   Divide line 8A by line 8B  
   (insert as percent, not decimal)                                                          9C .                                     %

                                         *10424111694*
                                                            10424111694

Schedule E                                                                                                            Page 2
Part II - Business/Other Income Questionnaire
1.  List all business locations where the taxpayer has operations or partnership interests and indicate type of activities.  
This section must be completed; attach additional sheets if necessary.

City                                                       State         Nature of Business Activity

Accepts                               Registered to                      Files Returns 
Orders?     Yes     No                Do Business?         Yes        No in State?                            Yes     No
Property in                                    Property in 
State Leased?   Yes    No                      State Owned?      Yes     No

City                                                       State         Nature of Business Activity

Accepts                               Registered to                      Files Returns 
Orders?     Yes     No                Do Business?         Yes        No in State?                            Yes     No
Property in                                    Property in 
State Leased?   Yes    No                      State Owned?      Yes     No

City                                                       State         Nature of Business Activity

Accepts                               Registered to                      Files Returns 
Orders?     Yes     No                Do Business?         Yes        No in State?                            Yes     No
Property in                                    Property in 
State Leased?   Yes    No                      State Owned?      Yes     No

City                                                       State         Nature of Business Activity

Accepts                               Registered to                      Files Returns 
Orders?     Yes     No                Do Business?         Yes        No in State?                            Yes     No
Property in                                    Property in 
State Leased?   Yes    No                      State Owned?      Yes     No

2.  Briefly describe the nature of Indiana business activities, including the exact title and principal business activity of any partnership 
in which the taxpayer has an interest:

3.  Indicate any partnership in which you have a unitary or general partnership relationship:

4.  Briefly describe the nature of activities of sales personnel operating and soliciting business in Indiana:

5.  Do Indiana receipts for line 3A include all sales shipped from Indiana to (1) the U.S. government;  
or (2) locations where this taxpayer’s only activity in the state of the purchaser consists of the mere  
solicitation of orders? If no, please explain.                                                                    Yes        No

6.  List the source of any directly allocated income from partnerships, estates, and trusts not in the taxpayer’s apportioned tax base:

                                      *10424121694*
                                                    10424121694