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04                                                                                                                                                 IT-20S/IT-65                                 Indiana Department of Revenue
05                                                                                                                                                 2024 Schedule IN K-1 Shareholder’s/Partner’s Share of Indiana Adjusted Gross 
                                                                                                                                                   State Form 49181 
06                                                                                                                                                 (R24 / 8-24)                          Income, Deductions, Modifications, and Credits
07
08                                                                                                                                                                           Tax Year Beginning 99        99           2024 and Ending 99 99       9999
09
10                                                                                                                                                 Name of S Corporation/Partnership                                                   Federal Employer Identification Number
11
12                                                                                                                                                 XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX                                         9999999999
13
14                                                                                                                                                 Distributions – Provide Schedule IN K-1 to each shareholder/partner. Enclose Schedule IN K-1 with Form IT-20S/IT-65 return.
15
16                                                                                                                                                 Part 1 – Shareholder/Partner’s Identification Section
17                                                                                                                                                 1. Shareholder/Partner Name
18
19                                                                                                                                                 XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX Check if amended                              X
20                                                                                                                                                 2.  Shareholder/Partner FEIN or Social Security Number              3.  Shareholder/Partner Federal Pro Rata Percentage
21
22                                                                                                                                                     9999999999                                                               999.   99    %
23                                                                                                                                                 4. If the partner is a disregarded entity (DE), enter the partner’s:
24                                                                                                                                                  a. Name                                                                            b. FEIN
25
26                                                                                                                                                  XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX                                   9999999999
27                                                                                                                                                 5. What type of entity is the partner?
28
29                                                                                                                                                 XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
30                                                                                                                                                 6.  Shareholder/Partner State of Residence or Commercial Domicile   7.   Indiana County of Principal Employment 2-digit code
31
32                                                                                                                                                     XX                                                                       XX
33                                                                                                                                                 8. Payer’s Name                                                                     9. Payer’s FEIN
34
35                                                                                                                                                 XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX                                         9999999999
36
37                                                                                                                                                 10. Pass Through Entity Tax_________________________________________________________            10 99999999999.00
38
39                                                                                                                                                 11. IN State Tax Withheld ___________________________________________________________           11 99999999999.00
40
41                                                                                                                                                 12. IN County Tax Withheld  _________________________________________________________           12 99999999999.00
42
43
44                                                                                                                                                 Part 2 - Pro Rata Share of Indiana Pass-through Tax Credits from S Corporation/Partnership
45
46                                                                                                                                                                  Column A             Column B                      Column C        Column D 
47                                                                                                                                                              IT-20S/IT-65 FEIN        Certification    Certification/Project/PIN    Tax Credit      Column E 
48                                                                                                                                                              if Credit is from IN K-1 Year                          Number             Code        Amount Claimed
49
50                                                                                                                                                  1.          9999999999               9999             9999999999999999                9999        99999999999             .00
51
52                                                                                                                                                  2.          9999999999               9999             9999999999999999                9999        99999999999             .00
53
54                                                                                                                                                  3.          9999999999               9999             9999999999999999                9999        99999999999             .00
55
56                                                                                                                                                  4.          9999999999               9999             9999999999999999                9999        99999999999             .00
57                                                                         Pass-through entities with more than 24 IN K-1s must file electronically
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59
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62                                                                                                                                                                                       *24100000000*
63                                                                                                                                                                                                        24100000000
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04
05 Part 3 - Distributive Share Amount (use apportioned figures for nonresident shareholders/partners)
06
07 1.  Ordinary business income (loss) __________________________________________________                1     99999999999.00
08
09 2.  Net rental real estate income (loss) ________________________________________________             2     99999999999.00
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11 3.  Other net rental income (loss) ____________________________________________________               3     99999999999.00
12
13 4.  Guaranteed payments (for IT-65 filers only; if filing IT-20S, skip to line 5) ________________    4     99999999999.00
14
15 5.  Interest income ________________________________________________________________                  5     99999999999.00
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17 6.  Ordinary dividends _____________________________________________________________                  6     99999999999.00
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19 7.  Royalties _____________________________________________________________________                   7     99999999999.00
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21 8.  Net short-term capital gain (loss) __________________________________________________             8     99999999999.00
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23 9.  Net long-term capital gain (loss)  __________________________________________________             9     99999999999.00
24
25 10.  Net IRC Section 1231 gain (loss) __________________________________________________              10    99999999999.00
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27 11.  Other income (loss) ____________________________________________________________                 11    99999999999.00
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29 12.  IRC Section 179 expense deduction _______________________________________________                12    99999999999.00
30
31 13.  a. Portion of expenses related to investment portfolio income, including investment interest 
32       expense and other (federal nonitemized) deductions (see instructions) __________________   13a        99999999999.00
33
34 13. b. Other information from line 20 of federal K-1 related to investment interest and expenses not  
35       listed elsewhere (see instructions) _______________________________________________               13b 99999999999.00
36 14.  Total pro rata distributions. Add all positive amounts on lines 1 through 11. See instructions  
37     for lines 12, 13a, 13b, and if you reported negative amounts on lines 1 through 11. ___________   14    99999999999.00
38
39 Part 4 - State Modifications  Add or subtract the following. Designate the distributive share amount of each modification for Indiana 
40 adjusted gross income from line 2 on the front of Form IT-20S/IT-65. For nonresidents, apply apportioned figures. (Use a minus sign to 
41 denote negative amounts.)
42 1.  State income taxes deducted _____________________________________________________                 1     99999999999.00
43
44 2.  Net bonus depreciation allowance _________________________________________________                2     99999999999.00
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46 3.  Excess IRC Section 179 deduction  ________________________________________________                3     99999999999.00
47
48 4.  Interest on U.S. obligations  ______________________________________________________              4     99999999999.00
49
50 5.  Addback/Deduction  __________________________________________Code No.              5999                 99999999999.00
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52 6.  Addback/Deduction  __________________________________________Code No.              6999                 99999999999.00
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54 7.  Addback/Deduction  __________________________________________          Code No.           999     7     99999999999.00
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56 8.  Total distributive share of modifications (see instructions) _______________________________      8     99999999999.00
57
58 9.  Add Part 3, line 14, to Part 4, line 8. See instructions for reporting on Schedule PTET,  
59     Schedule Composite, and/or Schedule Composite-COR.  ___________  Adjusted Gross Income            9     99999999999.00
60
61
62                                          *24100000000*
63                                                                 24100000000
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