Form IT-41                                           Indiana Department of Revenue
State Form 11458 
(R20 / 8-24)                                         Fiduciary Income Tax Return                                  2024

Check box  
if amended                For the calendar year 2024 or fiscal year beginning                      2024 and ending
                                                                                 MM D D                               MM D D  Y Y Y Y
Name of Estate or Trust                                                     Address

Name and Title of Fiduciary                                                 City                                State ZIP Code

2-Digit County Code       Federal Employer Identification Number            Foreign Country 2-Character Code

                                                                                                                      Please round entries 

1.  Taxable income of fiduciary from federal Form 1041  ______________________________________________          1             .00

2.  Indiana additions or add-backs, see line 2 instructions  ____________________________________________    2                .00

3.  IRC Section 965 Income  ___________________________________________________________________                 3             .00

4.  Net operating loss deduction from federal return  _________________________________________________         4             .00

5.  Add lines 1 through 4 ___________________________________________________________ Total Income    5                       .00

6.  Interest on U.S. Government Obligations reported on federal return   _________________________________      6             .00

7.  Non-Indiana fiduciary income ________________________________________________________________               7             .00

8.  Indiana portion of net operating loss deduction (enclose Schedule IT-40NOL, see instructions) _____________ 8             .00

9.  Line 5 minus lines 6 through 8 _____________________________________________   State Taxable Income         9             .00

10.  State Adjusted Gross Income Tax: multiply line 9 by .0305 _________________________________________   10                 .00

11. Other Taxes from Form IT-41, Schedule 1, line 6  ________________________________________________   11                    .00

12. Add lines 10 and 11  _______________________________________________________________ Total Tax  12                        .00

13. Fiduciary estimated tax paid  ________________________________________________________________   13                       .00

14.  Other Credits (You MUST enclose verification), see line 14 instructions _______________________________   14             .00

15.  Add lines 13 and 14  ____________________________________________________________ Total Credits  15                      .00

16.  If line 12 is greater than line 15, enter the difference  ___________________________________ Balance Due  16            .00

17. Penalty, see line 17 instructions ______________________________________________________________   17                     .00

18. Interest ,see line 18 instructions ______________________________________________________________   18                    .00

19. Total Amount Due (Add lines 16 through 18)  ________________________________________         Payment Due  19              .00

20. Refund Due (If line 15 is greater than line 12, enter the difference)  ___________________________  Refund  20            .00

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Name of Estate or Trust                                                                                  Federal Employer Identification Number

Check Applicable Boxes                                                                                   Federal           State 
First Return                Final Return              Fiduciary Name Change             Address Change   Extension Extension

Retirement Plan    Estate   Simple Trust        Complex Trust         Bankruptcy Estate             ESBT Grantor Trust  Other (Please Specify)

Additional Information – Please answer the following questions or provide the requested information.

1. Enter the total number of beneficiaries

2. Enter the number of nonresident beneficiaries

3. How many Schedule IN K-1s are included with this return?

4.  If this is an estate return, enter the date of the decedent’s death and Social Security number 
    
   Decedent’s date of death                                     Decedent’s Social Security Number

5.  If this is a trust return, enter date the entity was created

6.  Was a final individual return filed for decedent? Yes       No

7. If this is a grantor trust return, enter the grantor’s Social Security number

   I authorize the department to discuss my return with my personal             Email 
   representative.                                                              Address
                                                                                Address
     Yes     No          If yes, complete the information below.

   Personal Representative’s Name (please print)                                City

   Telephone                                                                    State                    ZIP Code
   Number

Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the 
best of my knowledge and belief it is true, correct, and complete. If prepared by a person other than the taxpayer, this declaration is 
based upon all information of which the preparer has any knowledge.
Signature of Fiduciary or Officer                     Telephone Number                  Date             Mail completed return with 
                                                                                                         payment to: 
                                                                                                                   Indiana  
                                                                                                         Department of Revenue 
Signature of Preparer                                 Telephone Number                  Date             Fiduciary Section 
                                                                                                         P.O. Box 6192 
                                                                                                         Indianapolis, IN 46206-6192
Preparer's Address                                    Preparer's Identification Number                   Mail all other returns to: 
                                                                                                                 Indiana 
                                                                                                         Department of Revenue 
City                                                            State               ZIP Code             Fiduciary Section 
                                                                                                         P.O. Box 6079 
                                                                                                         Indianapolis, IN 46206-6079

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