01
0000000000111111111122222222223333333333444444444455555555556666666666777777777788888
1234567890123456789012345678901234567890123456789012345678901234567890123456789012345
04    Schedule CT-40PNR                           Indiana Department of Revenue                                          Enclosure 
05    Form IT-40PNR               County Tax Schedule for Part-Year                                              Sequence No. 08
      State Form 47906                                                                             2024
06    (R24 / 9-24)                and Full-Year Indiana Nonresidents
07
08 Name(s) shown on Form IT-40PNR                                                           Your Social Security Number
09
10 XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX                                          999               99 9999
11
12
13 Section 1 – To be completed by those taxpayers who were residents of an Indiana county as of Jan. 1, 2024.
14
15 1.  Enter the amount from IT-40PNR, line 7 (see instructions if you 
16    lived in a reciprocal state but worked in Indiana). Note: If both           Column A – Yours            Column B – Spouse’s
17    you and your spouse lived in the same county on January 1, 
18    enter the entire amount on line 1A only (see instructions) ___   1A         99999999999.00              1B 99999999999.00
19
20 2.  Enter the county tax rate from the chart on the back of 
21    this schedule for the county where you lived on Jan. 1, 2024      2A       .  99999999999               2B .99999999999
22
23 3.  Multiply line 1 by the rate on line 2 (leave blank if less than zero)   3A 99999999999.00              3B 99999999999.00
24
25 4.  Add lines 3A and 3B. Enter the total here. Perry County residents: If you live in Perry 
26    County and worked in the Kentucky counties of Breckinridge, Hancock or Meade, you must 
27    complete lines 5 and 6. Otherwise, enter the total here and on line 7 below. __________________         4  99999999999.00
28
29 5.  Enter the amount of income that was taxed by certain Kentucky localities (see instructions) _____      5  99999999999.00
30
31 6.  Multiply line 5 by the rate for Perry County. See County Rate Chart and enter total here ________      6  99999999999.00
32
33 7. Enter total of line 4 minus line 6. Continue with Section 2 below if you are married filing jointly and 
34    you/spouse need to complete it. Otherwise, enter this amount on line 9 of Form IT-40PNR ______          7  99999999999.00
35
36
37
38 Section 2 – To be completed by those taxpayers who, on Jan. 1, 2024, were not residents of an Indiana county, 
39    but who worked in Indiana as of Jan. 1, 2024.
40
41                                                                                Column A – Yours            Column B – Spouse’s
42 1.  Enter your principal employment income 
43    (see instructions) __________________________________   1A                  99999999999.00              1B 99999999999.00
44 2.  Enter deductions. See the complete list of 
45    allowable deductions in the instructions _________________   2A             99999999999.00              2B 99999999999.00
46
47 3.  Subtract line 2 from line 1 ____________________________   3A              99999999999.00              3B 99999999999.00
48 4.  Enter some or all of the exemptions from line 9 of 
49    Schedule D (see instructions)  ________________________   4A                99999999999.00              4B 99999999999.00
50
51 5.  Subtract line 4 from line 3 (if less than zero, leave blank) ___   5A      99999999999.00              5B 99999999999.00
52 6.  Enter the county tax rate from the chart on the back of this 
53    schedule for the county where you worked on Jan. 1, 2024  _       6A       .  9999999                   6B .9999999
54                                DRAFT
55 7.  Multiply the income on line 5 by the rate on line 6 _________   7A         99999999999.00              7B 99999999999.00
56 8.  Enter total of 7A plus 7B; carry to Form IT-40PNR, line 9. (If you have an amount on Section 1, 
57    line 7 above, combine that with the amount on line 8 and enter total on Form IT-40PNR, line 9) __       8  99999999999.00
58
59
60
61
62                                *16824111694*
63                                                             16824111694
64
65
66