Form IT-40PNR                               Indiana Department of Revenue
           State Form 472 
           (R23 / 9-24)                 Indiana Part-Year or Full-Year Nonresident 
                                                Individual Income Tax Return                                 2024
                                                                Due April 15, 2025
                                If filing for a fiscal year, enter the dates (see instructions) (MM/DD/YYYY):

                                from                                       to:
                                                                                                                Place “X” in box 
Place “X” in box if you are applying for ITIN.          Place “X” in box if spouse is applying for ITIN.        if amending.
Your Social                                             Spouse’s Social                                      Place “X” in box if you are 
Security Number                                         Security Number                                      married filing separately.
Your first name                                      Initial    Last name                                        Suffix

If filing a joint return, spouse’s first name        Initial    Last name                                        Suffix

Present address (number and street or rural route) 

                                                                                                             Foreign country 2-character 
City                                                                      State        ZIP/Postal code       code (see instructions) 

Enter below the 2-digit county code numbers (found on the back of Schedule CT-40PNR) for the county where you lived and 
worked on Jan. 1, 2024.    
County where                    County where                              County where          County where 
you lived                       you worked                                spouse lived          spouse worked

                                                                                                                Round all entries
 1.  Complete Schedule A first. Enter here the amount from Section 3,  
     line 36B, and enclose Schedule A    _____________________________________          Indiana Income    1                            .00

 2.  Enter amount from Schedule B, line 6, and enclose Schedule B ___________           Indiana Add-Backs 2                            .00

 3.  Add line 1 and line 2 _____________________________________________________________                  3                            .00

 4.  Enter amount from Schedule C, line 12, and enclose Schedule C           ________Indiana Deductions   4                            .00

 5.  Subtract line 4 from line 3 _________________________________________________________                5                            .00

 6.  You must complete Schedule D. Enter amount from Schedule D, line 9,  
     and enclose Schedule D      ________________________________________Indiana Exemptions               6                            .00

 7.  Subtract line 6 from line 5 ______________________________Indiana Adjusted Gross Income              7                            .00
 8.  State adjusted gross income tax: multiply line 7 by 3.05% (.0305) 
     (if answer is less than zero, leave blank) __________________            8                 .00
 9.  County tax. Enter county tax due from Schedule CT-40PNR 
     (if answer is less than zero, leave blank) __________________         9                    .00

10.  Other taxes. Enter amount from Schedule E, line 5 (enclose sch.)   10                      .00

11.  Add lines 8, 9 and 10. Enter total here and on line 15 on the back _____________ Indiana Taxes          11                        .00

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12.  Enter credits from Schedule F, line 13 (enclose schedule)  ____   12                         .00

13.  Enter offset credits from Schedule G, line 8 (enclose schedule) __   13                      .00

14.  Add lines 12 and 13  ________________________________________________ Indiana Credits                       14     .00

15.  Enter amount from line 11  ____________________________________________ Indiana Taxes                       15     .00

16.  If line 14 is equal to or more than line 15, subtract line 15 from line 14 (if smaller, skip to line 23) _  16     .00

17.  Enter donations from Schedule IN-DONATE (enclose schedule); cannot be greater than line 16 ___              17     .00

18.  Subtract line 17 from line 16 ___________________________________________               Overpayment         18     .00

19.  Amount from line 18 to be applied to your 2025 estimated tax account (see instructions).

    a.  Enter your county code       county tax to be applied ____  19a                           .00

    a.  Spouse’s county code         county tax to be applied ____  19b                           .00

    b.  Indiana adjusted gross income tax to be applied ________  19c                             .00

    c.  Total to be applied to your estimated tax account (a + b + c; cannot be more than line 18) ___   19d            .00

20.  Penalty for underpayment of estimated tax from Schedule IT-2210 and IT-2210A  _____________                 20     .00

    a.  Enter code A if annualizing. Enter Code F if farmer or fisherman   __________          20a

21. Refund: Line 18 minus lines 19d and 20. Note: If less than zero, see line 23 instructions _ Your Refund      21     .00

22. Direct Deposit (see instructions)

    a.  Routing Number

    b.  Account Number

    c.  Type:     Checking           Savings            Hoosier Works MC

    d.  Place an “X” in the box if refund will go to an account outside the United States.

23.  If line 15 is more than line 14, subtract line 14 from line 15. Add to this any amount on line 20 
    (see instructions) _______________________________________________________________                           23     .00

24.  Penalty if filed after due date (see instructions) ________________________________________                 24     .00

25.  Interest if filed after due date (see instructions) ________________________________________                25     .00

26.  Amount Due: Add lines 23, 24 and 25 ________________________________ Amount You Owe                         26     .00 
    Do not send cash. Please make your check or money order payable to:  
    Indiana Department of Revenue. See instructions if paying by credit card.
Sign and date this return after reading the Authorization statement on Schedule H. You must enclose Schedule H (both pages).

Your Signature                               Date                       Spouse’s Signature                          Date
• If enclosing payment mail to: Indiana Department of Revenue, P.O. Box 7224, Indianapolis, IN 46207-7224.
• Mail all other returns to: Indiana Department of Revenue, P.O. Box 40, Indianapolis, IN 46206-0040.

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