State Form 49103    Indiana Department of Revenue
       (R9 / 8-21)
                                                    Schedule 8-D
                    Schedule of Indiana Affiliated Group Members

        for Period Beginning Month _______________  Year _______ and Ending Month _______________ Year _______

This schedule must be enclosed with Form IT-20 or Form URT-1 when filing on a consolidated basis.

Complete each column listing all members of an affiliated controlled group included in the Indiana consolidated adjusted gross income 
tax or utility receipts tax return. All affiliated companies in the consolidated group are required to use the identical accounting period.

Check column A if the corporation is a new addition to the Indiana affiliated group. Indicate the amount in column E if any estimated 
tax was separately paid by the affiliate under its ID number. Indicate in column F the date the corporation qualified to do business in 
Indiana.

                    Affiliated Entities Filing Consolidated Indiana Return

A                 B                                 C                     D                      E                 F
Check                                               Federal Employer      Date & state           Estimated tax     Qualifying 
if new  Name/address of each affiliated corporation Identification Number of incorporation       paid by affiliate date

                    *24100000000*
                                                    24100000000

                                    Instructions for Completing Schedule 8-D

Who May File a Consolidated Tax Return
An election must be made by an affiliated group wishing to file a consolidated income tax return. An annual return, including 
Schedule 8-D or an acceptable substitute schedule, is deemed an election to file a consolidated return by the corporations 
listed in the return. Prior permission from the department to file a consolidated return is not necessary. However, an affiliated 
group must obtain permission in writing from the department to discontinue filing on a consolidated basis. In such a case, 
the group must make a separate application showing good cause why the filing change should be permitted on or before the 
date the returns are filed. The request for permission to discontinue filing consolidated must include the reasons for desiring 
the discontinuance and should be addressed to:

                                                Indiana Department of Revenue
                                                     Tax Policy Division
                                                100 N Senate Ave, N248, MS 102
                                                Indianapolis, IN 46204-2253

Adjusted Gross Income Tax Act
An affiliated group (as defined under I.R.C. Sec. 1504) has the privilege of filing a consolidated adjusted gross income tax 
return as provided in Indiana Code (IC) 6-3-4-14. The Indiana consolidated adjusted gross income tax return must include 
any member of the affiliated group having income or loss attributed to Indiana during the year.

Utility Receipts Tax Act
Corporations may file a consolidated utility receipts tax return if they are incorporated or qualified to do business in Indiana, 
are affiliated as defined in  IC 6-2.3-6-5, and elect to file a consolidated return at the time the first annual return is filed. Affiliated 
for utility receipts tax purposes means 1 corporation owns at least 80% of the voting stock of another corporation, exclusive 
of directors' qualifying shares. An affiliated group is a group of such corporations linked together by the 80% ownership of 1 
with another. This definition does not include an S corporation.

 Example:
 (1) Corporation A owns 80% of the voting stock of Corporation B. Corporation B owns 80% of Corporation C. 
     Corporations A, B, and C are members of an affiliated group.
 (2) Corporation A owns 80% of Corporation B. Corporation A also owns 80% of Corporation C. Corporations A, B, and 
     C are members of an affiliated group.

Each member of an affiliated group is deemed affiliated with every other member. Brother-sister corporations (having a 
common owner that is not a parent corporation but themselves owning no stock in each other) do not satisfy the 80% 
ownership requirement and are therefore not permitted to file a consolidated return.
 
Liability of Each Corporate Member for Returns and Tax  
The fact that a certain member corporation is designated and approved to make the consolidated return for the group will 
not relieve any member of liability for filing the return and paying tax for the group. The group and each member thereof is 
jointly and severally liable. The corporation chosen to file the affiliated group's first consolidated return will continue to file 
the return and pay the tax due with the return unless permission is granted by the department to change filing members.

Enclose completed Schedule 8-D when filing a consolidated tax return with Form IT-20 or Form URT-1.

                                     *24100000000*
                                                         24100000000