Form                                          Indiana Department of Revenue
    ES-40                    2023                 Estimated Tax Payment Form 
 State Form 46005
    (R23 / 9-22)

    Your Social                                                 Spouse’s Social 
    Security Number                                             Security Number

    Your first name                                    Initial Last name

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

    Present address (number and street or rural route) 

    City                                                          State                   ZIP/Postal code

Estimated Tax Designation and Payment Area
Complete the worksheet on the back of this form to figure your estimated tax payment.

1. State tax due from line J of worksheet  ________________________________________       State Tax    1  .00

2. From line K of worksheet: 
    a. Enter your county code ____________________________________
    b. Enter county tax ______________________________________________            Your County Tax      2b .00

3. From line L of worksheet: 
    a. Enter spouse’s county code (if different from yours) ______________
    b. Enter spouse’s county tax __________________________________           Spouse’s County Tax      3b .00

4. Add lines 1, 2b and 3b ______________________________       Estimated Tax Installment Payment       4  .00
 •  Please make your check or money order payable to: Indiana Department of Revenue. 
    See instructions for other payment options.

Installment Period Information

Place an “X” in the appropriate box to show which payment you are making:
1stInstallment payment due April 18, 2023                      2ndInstallment payment due June 15, 2023

3rd Installment payment due Sept. 15, 2023                     4thInstallment payment due Jan. 16, 2024

                                                  Mail entire form and payment to:
                                                  Indiana Department of Revenue
                                                           P.O. Box 6102
                                                  Indianapolis, IN 46206-6102

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                                         Instructions for Form ES-40

To make an estimated tax payment online, log on               automatically issued (after we receive your first payment) 
to DOR’s e-services portal, the Indiana Taxpayer              don’t get to you by the next payment’s due date.
Information Management Engine (INTIME), at                    For more information about estimated tax, get Income Tax 
intime.dor.in.gov.                                            Information Bulletin #3 at www.in.gov/dor/files/reference/
                                                              ib03.pdf.
If you expect to have income during the tax year that:
y Will not have Indiana tax withheld, or                      Pay the amount due on or before the installment due date. 
y If you think the amount withheld will not be enough to      Enclose your check or money order made payable to the 
  pay your tax liability, and                                 Indiana Department of Revenue. Write your Social Security 
y You expect to owe more than $1,000 when you file your  number on the check or money order. Note: All payments 
  tax return, then you should pay estimated tax.              must be made with U.S. funds.

Use the worksheet below to determine how much you’ll          You can also make your estimated tax payment online via 
owe. The first installment payment is due April 18, 2023.     INTIME at intime.dor.in.gov. 
The remaining three payments are due June 15 and Sept. 
15, 2023, and Jan. 16, 2024.                                  Note: Do Not mail Form ES-40 if paying by credit card or 
                                                              eCheck.
Use this form to make an estimated tax payment. We 
suggest that first-time estimated income taxpayers make a 
copy of the blank form. This is in case the vouchers that are 

 Worksheet to figure your 2023 estimated tax due – see instructions below

 A. Total estimated income for 2023  .......................................................................................................... A  ___________
 B. Total exemption amount  ....................................................................................................................... B  ___________ 
 C. Amount subject to tax (line A minus line B)  ..........................................................................................     C ___________ 
 D. Amount of state income tax due (line C x .0315)  ................................................................................. D ___________ 
 E. Amount of county income tax due (line C x the appropriate county tax rate(s))  .................................. E  ___________
 F. Anticipated state and county tax due for 2023 (add line D and line E) .................................................                     F  ___________
 G. Total anticipated credits (including anticipated 2023 state and county income tax withheld)  ..............                                 G ___________ 
 H. Amount due (line F minus line G) .........................................................................................................  H ___________ 
 I.  Each installment payment due for 2023 (divide line H by 4) .....................................                 Enter on Line 4  I  ___________ 
 J. Enter portion of line I that represents your estimated state tax due ..........................                   Enter on Line 1  J  ___________
 K. Enter portion of line I that represents your (and spouse’s if same  
  county) estimated county tax due. Enter 2-digit county code (from  
  county tax chart)             ......................................................................................Enter on Line 2          K  ___________
 L. Enter portion of line I that represents spouse’s estimated county  
  tax due if for a different county than the one on line K. Enter 2-digit  
  county code        ..............................................................................................   Enter on Line 3  L  ___________

Line B – Enter the total amount of exemptions you             Line I – This is your estimated tax installment payment. 
are eligible to claim on Indiana’s Schedule 3, line 7, or     Enter this amount on line 4, Estimated Tax Installment 
Schedule D, line 9. Limitation: If you are a nonresident      Payment, at the top of the form. 
alien (not a U.S. citizen and do not meet the green card 
test) you may claim only one $1,000 exemption (even if        Lines J, K and L – If you are paying only the amount of 
married filing jointly and/or with dependents).               estimated Indiana income tax due, enter the amount from 
                                                              line I on line 1, State Tax Due, at the top of the form. If 
Line E – Multiply amount on line C by the appropriate         the amount on line I also includes estimated county tax, 
county tax rate(s). Find your rate on page 3 of               enter the portion on lines 2 and/or 3 at the top of the form. 
Departmental Notice #1, located at www.in.gov/dor/files/      Only break out your spouse’s estimated county tax if your 
reference/dn01.pdf.                                           spouse owes tax to a county other than yours.

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