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04 Form FIT-20                                                     Indiana Department of Revenue
   State Form 44623                          Indiana Financial Institution Tax Return
05 (R22 / 8-23)                                For Calendar Year Ending December 31, 2023 or                                                                                   2023
06
07                     Fiscal Year Beginning                            2023 and ending
08
   Check box if amended                Check box if amendment is due to a federal audit                           Check box if name changed
09
10 Name of Corporation                                                                                                  Federal Employer Identification Number
11 Number and Street                                                             Principal Business Activity Code       Foreign Country 2-Character Code
12
13 City                                       State                    ZIP Code           2-Digit County Code           Telephone Number
14 Check box if this is a state chartered credit union or an investment company registered under the Investment Company Act of 1940.  
15 (Also see instructions for line 19 and FIT-20 Schedule E-U.)
16 L.  Date of incorporation ____________ in the state of _______________        S. Check all boxes that apply: 
17 M.  State of commercial domicile ____________________                            Initial Return      Final Return                       In Bankruptcy                                             REMIC  
18 N.  Year of initial Indiana return _____________________                      T. Is this return filed on a combined basis?     Yes                                                       No   
19 O. Location of accounting records if different from above address:               If yes, complete Schedule H.
20    ________________________________________________________                   U. Is this a separate return by a member of a unitary group?  
21 P. Accounting method:     Cash      Accrual                                      (See instructions on page 5.)     Yes                                                           No 
22 Q. Did the corporation make estimated tax payments using a different          V. Do you have on file a valid extension of time to file your return (federal 
23    Federal Employer Identification Number?     Yes               No              Form 7004 or an electronic extension of time)?     Yes                                                           No 
24    List any other Federal Employer Identification Numbers on Schedule H.      W. Are you a member of a partnership?     Yes                                                              No  
25 R.  Is 80% or more of your gross income derived from making, acquiring,          If you answer yes, see instruction page 5.
26    selling, or servicing loans or extensions of credit?     Yes          No   
27    If you answer no, do not file this return; file Form IT-20.
28                                                                             Schedule A
29 Income:                                                                                                                                                                         Round All Entries
30 1.   Federal taxable income (before federal NOL and special deductions); use a minus sign for negative amounts ......                                                       1                        00
31 2.   Qualifying dividend deduction ...................................................................................................................................      2                        00
32 3.   Subtotal (Subtract line 2 from line 1) .........................................................................................................................       3                        00
33 Add back – Enter an amount equal to the deduction taken for:
34 4.   Bad debts (IRC Sec. 166) (see instructions) .............................................................................................................              4                        00
35 5.   Bad debt reserves for banks (IRC Sec. 585) .............................................................................................................               5                        00
36 6.   Bad debt reserves (IRC Sec. 593) ............................................................................................................................          6                        00
37 7.   Charitable contributions (IRC Sec. 170) ....................................................................................................................           7                        00
38 8.   All state and local income taxes ................................................................................................................................      8                        00
39 9.   Net capital loss carryovers to the extent used in offsetting capital gains on federal Schedule D (IRC Sec. 1212)......                                                 9                        00
40 10.  Amount of interest excluded for state and local obligations (IRC Sec. 103)  
41      minus the associated expenses (IRC Sec. 265) .......................................................................................................                   10                       00
42 Other modifications to income (see instructions):
43 11A. Excess business interest deduction, add or subtract net amount .............................................................................                           11A                      00
44 11B. Net bonus depreciation, add or subtract net amount ................................................................................................                    11B                      00
45 11C. Excess IRC Section 179 deduction, add or subtract .................................................................................................                    11C                      00
46      If line 11A, 11B, or 11C are negative, use a minus sign.
47 11D. Qualified patents income deduction (use a minus sign for negative amounts) .........................................................                                   11D                      00
48 12A. Enter name of addback or deduction  ___________________________________________ Code No. __  __  __                                                                    12A                      00
49 12B. Enter name of addback or deduction  ___________________________________________ Code No. __  __  __                                                                    12B                      00
50 12C. Enter name of addback or deduction  ___________________________________________ Code No. __  __  __                                                                    12C                      00
51 12D. Enter name of addback or deduction  ___________________________________________ Code No. __  __  __                                                                    12D                      00
52 13.  Total addbacks (add lines 4 through 12D) .................................................................................................................             13                       00
53 14.  Subtotal (add line 3 and line 13) ................................................................................................................................     14                       00
54 Deductions:
55 15.  Subtract income that is derived from sources outside the U.S. and included in federal taxable income ..................                                                15                       00
56 16.  Subtract an amount equal to a debt or portion of a debt that becomes worthless - net of all recoveries (IRC Sec. 166) ..                                               16                       00
57 17.  Subtract an amount equal to any bad debt reserves that are included in federal income because of  
58      accounting method changes (IRC Sec. 585(c)(3)(a) or Sec. 593) ............................................................................                             17                       00
59 18.  Total Deductions (add lines 15 through 17) ...............................................................................................................             18                       00
60 19.  Total  Income Prior to Apportionment (subtract line 18 from line 14) .........................................................................                         19                       00
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06 20.  Total Income Prior to Apportionment (amount from line 19) ......................................................................................               20              00
07 21.  Apportionment Percentage (line 15 of Schedule E-U) ..............................................................................................              21  .           %
08 22.  Current Year Apportioned Adjusted Gross Income attributed to Indiana (multiply line 20 by line 21) ...................                                         22              00
09 23.  Indiana Net Capital Loss Adjustment from attached worksheet. Line 23 may not exceed amount on line 22 ..............                                           23              00
10 24.  Subtotal of line 22 minus line 23. Do not enter an amount less than zero ................................................................                      24              00
11 25.  Indiana Net Operating Loss Deduction from Schedule FIT-20 NOL. Line 25 may not exceed amount on line 24 .......                                                25              00
12 26.  Total Indiana Adjusted Gross Income subject to tax (subtract line 25 from line 24) ..................................................                          26              00
13 27.  Financial Institution Tax (multiply line 26 by tax rate; see instructions) .....................................................................               27              00
14 28. Less: Nonresident Taxpayer Credit (enclose Schedule FIT-NRTC) ..................................................................(816)                           28              00
15 29.  Net Financial Institution Tax Due (subtract line 28 from line 27) ...............................................................................              29              00
16 30.  Sales/Use Tax Due (see instructions) .......................................................................................................................   30              00
17 31.  Subtotal Due (add lines 29 and 30) ........................................................................................................................... 31              00
18 Tax Liability Credits (enclose schedules)
19 32.  Neighborhood Assistance Tax Credit (NC-20) ...................................................................................................(828)            32              00
20 33.  Enterprise Zone Employment Expense Credit (EZ 2) .......................................................................................(812)                  33              00
21 34.  Enterprise Zone Loan Interest Tax Credit (LIC) .................................................................................................(814)          34              00
22 35.  Enter name of other credit _______________________________________                                 Code No. 35a. __  __  __                                    35b             00
23 36.  Enter name of other credit _______________________________________                                 Code No. 36a. __  __  __                                    36b             00
24 37. Enter the total of certified credits claimed from Schedule IN-OCC and enclose this schedule with your return .......                                            37              00
25 38.  Total Credits (add lines 32 through 37) .....................................................................................................................  38              00
26 39.  Net Tax Due (subtract line 38 from line 31) ...............................................................................................................    39              00
27 Credit for Estimated Tax and Other Payments
28 40.  Total quarterly estimated income tax paid (itemize quarterly FT-QP payments below) .............................................                               40              00
29     Qtr1_________ Qtr 2_________ Qtr 3 _________ Qtr 4_________
30 41.  Extension payment _________ and prior year overpayment credit _________ Enter combined total .....................                                             41              00
31 42.  Other payments (enclose supporting documentation) ...............................................................................................              42              00
32 43.  EDGE credit. Enter the total EDGE credit amount claimed (line 19 on Schedule IN-EDGE) ....................................                                     43              00
33 44.  EDGE-R credit. Enter the total EDGE-R credit amount claimed (line 19 on Schedule IN-EDGE-R) ........................                                           44              00
34 45.  Total Payments (add lines 40 through 44) .................................................................................................................     45              00
35 46. Balance of Tax Due (subtract line 45 from line 39. If line 45 exceeds line 39, enter -0-) .........................................                             46              00
36 47.  Penalty for the Underpayment of Tax from Schedule FIT-2220 (Form page 4) .........................................................                             47              00
37 48.  If payment is made after the original due date, add interest (see instructions) .........................................................                      48              00
38 49. Late penalty: If paying late, enter 10% of line 46. If line 31 is zero, enter $10 per day filed past due date ...............                                   49              00
39 50.  Total Due (add lines 46 through 49) Payable in U.S. funds to: Indiana Department of Revenue ............................                                       50              00
40 51.  Total Overpayment (subtract lines 39, 47, 48, and 49 from line 45) ..........................................................................                  51              00
41 52.  Refund (enter portion of line 51 to be refunded) .......................................................................................................       52              00
42 53.  Overpayment Credit (amount of line 51 to be applied to next year’s estimated tax account) ...................................                                  53              00
43 Certification of Signatures and Authorization Section                                                   Paid Preparer’s Email Address
44 Under penalties of perjury, I declare I have examined this return, including all accompanying schedules 
45 and statements, and to the best of my knowledge and belief it is true, correct, and complete.
46 I authorize the Department to discuss my return with my personal  
47 representative (see instructions)                    Yes             No 
48                                                                         Paid Preparer: Firm’s Name (or yours if self-employed)
49 Personal Representative’s Name (Print or Type)
50                                                                         PTIN
51 Personal Representative’s Email Address
52
53 Signature of Corporate Officer                           Date           Telephone Number
54
55 Print or Type Name of Corporate Officer                  Title          Address
56
57 Signature of Paid Preparer                               Date           City
58
59 Print or Type Name of Paid Preparer                                     State                                                                                           ZIP Code + 4
60                       Please mail your return to: Indiana Department of Revenue, PO Box 7228, Indianapolis, IN 46207-7228.
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