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04 Form IT-20S                                       Indiana Department of Revenue
   State Form 10814
05 (R22 / 8-23)                    Indiana S Corporation Income Tax Return                                        2023
06                                         for Calendar Year Ending December 31, 2023
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08                    or Other Tax Year Beginning     99        99        2023 and Ending 99      99          9999
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10 Check box if amended. X                                                                      Check box if name changed. X
11 Name of Corporation                                                                    Federal Employer Identification Number
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13 XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX                                                    9999999999
14 Number and Street                                           Principal Business Activity Code   Foreign Country 2-Character Code
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16  XXXXXXXXXXXXXXXXXXXXXXXXXXXXXX                                        99999999                            XX
17 City                                               State                2-Digit County Code    ZIP Code
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19      XXXXXXXXXXXXXXXXXXXX                                   XX                  XX             999999999                 M. Year of initial 
20 Telephone Number                   K. Date of incorporation     In the State of L. State of commercial domicile          Indiana return
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22        9999999999                  99       99     9999                XX                      XX                          9999
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24 N. Accounting method:  Cash X      Accrual    X    Other     X        O. Date of election as S corporation 99           99  9999
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26 P. Check all boxes that apply to entity:
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28  Initial Return X        Final Return   X         In Bankruptcy X       Composite Return     X    PTET Return           X
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30 Q. Enter total number of shareholders:  9999             W. Enter number of nonresident shareholders:      9999
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32 R. I have on file a valid extension of time to file my return (federal Form 7004  or an electronic extension of time). X
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34 S. The corporation filed as a C corporation for the prior tax period. X
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36 T. This corporation is a member of a partnership. X
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38 U. This entity reports income from disregarded entities. X      V. Check box if reporting a credit on Schedule IT-20REC.   X
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40                                                                                                               Round all entries
41 Schedule A - S Corporation Adjusted Gross Income
42  1.  Total net income (loss) from U.S. S corporation return, Form 1120S Schedule K  
43      (see instructions); use minus sign for negative amounts                                               1  99999999999.     00
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45  2.  a. Enter name of addback or deduction (see instructions) XXXXXXXX         Code. No.   999             2a 99999999999.00                 
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47      b. Enter name of addback or deduction  XXXXXXXXXXXXXXXXXX                 Code. No.   999             2b 99999999999.00 
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49      c. Enter name of addback or deduction  XXXXXXXXXXXXXXXXXX                 Code. No.   999             2c 99999999999.00 
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51      d. Enter name of addback or deduction  XXXXXXXXXXXXXXXXXX                 Code. No.   999             2d 99999999999.00 
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53      e. Enter name of addback or deduction  XXXXXXXXXXXXXXXXXX                 Code. No.   999             2e 99999999999.00
54      f . Enter the total amount of addbacks and deductions from any additional sheets (use a 
55        minus sign for negative amount)                                                                     2f 99999999999.00
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57  3.  Total S corporation income, as adjusted (add lines 1 through 2f)                                      3  99999999999.00
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59  4.  Enter percentage for Indiana apportioned adjusted gross income from IT-20S Schedule E line 9          4  999. 99           %
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04
05 Schedule B - Excess Net Passive Income and Built-In Gains
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07 5.  LIFO recapture income (see instructions)                                                                 5     99999999999.00 
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09 6.  Excess net passive income from federal worksheet                                                         6     99999999999.00
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11 7.  Built-in gains from federal Schedule D (1120S)                                                           7     99999999999.00
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13 8.  Add the amounts on lines 5 through 7                                                                     8     99999999999.00 
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15 9.  Taxable income apportioned to Indiana (multiply line 8 by line 4) (if applicable)                        9     99999999999.00
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17 10.  Pre-conversion Indiana net operating loss (see instructions)                                            10    99999999999.00
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19 11.  Taxable income after loss. Line 9 minus line 10                                                         11    99999999999.00
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21 12.  Corporate adjusted gross income tax rate (*see instructions for line 12)                                      X tax rate
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23 13.  Total income tax from Schedule B (multiply line 11 by percent on line 12)                               13    99999999999.00
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25 Summary of Calculations
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27 14.  Sales/use tax on purchases subject to use tax from Sales/Use Tax Worksheet                              14    99999999999.00
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29 15.  Total composite tax from completed Schedule Composite (15G). Enclose schedule                           15    99999999999.00
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31 16.  Total pass through entity tax from Schedule PTET. Enclose schedule                                      16    99999999999.00
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33 17.  Total tax (add lines 13-16). If line 17 is zero, see line 26                                            17    99999999999.00
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35 18.  Total amount of pass-through withholding and PTET (enclose IN K-1 from the paying entity)               18    99999999999.00
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37 19. Total composite withholding IT-6WTH payments (see instructions)                                            19  99999999999.00
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39 20.  Other payments/credits (enclose supporting documentation)                                               20    99999999999.00
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41 21.  EDGE credit. Enter the total EDGE credit amount claimed (line 19 on Schedule IN-EDGE)                   21    99999999999.00
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43 22.  EDGE-R credit. Enter the total EDGE-R credit amount claimed (line 19 on Schedule IN-EDGE-R)   22              99999999999.00
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45 23. Other certified credits. Enter the total credit amount claimed (“Total” line from Schedule IN-OCC)       23    99999999999.00
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47 24. Subtotal (line 17 minus lines 18-23). If total is greater than zero, proceed to lines 25-26              24    99999999999.00
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49 25.  Interest: Enter total interest due; see instructions (contact the department for current interest rate) 25    99999999999.00
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51 26.  Penalty: If paying late, enter 10% of line 24; see instructions. If line 17 is zero, enter $10 per  
52     day filed past due date                                                                                  26    99999999999.00
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54 27.  Total Amount Due: Add lines 24-26. If less than zero, enter on line 28. Make check payable to:  
55     Indiana Department of Revenue. Make payment in U.S. funds                                                27    99999999999.00
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57 28. Overpayment and Refund Amount: Line 18 plus lines 19-23, minus lines 17 and 25-26.  
58     No carryforward allowed.                                                                                 28    99999999999.00
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04
05
06 Certification of Signatures and Authorization Section
   Under penalties of perjury, I declare I have examined this return, including all accompanying schedules and statements, and to  
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   the best of my knowledge and belief it is true, correct, and complete.
08                                                                       Paid Preparer’s
09                                                                       Email Address    XXXXXXXXXXXXXXXXXXXXXX
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11  I authorize the Department to discuss my return with my              Paid Preparer: Firm’s Name (or yours if self-employed)
12  personal representative (see instructions).
13                                                                       XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
14  X     Y  X       N                                                   Paid Preparer’s Name
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16  Personal Representative’s Name (please print)                        XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
17
18  XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX                                  PTIN      999999999
19  Email
20  Address                                                              Telephone Number    9999999999
21          999999999999999999999999999999
22  Signature of                                                         Address XXXXXXXXXXXXXXXXXXXXXXXXXXXXX
23  Corporate Officer __________________________________
24                                                                       City  XXXXXXXXXXXXXXXXXXXXXXXXXXXXX
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26  Date  99     99    9999                                              State        XX           ZIP Code+4 999999999
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28  Print or Type Name of Corporate Officer                              Paid Preparer’s Signature ____________________________
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30  XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
31  Title                                                                Date  99       99   9999
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33  XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
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35  If you owe tax, please mail your return to IN Department of          If you do not owe any tax, mail it to IN Department of Revenue, 
36    Revenue, PO Box 7205, Indianapolis, IN 46207-7205.                           PO Box 7147, Indianapolis, IN 46207-7147.
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