Schedule Composite                                          Indiana Department of Revenue
State Form 49188
(R22 / 8-23)                                               Entity’s Composite Indiana 
                                                         Adjusted Gross Income Tax Return

Entity’s Tax Year 2023 or Other Year Beginning           2023 and Ending

Name of Entity                                                                                                                                   Federal Employer Identification Number

See instructions. Enclose with Form IT-20S, IT-65, or IT-41. Use additional sheets if necessary.
                                                  Exception             State of        Enter Pro Rata                         Composite Adjusted Gross, Pass Through Entity, 
                                                  Code                  residency               Share                                          and County Income Tax                                                 Total Tax
                                                         A              B                       C                              D                 E                                                          F        G
                                                  Enter                 Enter the       Adjusted gross                         State Tax.        Pass Through      County tax.                                       Enter partner/
                                                  exception code        2-character     income attributed                      Multiply C by     Entity Tax (Enter (see instructions)                                shareholder/
                                                  (see instructions)    state of        to Indiana from                        .0315 (.0305 for  total amount from                                                   beneficiary tax 
                                                                        residency       IT-20S/IT-65 IN                        years ending in   Schedule PTET)                                                      liability (D - E + F) 
                                                                        for each non-   K-1, Part 4, Line                      2024; leave blank                                                                     (If E > D, enter F. 
Individual / Non-Corporate Entity Social Security                       resident listed 9, or IT-41 IN K-1,  if less than zero)                                                                                      Leave blank if  
Number or Federal Employer Identification Number                                        Part 4, line 9                                                                                                               less than zero.)
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13. Subtotal Column D, Column E, Column F, and Column G .......................................................................
14. Carryover totals from Columns D, E, F, and G from additional sheets.....................................................
15. Total tax (13G + 14G). Enter this amount on line 15 of Form IT-20S; 
    line 6a of Form IT-65; or, on Form IT-41, Schedule 1, line 2. ......................................................................................................................................... Total Tax
                                                         *24100000000*
                                                                                  24100000000