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04     Schedule IN-OCC                                                                                               Enclosure 
05     State Form 55629                   Other Certified Credits                                            Sequence No. 25
       (R9 / 9-23)
06                                                                                                       2023
07
08
09 Name shown on Form IT-40/IT-40PNR                                               Your Social Security Number
10
11 XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX                                            999        99  9999
12 Name shown on IT-20/IT-20NP/IT-65/IT-20S/FIT-20/IT-41                           Federal Employer Identification Number
13
14 XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX                                                 999999999
15
   Complete this schedule if you are reporting any of the following credits: EDGE-NR Credit; EDGE-NR Credit -Composite; Film and Media Production 
16 Credit; Film and Medial Production Credit - Composite;  Foster Care Donation Credit; Foster Care Donation Credit - Composite; Headquarters 
17 Relocation Credit; Headquarters Relocation Credit - Composite Hoosier Business Investment Credit; Hoosier Business Investment Credit - Composite; 
18 Hoosier Business Investment Credit - Logistics; Hoosier Business Investment Credit - Logistics - Composite; Natural Gas Commercial Vehicle Credit; 
19 Natural Gas Commercial Vehicle Credit - Composite; Redevelopment Tax Credit; Redevelopment Tax Credit - Composite; School Scholarship Credit; 
20 School Scholarship Credit - Composite; Venture Capital Investment Credit; Venture Capital Investment Credit - Composite; VCI - Qualified Indiana 
   Investment Fund; VCI - Qualified Indiana Investment Fund - Composite. 
21
22     Column A             Column B                     Column C                  Column D                  Column E
23     IT-20S/IT65                                       Certification/
24     Enter FEIN if Credit Certification                Project                   Tax Credit                Amount 
25     is from IN K-1                Year                Number                    Code                      Claimed
26
27  1. 999999999            9999          9999999999999999                         9999                  1  99999999999                             .00
28
29  2. 999999999            9999          9999999999999999                         9999                  2  99999999999                             .00
30
31  3. 999999999            9999          9999999999999999                         9999                  3  99999999999                             .00
32
33  4. 999999999            9999          9999999999999999                         9999                  4  99999999999                             .00
34
35  5. 999999999            9999          9999999999999999                         9999                  5  99999999999                             .00
36
37  6. 999999999            9999          9999999999999999                         9999                  6  99999999999                             .00
38
39  7. 999999999            9999          9999999999999999                         9999                  7  99999999999                             .00
40
41  8. 999999999            9999          9999999999999999                         9999                  8  99999999999                             .00
42
43  9. 999999999            9999          9999999999999999                         9999                  9  99999999999                             .00
44
45 10. 999999999            9999          9999999999999999                         9999                  10 99999999999                             .00
46
47 11. 999999999            9999          9999999999999999                         9999                  11 99999999999                             .00
48
49 12. 999999999            9999          9999999999999999                         9999                  12 99999999999                             .00
50
51 13. 999999999            9999          9999999999999999                         9999                  13 99999999999                             .00
52
53 14. 999999999            9999          9999999999999999                         9999                  14 99999999999                             .00
54
55 15. 999999999            9999          9999999999999999                         9999                  15 99999999999                             .00
56
57 16. Add amounts from Column E, lines 1 - 15, and enter total here. Carry to the 
58     appropriate line on: Schedule 6; Schedule G; Form IT-20; Form IT-20NP; Form IT-41; or 
59     Form FIT-20 (Form IT-65 and Form IT-20S filers must see special reporting instructions) ____Total 16 99999999999.00
60
61
62                                   *21523111694*
63                                                       21523111694
64
65
66

                                   Instructions for Other Certified Credits

Who Must Complete This Schedule                                         Column B. Enter the tax year for which the credit has been 
You must complete this schedule if you are reporting any of the         certified. You can find this information in the certification letter 
following credits:                                                      you received from the authorizing entity or on your IN K-1, if 
                                                     Tax Credit         applicable. 
Credit Name                                               Code
                                                                        Column C. Certification or project numbers and PINs* are 
EDGE-NR Credit                                                     865  numeric characters. Enter the certification or project number you 
EDGE-NR Credit - Composite                                *1865         received from the authorizing entity. You can find this number in 
Film and Media Production Credit                                   869  the certification letter you received from the authorizing entity or on 
                                                                        your IN K-1. If you also have received a PIN, add it to the right of 
Film and Medial Production Credit - Composite             *1869         your project number and enter the combined number in this box.
Foster Care Donation Credit                                        867  For example, express the combined certification or project number 
Foster Care Donation Credit - Composite                   *1867         “123456” and PIN “1234” as “1234561234” in Column C. Do not 
                                                                        include any dashes.
Headquarters Relocation Credit                                     818
Headquarters Relocation Credit - Composite                *1818         *You may have a Venture Capital Investment Credit that has
Hoosier Business Investment Credit                         820          no certification number, project number, or PIN associated
                                                                        with it. If this is the case, enter in Column B the first year you
Hoosier Business Investment Credit - Composite        *1820             were eligible to claim the credit, and the 3- or 4-digit tax credit
Hoosier Business Investment Credit - Logistics             860          code number associated with it in Column D. Make sure to
                                                                        keep your approval paperwork with your records as the
Hoosier Business Investment Credit - Logistics - 
                                                                        department may request it at a later date.
Composite                                             *1860
Natural Gas Commercial Vehicle Credit                      858          Column D. Enter the 3- or 4-digit* tax code number associated 
Natural Gas Commercial Vehicle Credit -                                 with the credit.
Composite                                             *1858
Redevelopment Tax Credit                                           863  *4-Digit Code Utilization. 
                                                                        The 4-digit code represents a certified credit that has been used 
Redevelopment Tax Credit  - Composite                     *1863         to offset a nonresident shareholder’s/partner’s (taxpayer’s) 
School Scholarship Credit                                  849          composite tax on the Indiana S corporation/partnership return. 
School Scholarship Credit - Composite                     *1849
                                                                        If the nonresident taxpayer has other Indiana-source income 
Venture Capital Investment Credit                                  835  and/or owes county tax, he will need to file an individual income 
Venture Capital Investment Credit - Composite             *1835         tax return with Indiana. Since the income taxed for composite 
VCI - Qualified Indiana Investment Fund                            868  purposes will also be included on the taxpayer’s income tax 
                                                                        return, the amount of the credit used on the composite filing may 
VCI - Qualified Indiana Investment Fund -                               also be used to offset tax due on the individual tax return.
Composite                                                 *1868
                                                                        Example: Partnership A has a Hoosier Business Investment (HBI) 
Line-by-line Instructions                                               Credit. As a nonresident partner, Jim’s share of that credit is $700. 
Enter the name of the entity claiming the credit(s).                    The partnership used $400 of Jim’s credit to offset his tax liability 
                                                                        on the composite filing, leaving a $300 remaining credit. The IN 
Enter the corresponding Social Security number or federal               K-1 will breakdown the credit as follows:
employer identification number.
Columns A – E. The following information details how to complete        Credit Name                3- or 4-Digit Code        Amount
Columns A - E. If you are claiming more than one 3-digit and/or         HBI Credit – Composite      1820                            $400
or 4-digit credit, please enter each one separately. Also, if you are 
                                                                        HBI Credit                  820                             $300
claiming an identical three-digit or four-digit code from multiple 
sources, such as a Hoosier Business Investment Credit from two 
different partnerships, list each credit and source on a separate line. Since Jim has other Indiana-source income, he will file Form 
                                                                        IT-40PNR, reporting all Indiana-source income (including his 
Column A. If you are a member of an S corporation or partnership        income taxed on the composite return). When completing the  
and are claiming one or more of the above credits from your IN          IN-OCC, he will be able to use up to $700 of his HBI credit, using 
K-1, enter the federal employer identification number of the S          the amount associated with the 4-digit number first. 
corporation or partnership in this column. If the credit you are 
reporting does not flow from an S corporation or partnership,           For example, if his total state tax liability is $500, he will list “HBI 
leave this column blank.                                                1820 $400” on Schedule IN-OCC, and then report the remaining 
                                                                        amount needed as “HBI 820 $100”. He will have a remaining $200 
Do not use a dash when entering the number. For example, enter          HBI credit (3-digit code 820) available to be carried forward.
12-3456789 as 123456789.

                                          *24100000000*
                                                                   24100000000

Important. The credit used to offset the composite tax, labeled        Special Instructions for Form IT-20S/IT-65 Filers:
with a 4-digit code, must be utilized on the individual tax return     If filing this schedule with the IT-20S or IT-65, only reflect the 
prior to using any credit labeled with a 3-digit credit code.          credit amounts for the partners/shareholders included on the 
                                                                       composite return. Do not include credits from the IN K-1’s that 
The 4-digit code has the same carryforward provision as does its       are for Indiana residents. Enter the combined pro rata credits on 
equivalent 3-digit code.                                               one line of the IN-OCC; do not enter a line for each composite 
                                                                       member.
Column E. Enter the amount of credit you are claiming.
                                                                       If the IT-20S or IT-65 has received an IN K-1 reflecting a 4-digit 
Limitation. The credits listed on this schedule are limited to offset  pass-through credit from another entity that has already been 
Indiana adjusted gross income tax. For example, if your School         utilized on a mandatory composite filing on the behalf of the 
Scholarship Credit is $500 and your adjusted gross income tax          current filing entity, this amount must be reflected on the IN-OCC 
is $425, you should enter the $425 limited amount in Column E.         prior to any unutilized 3-digit credit code amount.
Since any unused portion of this credit is eligible to be carried 
over to the next tax year, you will be eligible to claim the remaining The total amount of 3- and 4-digit credit codes claimed against the 
$75 credit on next year’s tax return.                                  composite return cannot exceed the entity’s total tax due.

Line 16                                                                In addition, use tax cannot be offset by these nonrefundable 
Once you have completed this schedule, carry the credit amount         credits if included in the total tax due.
from Column E, line 16, to the appropriate form/schedule 
(Schedule 6 or Schedule G for individual filers, Form IT-20, Form      Note. For more information about these credits, see the instruction 
IT-20S, Form IT-20NP, Form IT-41 or Form FIT-20), and enclose          booklets posted online at www.in.gov/dor/tax-forms/ for:
this schedule when filing your tax return.                             • Form IT-40/IT-40PNR (Schedule 6/G claimants)
                                                                       • Form IT-20
Note. If filing by paper and you need more than 15 lines, complete     • Form IT-20NP
and attach additional copies of Schedule IN-OCC as needed,             • Form FIT-20
but do not complete line 16. On the first schedule, enter the total    • Form IT-65
credit amounts from all pages on line 16.                              • Form IT-20S

Form IT-20S/IT-65 filers must see the following Special 
Instructions.

                                           *24100000000*
                                                              24100000000