Form                                       INDIANA DEPARTMENT OF REVENUE
     IT-41                              FIDUCIARY INCOME TAX RETURN
State Form 11458                                                                                                2023
(R19 / 8-23)
Check box 
if amended                 For the calendar year 2023 or fiscal year beginning                   2023  and ending
                                                                                 MM D D                                 MM D D  Y Y Y Y
Name of Estate or Trust                                                      Address

Name and Title of Fiduciary                                                  City                               State ZIP Code

2-Digit County Code        Federal Employer Identification Number            Foreign Country 2-Character Code

                                                                                                                      Please round entries 

1.  Taxable income of fiduciary from federal Form 1041  _____________________________________________           1             .00

2.  Indiana additions or add-backs, see line 2 instructions  ___________________________________________        2             .00

3.  IRC Section 965 Income  __________________________________________________________________                  3             .00

4.  Net operating loss deduction from federal return  ________________________________________________          4             .00

5.  Add lines 1 through 4 __________________________________________________________ Total Income                 5           .00

6.  Interest on U.S. Government Obligations reported on federal return   ________________________________       6             .00

7.  Non-Indiana fiduciary income _______________________________________________________________                7             .00

8.  Indiana portion of net operating loss deduction (enclose Schedule IT-40NOL, see instructions) ____________  8             .00

9.  Line 5 minus lines 6 through 8 ____________________________________________ State Taxable Income            9             .00

10.  State Adjusted Gross Income Tax: multiply line 9 by .0315 ________________________________________         10            .00

11. Other Taxes from Form IT-41, Schedule 1, line 6  _______________________________________________            11            .00

12. Add lines 10 and 11  _______________________________________________________________Total Tax               12            .00

13.  Fiduciary estimated tax paid  _______________________________________________________________              13            .00

14.  Other Credits (You MUST enclose verification), see line 14 instructions ______________________________     14            .00

15. Add lines 13 and 14  ___________________________________________________________ Total Credits              15            .00

16. If line 12 is greater than line 15, enter the difference  __________________________________ Balance Due    16            .00

17.  Penalty, see line 17 instructions _____________________________________________________________            17            .00

18.  Interest ,see line 18 instructions _____________________________________________________________           18            .00

19. Total Amount Due (Add lines 16 through 18)  _______________________________________ Payment Due             19            .00

20. Refund Due (If line 15 is greater than line 12, enter the difference)  __________________________  Refund   20            .00

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Name of Estate or Trust                                                                                Federal Employer Identification Number

Check Applicable Boxes                                                                                 Federal                               State
First Return               Final Return      Fiduciary Name Change                      Address Change Extension                          Extension

Retirement Plan     Estate Simple Trust    Complex Trust              Bankruptcy Estate           ESBT Grantor Trust  Other (Please Specify)     

Additional Information - Please answer the following questions or provide the requested information.

1. Is there a nonresident beneficiary? Yes   No

2. How many Schedule IN K-1s are included with this return?

3. If this is an estate return, enter the date of the decedent’s death and Social Security number

Decedent’s date of death                                        Decedent’s Social Security Number

4. If this is a trust return, enter date the entity was created                     5. Was a final individual return filed for decedent? Yes No

6. If this is a grantor trust return, enter the grantor’s Social Security number

I authorize the department to discuss my return with my personal                Address
representative.
      Yes    No        If yes, complete the information below. 
                                                                                City

Personal Representative’s Name (please print)
                                                                                State                  ZIP Code 

Email 
Address

Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge 
and belief it is true, correct, and complete. If prepared by a person other than the taxpayer, this declaration is based upon all information of which the 
preparer has any knowledge.
Signature of Fiduciary or Officer            Telephone Number                           Date
                                                                                                       Mail completed return with 
                                                                                                       payment to:
                                                                                                                 Indiana  
Signature of Preparer                        Telephone Number                           Date           Department of Revenue
                                                                                                       Fiduciary Section
                                                                                                       P.O. Box 6192
Preparer's Address                           Preparer's Identification Number                          Indianapolis, IN 46206-6192

                                                                                                       Mail all other returns to:
                                                                                                                 Indiana
City                                                            State               ZIP Code           Department of Revenue
                                                                                                       Fiduciary Section
                                                                                                       P.O. Box 6079
                                                                                                       Indianapolis, IN 46206-6079

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