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04 Schedule Composite                                          Indiana Department of Revenue
   State Form 49188 
05 (R23 / 8-24)                                               Entity’s Composite Indiana 
06                                                          Adjusted Gross Income Tax Return
07
08 Entity’s Tax Year 2024 or Other Year Beginning           2024 and Ending
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10
11   Name of Entity                                                                                                                               Federal Employer Identification Number
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14 See instructions. Enclose with Form IT-20S, IT-65, or IT-41. Use additional sheets if necessary.
15 Individual / Non-Corporate Entity Social Security Exception          State of        Enter Pro Rata                          Composite Adjusted Gross, Pass Through Entity, 
16 Number or Federal Employer Identification Number  Code               Residency                  Share                                        and County Income Tax                  Total Tax
17                                                          A           B                          C                            D                 E                   F                 G
18                                                   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/
19                                                   (see instructions) state of        to Indiana from                         .0305 (.03 for    total amount from                    beneficiary tax 
20                                                                      residency       IT-20S/IT-65 IN                         years ending in   Schedule PTET)                       liability (D - E + F) 
21                                                                      for each non-   K-1, Part 4, Line                       2025; leave blank                                      (If E > D, enter F. 
                                                                        resident listed 9, or IT-41 IN K-1,  if less than zero)                                                        Leave blank if  
22                                                                                      Part 4, line 9                                                                                 less than zero.)
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24  1.
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34  8.
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36  9.
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39 11.
40 12.
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42 13. Subtotal Column D, Column E, Column F, and Column G .....................................................................
43 14. Carryover totals from Columns D, E, F, and G from additional sheets ...................................................
44
45 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
46
47                                                          *24100000000*
48                                                                                24100000000
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