01
0000000000111111111122222222223333333333444444444455555555556666666666777777777788888
1234567890123456789012345678901234567890123456789012345678901234567890123456789012345
04 Schedule IN-EDGE-R                Economic Development for a Growing 
   State Form 55363
05 (R9 / 9-22)                       Economy Retention Credit
06                                   This schedule must be enclosed when claiming this credit.   2022     Enclosure 
07                                                                                                      Sequence No. 24
08
09 Name shown on Form IT-40/IT-40PNR                                         Your Social Security Number
10                                                                        E                                    A
11 XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX                           999                 99   9999
12 Name shown on IT-20/IT-20NP/IT-65/IT-20S/FIT-20                           Federal Employer Identification Number
13                                                                        BM                              DS
14 XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX                           99                  9999999
15
16                 Column A          Column B      Column C                 Column D                  Column E
17                 IT-20S/IT65
18             Enter FEIN if EDGE-R  Certification Project                   Project                    Amount 
19             Credit is from IN K-1 Year          Number                    PIN                        Claimed
20
21  1. 99          9999999           9999          999999                 99999999               99999999999.00
22
23  2. 99          9999999           9999          999999                 99999999               99999999999.00
24
25  3. 99          9999999           9999          999999                 99999999               99999999999.00
26
27  4. 99          9999999           9999          999999                 99999999               99999999999.00
28
29  5. 99          9999999           9999          999999                 99999999               99999999999.00
30
31  6. 99          9999999           9999          999999                 99999999               99999999999.00
32
33  7. 99          9999999           9999          999999                 99999999               99999999999.00
34
35  8. 99          9999999           9999          999999                 99999999               99999999999.00
36
37  9. 99          9999999           9999          999999                 99999999               99999999999.00
38
39 10. 99          9999999           9999          999999                 99999999               99999999999.00
40
41 11. 99          9999999           9999          999999                 99999999               99999999999.00
42
43 12. 99          9999999           9999          999999                 99999999               99999999999.00
44
45 13. 99          9999999           9999          999999                 99999999               99999999999.00
46
47 14. 99          9999999           9999          999999                 99999999               99999999999.00
48
49 15. 99          9999999           9999          999999                 99999999               99999999999.00
50
51 16. 99          9999999           9999          999999                 99999999               99999999999.00
52
53 17. 99          9999999           9999          999999                 99999999               99999999999.00
54
55 18. 99          9999999           9999          999999                 99999999               99999999999.00
56 19. Add amounts from Column E, lines 1 - 18, and enter total here.  
57     Carry to the appropriate line on: Schedule 5 of Form IT-40; Schedule F of Form IT-40PNR;  
58     Form IT-20; Form IT-65; Form IT-20S; Form IT-20NP; or Form FIT-20. Total EDGE-R Credit    99999999999.00
59
60
61
62                                   *18722111694*
63                                                 18722111694
64
65
66

                                    Instructions for Schedule IN-EDGE-R

Economic Development for a Growing Economy                        Column B. Enter the tax year for which the credit has been 
Retention (EDGE-R) Credit                                         certified. You can find this 4-digit number in the certification 
If you are claiming the EDGE-R credit, you must complete  letter you received from the IEDC or on your IN K-1.
this schedule and enclose it with your tax return. Otherwise, 
this credit will not be allowed.                                  Column C. Enter the project number you received from the 
                                                                  IEDC. You can find this 6-digit number in the certification letter 
For eligibility requirements, please contact the Indiana  you received from the IEDC or on your IN K-1.
Economic Development Corporation at One North Capitol, 
Suite 700, Indianapolis, IN 46204, or by calling 317-232-8800.    Column D. Enter the project PIN you received from the IEDC. 
You can also visit www.in.gov/iedc for additional information.    You can find this 5- or 8-digit number in the certification letter 
                                                                  you received from the IEDC or on your IN K-1. If you are 
Line-by-line Instructions                                         claiming a credit for a year prior to 2014 and therefore do not 
Enter the name of the individual, corporation, or nonprofit       have a PIN, please leave this column blank.
organization claiming the credit. 
                                                                  Column E. Enter the amount of credit you are claiming. 
Enter your Social Security number or federal employer 
identification number.                                            Line 19. Add the amounts in Column E, lines 1 – 18, and 
                                                                  enter the total here. This is your total EDGE-R credit. Enter 
The following information details how to complete Columns  this amount on the appropriate line on: Schedule 5 of Form 
A - E. If you are claiming more than one credit, please enter  IT-40; Schedule F of Form IT-40PNR; Form IT-20; Form IT-65; 
each one separately.                                              Form IT-20S; Form IT-20NP; FIT-20; or IT-41.

Column A. If you are a shareholder in an S corporation or a 
partner in a partnership and are claiming the EDGE-R credit 
from your IN K-1, enter the federal employer identification 
number of the S corporation or partnership in this column. 
Enter the first two digits of the federal employer identification 
number in the first box, and enter the remaining seven digits 
in the second box. If you are    not a shareholder in an S 
corporation or a partner in a partnership, please leave this 
column blank.

                                    *24100000000*
                                           24100000000