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Form IT-65 Indiana Department of Revenue
State Form 11800
(R21 / 8-22) Indiana Partnership Return 2022
for Calendar Year Ending December 31, 2022

or Other Tax Year Beginning 2022 and Ending

Check box if amended. Check box if amendment is due to a federal audit. Check box if name changed.
Name of Partnership Federal Employer Identification Number

Number and Street Principal Business Activity Code Foreign Country 2-Character Code

City State ZIP Code 2-Digit County Code

M. Year of initial
Telephone Number K. Date of organization In the State of L. State of commercial domicile Indiana return

N. Accounting method: Cash Accrual Other U. Check box if claiming a credit on Form IT-20REC

O. Check all boxes that apply to entity: Initial Return Final Return In Bankruptcy Composite Return

P. Enter total number of partners: Enter number of nonresident partners:

Q. I have on file a valid extension of time to file my return (federal Form 7004 or an electronic extension of time).

R. This is a partnership that has elected to be subject to tax at the partnership level.

S. This partnership is a member of another partnership(s). T. This entity reports income from disregarded entities.

Aggregate Partnership Distributive Share Income (see worksheet) Round all entries
1. Total net income (loss) from U.S. partnership return, Form 1065 Schedule K (see instructions);
use minus sign for negative amounts ______________________________________________ 1 .00

2. a. Enter name of addback or deduction (see instructions) Code. No. 2a .00

b. Enter name of addback or deduction Code. No. 2b .00

c. Enter name of addback or deduction Code. No. 2c .00
d. Enter the total amount of addbacks and deductions from any additional sheets (use a
minus sign for negative amount) ________________________________________________ 2d .00

3. Total partnership income, as adjusted (add lines 1 through 2d) __________________________ 3 .00
4. Enter percentage for Indiana apportioned adjusted gross income from IT-65 Schedule E line 9,
if applicable __________________________________________________________________ 4 . %
Summary of Calculations
5. Sales/use tax due on purchases subject to use tax from Sales/Use Tax worksheet __________ 5 .00
6. a. Enter amount from line 15G of completed
Schedule Composite ____________________________ 6a .00
b. Enter amount from line 29C of completed
Schedule Composite-COR ________________________ 6b .00
c. Enter amount from line 16 of completed
Schedule IN-EL ________________________________ 6c .00
d. Add amounts from lines 6a - 6c. Attach Schedule Composite/Composite-COR/IN-EL 6d .00

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7.  Total tax (add lines 5 and 6d). Caution:  If line 7 is zero, see line 16 late file penalty __________ 7            .00

8.  Total amount of pass-through withholding (enclose IN K-1 from the paying entity) ___________          8            .00

9.  Total composite withholding IT-6WTH payments (see instructions) _______________________               9            .00

10.  Other payments/credits (enclose documentation)  ____________________________________   10                         .00

11.  EDGE credit. Enter the total EDGE credit amount claimed (line 19 on Schedule IN-EDGE) ____   11                   .00

12.  EDGE-R credit. Enter the total EDGE-R credit amount claimed (line 19 on Schedule IN-EDGE-R)  12                   .00
13.  Certified Credits. Enter the total of certified credits claimed from Schedule IN-OCC and enclose  
    this schedule with your return. ___________________________________________________   13                           .00

14. Subtotal (line 7 minus lines 8-13). If total is greater than zero, proceed to lines 15-17 ________    14           .00

15.  Interest: Enter total interest due; see instructions (contact the department for current interest rate)  15       .00
16. Penalty: If paying late, enter 10% of line 14. If line 7 is zero, enter $10 per day filed past the  
    due date; see instructions _______________________________________________________   16                            .00
17.  Penalty: If failing to include all nonresident partners on composite return, enter $500;  
    see instructions _______________________________________________________________                        17         .00
18. Total Amount Due (add lines 14-17). If less than zero, enter on line 19.  
    Make payment in U.S. funds _____________________________________________________   18                              .00
19. Overpayment and Refund Amount (add lines 8-13, and then subtract lines 7, 15, 16, and 17).
    No carryforward allowed.  _______________________________________________________   19                             .00
Certification of Signatures and Authorization Section
Under penalties of perjury, I declare I have examined this return, including all accompanying schedules and statements, and to the best 
of my knowledge and belief it is true, correct, and complete.
Signature                                                       Paid Preparer’s 
                                                                Email Address 
   I authorize the Department to discuss my return with my      Paid Preparer: Firm’s Name (or yours if self-employed)
   personal representative (see instructions).

    Y             N    Date ____________________________        Paid Preparer’s Name

   Personal Representative’s Name (please print)

                                                                PTIN
   Email
   Address                                                      Telephone Number

   Signature of                                                 Address
   Corporate Officer __________________________________
                                                                City
   Print or Type Name of Corporate Officer
                                                                State                                   ZIP Code+4

   Title                                                        Paid Preparer’s Signature ____________________________

                                                                Date _____________________________________________

    If you owe tax, please mail your return to IN Department of If you do not owe any tax, mail it to IN Department of Revenue, 
      Revenue, PO Box 7205, Indianapolis, IN 46207-7205.                      PO Box 7147, Indianapolis, IN 46207-7147.

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