Schedule 4               Indiana Department of Revenue                                                  Enclosure 
   Form IT-40               Schedule 4: Other Taxes                                                 Sequence No. 03B
   State Form 56540                                                             2024
   (R6 / 9-24)

Name(s) shown on Form IT-40                                                     Your Social Security Number

1.  Use tax on out-of-state purchases from line 4 of Sales/Use Tax Worksheet __________________   1        .00

2.  Household employment taxes. Enclose Schedule IN-H __________________________________          2        .00

3. Recapture of certain Indiana offset credits. Enclose Schedule IN-CR _______________________    3        .00

4.  Add lines 1 through 3. Enter here and on Form IT-40, line 10 ______________ Total Other Taxes 4        .00

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