PDF document
- 1 -

Enlarge image
01
0000000000111111111122222222223333333333444444444455555555556666666666777777777788888
1234567890123456789012345678901234567890123456789012345678901234567890123456789012345
04        Schedule D                                      Indiana Department of Revenue                                       Enclosure 
          Form IT-40PNR                                                                                         Sequence No. 04
05        State Form 54032                                Schedule D: Exemptions                        2024
06        (R15 / 9-24)
07 Name(s) shown on Form IT-40PNR                                                                  Your Social Security Number
08
09 XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX                                                  999     99  9999
10 Complete and enclose Schedule IN-DEP: Dependent Information and Additional Dependent Child Information if you are 
11 claiming dependents on lines 2 and/or 3 below. Complete and enclose Schedule IN-DEP-A: Adopted Dependent Information if 
12 you are claiming dependents on line 6 below.
13                                                                                                             Round all entries
14
15  1.  Enter $2000 if you are married filing jointly; otherwise, enter $1000 ________________________      1  99999999999.00
16
17  2.  Enter the number of dependents listed on Schedule IN-DEP, Box 5             99 x $1000 __________   2  99999999999.00 
18      You MUST enclose Schedule IN-DEP.
19
20  3.  You may claim an additional exemption for each qualifying dependent child:
21       who is a son, stepson, daughter, stepdaughter, foster child and/or child for whom you are a  
22        legal guardian;
23       who was under the age of 19 by Dec. 31, 2024; or
24       who is a full-time student who was under the age of 24 by Dec. 31, 2024; and
25       who you are eligible to claim as a dependent on line 2 above.
26
27      Enter the number of additional dependents 
28      listed on Schedule IN-DEP, Box 6.                 99      x $1500 _____________________________     3  99999999999.00
29
30  4.  Place “X” in box(es) below if, by December 31, 2024:
31
32          You were age 65 or older          X      and/or blind X
33
34               Spouse was 65 or older       X      and/or blind X
35
36      Total number of boxes with Xs             99  x $1000 _____________________________________         4  99999999999.00
37
38  5.  If age 65 or older, enter amount from Schedule A, line 36A.       99999999999999999999
39       If filing as married filing separately and this amount is less than $20,000, place “X” in  
40        the “You were age 65 or older” box below. 
41       For all other filers age 65 or older, if this amount is less than $40,000, place “X” in  
42        appropriate box(es) below.
43
44          You were age 65 or older          X
45
46               Spouse was 65 or older       X
47
48      Total number of boxes with Xs             99  x $500 ______________________________________         5  99999999999.00
49
50  6.  Enter the number of additional adopted child  
51      exemptions listed on Schedule IN-DEP-A, Box 6             99      x $3000  ________________________ 6  99999999999.00 
52      You MUST enclose Schedule IN-DEP-A.
53
54  7.  Add lines 1, 2, 3, 4, 5 and 6  _______________________________________________________              7  99999999999.00
55
56  8.  Enter the number from Schedule A, Proration Section, line 21D ___________________________           8  9.999
57
58  9.  Multiply line 7 by line 8. Enter here and on Form IT-40PNR, line 6 __________Total Exemptions       9  99999999999.00
59
60
61
62                                                   *23724111694*
63                                                                       23724111694
64
65
66






PDF file checksum: 1668069912

(Plugin #1/10.13/13.0)