Schedule F /                           Indiana Department of Revenue                                           Enclosure 
   Schedule IN-DONATE                     Schedule F: Credits                                          Sequence No. 05
   Form IT-40PNR                                                                       2024
   State Form 54033 
   (R15 / 9-24)
Name(s) shown on Form IT-40PNR                                                         Your Social Security Number

                                                                                                       Round all entries

1.  Indiana state tax withheld: See instructions ___________________________________________        1                   .00

2.  Indiana county tax withheld: See instructions  _________________________________________        2                   .00

3.  Pass Through Entity Tax Credit  ____________________________________________________             3                  .00

4.  Estimated tax paid for 2024: include any extension payment made with Form IT-9  ____________    4                   .00

5. Unified tax credit for the elderly ____________________________________________________          5                   .00
6.  Earned income credit: see instructions
   Enter earned income credit from 
   Schedule IN-EIC, line A-3 _______________________________Box A                      .00

   Enter number from Schedule A, Proration Section, line 21D ___ Box B .

   Multiply Box A by Box B, enter total here _____________________________________________          6                   .00

7.  Lake County residential income tax credit ____________________________________________          7                   .00

8.  Economic development for a growing economy credit. Enter amount from Schedule IN-EDGE,  
   line 19 (enclose schedule) ________________________________________________________              8                   .00

9.  Economic development for a growing economy retention credit. Enter amount from  
   Schedule IN-EDGE-R, line 19 (enclose schedule) ______________________________________            9                   .00

10.  Headquarters relocation credit (refundable portion - see instructions) _______________________ 10                  .00

11.  Adoption Credit _________________________________________________________________              11                  .00

12.  Reserved for future use __________________________________________________________             12                  .00

13.  Add lines 1 through 12. Enter total here and on Form IT-40PNR, line 12 _________ Total Credits 13                  .00

                                          Schedule IN-DONATE
                    Important: The amount on line 2 cannot exceed the amount on Form IT-40PNR, line 16.

1.  Donations: List fund name, 3-digit code and amount to be donated (see instructions)

   a.  Enter fund name                                                 code no.                     1a                  .00

   b.  Enter fund name                                                 code no.                     1b                  .00

   c.  Enter fund name                                                 code no.                     1c                  .00

2.  Add lines 1a through 1c. Enter total here and on Form IT-40PNR, line 17  _____ Total Donations   2                  .00

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