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04       Schedule IN-OCC                                        Indiana Department of Revenue                                                                       Enclosure 
         State Form 55629                                                                                                                               Sequence No. 25
05       (R10 / 9-24)                                           Other Certified Credits                                                2024
06
07 Name shown on Form IT-40/IT-40PNR                                                                                                    Your Social Security Number
08
09 XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX                                                                                             999   99             9999
10 Name shown on IT-20/IT-20NP/IT-65/IT-20S/FIT-20/IT-41                                                                                Federal Employer Identification Number
11
12 XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX                                                                                                 999999999
13
14 Complete Part A if you are reporting any of the following credits: Attainable Homeownership Credit, Attainable Homeownership Credit - Composite, EDGE-NR Credit; EDGE-NR 
15 Credit -Composite; Film and Media Production Credit; Film and Medial Production Credit - Composite; Foster Care Donation Credit; Foster Care Donation Credit - Composite; 
16 Headquarters Relocation Credit; Headquarters Relocation Credit - Composite Hoosier Business Investment Credit; Health Reimbursement Arrangement Credit, Historic 
17 Rehabilitation Credit, Historic Rehabilitation Credit - Composite, Hoosier Business Investment Credit - Composite; Hoosier Business Investment Credit - Logistics; Hoosier Business 
18 Investment Credit - Logistics - Composite; Natural Gas Commercial Vehicle Credit; Natural Gas Commercial Vehicle Credit - Composite; Physician Practice Ownership Credit, 
19 Redevelopment Tax Credit; Redevelopment Tax Credit - Composite; School Scholarship Credit; School Scholarship Credit - Composite; Venture Capital Investment Credit; Venture 
20 Capital Investment Credit - Composite; VCI - Qualified Indiana Investment Fund; VCI - Qualified Indiana Investment Fund - Composite. 
21
22 Part A
23       Column A         Column B      Column C                Column D                       Column E                                Column F         Column G
24    IT-20S/IT-41/IT-65 
                          Certification Certification / Project Tax Credit                     Amount                                  Amount        Carryforward 
25 Enter FEIN if Credit 
                          Year          Number                                      Code       Available                               Claimed          Amount
26        is from IN K-1
27
28 1. 9999999999999       9999          999999999999999999                          9999    99999999999                       00    1. 9999999999900 9999999999900
29
30 2. 9999999999999       9999          999999999999999999                          9999    99999999999                       00    2. 9999999999900 9999999999900
31
32 3. 9999999999999       9999          999999999999999999                          9999    99999999999                       00    3. 9999999999900 9999999999900
33
34 4. 9999999999999       9999          999999999999999999                          9999    99999999999                       00    4. 9999999999900 9999999999900
35
36 5. 9999999999999       9999          999999999999999999                          9999    99999999999                       00    5. 9999999999900 9999999999900
37
38 6. 9999999999999       9999          999999999999999999                          9999    99999999999                       00    6. 9999999999900 9999999999900
39
40 7. 9999999999999       9999          999999999999999999                          9999    99999999999                       00    7. 9999999999900 9999999999900
41 8. Add amounts from column F, line 1 - 7, and enter the total here. Carry to the 
42    appropriate line on: Schedule 6; Schedule G; Form IT-20; Form IT-20NP; Form IT-41; or 
43    Form FIT-20 (Form IT-65 and Form IT-20S filers must see special reporting instructions) ................................Total 8. 9999999999900
44
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47                                                       *21524111694*
48                                                                                  21524111694
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00000000001111111111222222222233333333334444444444555555555566666666667777777777888888888899999999990000000000
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04
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09 Part B
10       Column A       Column B     Column C                Column D   Column E       Column F      Column G
11  IT-20S/IT-41/IT-65 
                        First Credit Certification / Project Tax Credit Amount         Amount        Carryforward 
12 Enter FEIN if Credit 
                        Year         Number                  Code       Available      Claimed       Amount
13        is from IN K-1
14
15 1. 9999999999999     9999         999999999999999999      9999       99999999999 00 9999999999900 9999999999900
16
17 2. 9999999999999     9999         999999999999999999      9999       99999999999 00 9999999999900 9999999999900
18
19 3. 9999999999999     9999         999999999999999999      9999       99999999999 00 9999999999900 9999999999900
20
21 4. 9999999999999     9999         999999999999999999      9999       99999999999 00 9999999999900 9999999999900
22
23 5. 9999999999999     9999         999999999999999999      9999       99999999999 00 9999999999900 9999999999900
24
25 6. 9999999999999     9999         999999999999999999      9999       99999999999 00 9999999999900 9999999999900
26
27 7. 9999999999999     9999         999999999999999999      9999       99999999999 00 9999999999900 9999999999900
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47                                          *24100000000*
48                                                           24100000000
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                                    Instructions for Other Certified Credits

Who Must Complete This Schedule                                     Part A Line-by-line Instructions
You must complete Part A of the schedule if you are reporting       Enter the name of the entity claiming the credit(s).
any of the credits listed in the table below. In addition, you must 
complete Part B if you:                                             Enter the corresponding Social Security number or federal 
• Have any credits that you are carrying forward from a             employer identification number.
  previous taxable year,
• Have any credits that first became available during the           Columns A – E. The following information details how to 
  taxable year and were not used during the taxable year, and/      complete Columns A – E. If you are claiming more than one 3-digit 
  or                                                                and/or 4-digit credit, please enter each one separately. Also, if you 
• Have any research expense credits for an individual that are      are claiming an identical three-digit or four-digit code from multiple 
  not reflected on a Schedule IN K-1 or IT-41 Schedule IN K-1.      sources, such as a Hoosier Business Investment Credit from two 
                                                                    different partnerships, list each credit and source on a separate 
                                                 Tax Credit         line.
Credit Name                                               Code
Attainable Homeownership Credit                           875       Column A. If you are a member of an S corporation or 
Attainable Homeownership Credit -Composite                1875      partnership or a beneficiary of an estate or trust and are claiming 
EDGE-NR Credit                                            865       one or more of the above credits from your IN K-1, enter the 
                                                                    federal employer identification number of the S corporation, 
EDGE-NR Credit - Composite                              *1865
                                                                    part nership, estate, or trust in this column. If the credit you are 
Film and Media Production Credit                          869       reporting does not flow from an S corporation, partnership, estate, 
Film and Medial Production Credit - Composite           *1869       or trust, leave this column blank.
Foster Care Donation Credit                               867
Foster Care Donation Credit - Composite                 *1867       Do not use a dash when entering the number. For example, enter 
                                                                    12-3456789 as 123456789.
Headquarters Relocation Credit                            818
Headquarters Relocation Credit - Composite              *1818       Column B. Enter the tax year for which the credit has been 
Health Reimbursement Arrangement Credit                   878       certified. You can find this information in the certification letter 
Historic Rehabilitation Credit                            879       you received from the authorizing entity or on your IN K-1, if 
                                                                    applicable. 
Historic Rehabilitation Credit - Composite                1879
Hoosier Business Investment Credit                         820      Column C. Certification or project numbers and PINs* are 
Hoosier Business Investment Credit - Composite           *1820      numeric characters. Enter the certification or project number you 
Hoosier Business Investment Credit - Logistics             860      received from the authorizing entity. You can find this number in 
Hoosier Business Investment Credit - Logistics -                    the certification letter you received from the authorizing entity or on 
Composite                                                *1860      your IN K-1. If you also have received a PIN, add it to the right of 
                                                                    your project number and enter the combined number in this box.
Natural Gas Commercial Vehicle Credit                      858
Natural Gas Commercial Vehicle Credit -                             For example, express the combined certification or project number 
Composite                                                *1858      “123456” and PIN “1234” as “1234561234” in Column C. Do not 
Physician Practice Ownership Credit                       880       include any dashes.
Redevelopment Tax Credit                                  863
Redevelopment Tax Credit - Composite                    *1863       *You may have a Venture Capital Investment Credit that has no 
                                                                    certification number, project number, or PIN associated with it. If 
School Scholarship Credit                                  849
                                                                    this is the case, enter in Column B the first year you were eligible 
School Scholarship Credit - Composite                   *1849       to claim the credit, and the 3- or 4-digit tax credit code number 
Venture Capital Investment Credit                         835       associated with it in Column D. Make sure to keep your approval 
Venture Capital Investment Credit - Composite           *1835       paperwork with your records as the department may request it at 
VCI - Qualified Indiana Investment Fund                   868       a later date.

VCI - Qualified Indiana Investment Fund -                           For the physician practice credit, enter your license number 
Composite                                               *1868       without the last letter. For example, if you have licenses 
                                                                    98765432A and 98765432B, enter “98765432.”

                                                                    Column D. Enter the 3- or 4-digit* tax code number associated 
                                                                    with the credit.

                                           *24100000000*
                                                          24100000000

*4-Digit Code Utilization. The 4-digit code represents a certified       Note. If filing by paper and you need more than 7 lines, complete 
credit that has been used to offset a nonresident shareholder’s/         and attach additional copies of Schedule IN-OCC as needed, but 
partner’s (taxpayer’s) composite tax on the Indiana S corporation/       do not complete line 8. On the first schedule, enter the total credit 
partnership return.                                                      amounts from all pages on line 8.

If the nonresident taxpayer has other Indiana-source income              Form IT-20S/IT-65 filers must see the following Special 
and/or owes county tax, he will need to file an individual income        Instructions.
tax return with Indiana. Since the income taxed for composite 
purposes will also be included on the taxpayer’s income tax              Special Instructions for Form IT-20S/IT-65 Filers
return, the amount of the credit used on the composite filing may        If filing this schedule with the IT-20S or IT-65, only reflect the 
also be used to offset tax due on the individual tax return.             credit amounts for the partners/shareholders included on the 
                                                                         composite return. Do not include credits from the IN K-1’s that 
Example. Partnership A has a Hoosier Business Investment (HBI)           are for Indiana residents. Enter the combined pro rata credits on 
Credit. As a nonresident partner, Jim’s share of that credit is $700.    one line of the IN-OCC; do not enter a line for each composite 
The partnership used $400 of Jim’s credit to offset his tax liability    member.
on the composite filing, leaving a $300 remaining credit. The IN 
K-1 will breakdown the credit as follows:                                If the IT-20S or IT-65 has received an IN K-1 reflecting a 4-digit 
                                                                         pass-through credit from another entity that has already been 
       Credit Name        3- or 4-Digit Code   Amount                    utilized on a mandatory composite filing on the behalf of the 
                                                                         current filing entity, this amount must be reflected on the IN-OCC 
HBI Credit – Composite                 1820                   $400
                                                                         prior to any unutilized 3-digit credit code amount.
HBI Credit                                 820                $300
                                                                         The total amount of 3- and 4-digit credit codes claimed against the 
Since Jim has other Indiana-source income, he will file Form IT-         composite return cannot exceed the entity’s total tax due.
40PNR, reporting all Indiana-source income (including his income 
taxed on the composite return). When completing the IN-OCC, he           In addition, use tax cannot be offset by these nonrefundable 
will be able to use up to $700 of his HBI credit, using the amount       credits if included in the total tax due.
associated with the 4-digit number first. 
                                                                         Note. For more information about these credits, see the 
For example, if his total state tax liability is $500, he will list “HBI instruction booklets posted online at www.in.gov/dor/tax-forms for:
1820 $400” on Schedule IN-OCC, and then report the remaining             • Form IT-40/IT-40PNR (Schedule 6/G claimants)
amount needed as “HBI 820 $100”. He will have a remaining $200           • Form IT-20
HBI credit (3-digit code 820) available to be carried forward.           • Form IT-20NP
                                                                         • Form FIT-20
Important. The credit used to offset the composite tax, labeled          • Form IT-65
with a 4-digit code, must be utilized on the individual tax return       • Form IT-20S
prior to using any credit labeled with a 3-digit credit code. 
                                                                         Part B Line-by-Line Instructions
The 4-digit code has the same carryforward provision as does its 
equivalent 3-digit code.                                                 Note. If you have multiple credits with the same code available 
                                                                         but for different sources (e.g., research expense credits from 
Column E. Enter the amount of credit you are claiming.                   two separate pass through entities) and/or different years (e.g., 
                                                                         the same credit type that first became available during different 
Limitation. The credits listed on this schedule are limited to offset    years), list each year and source on a separate line.
Indiana adjusted gross income tax. For example, if your School 
Scholarship Credit is $500 and your adjusted gross income tax            Column A. If you are a member of an S corporation or 
is $425, you should enter the $425 limited amount in Column E.           partnership or a beneficiary of an estate or trust and are claiming 
Since any unused portion of this credit is eligible to be carried        one or more of the above credits from your IN K-1, enter the 
over to the next tax year, you will be eligible to claim the remaining   federal employer identification number of the S corporation, 
$75 credit on next year’s tax return.                                    partnership, estate, or trust in this column. If the credit you are 
                                                                         reporting does not flow from an S corporation, partnership, estate, 
Line 8. Once you have completed this schedule, carry the credit          or trust, leave this column blank. 
amount from Column E, line 8, to the appropriate form/schedule 
(Schedule 6 or Schedule G for individual filers, Form IT-20, Form        Do not use a dash when entering the number. For example, enter 
IT-20S, Form IT-20NP, Form IT-41 or Form FIT-20), and enclose            12-3456789 as 123456789.
this schedule when filing your tax return.

                                          *24100000000*
                                                               24100000000

Column B. Enter the first year for which you were first entitled to 
the credit. For instance, if you were first entitled to a credit in 2022 
but did not use the credit until 2024, enter 2022.

Column C. If you are claiming a credit from Schedule IN-OCC, 
enter the certification number for the credit associated with that 
line. Otherwise:
• Enter 111 if this is a research expense credit claimed by an 
  individual based on activities occurring as a sole proprietor.
• Enter 222 if this is a research expense credit claimed by 
  an individual as a result of activities occurring in a single-
  member limited liability company in which the individual is the 
  sole member or trust in which the individual is a grantor.
• Enter 0 for all other non-IN-OCC credits.

Column D. Enter the three-digit code associated with the credit. 
These will generally be found in the instruction booklet for your 
tax return. For individuals, enter the following for certain credits 
without a three-digit code:
• 807 – College credit
• 810 – Credit for out-of-state local taxes
• 811 – Credit for taxes paid to another state

Column E. Enter the amount of credit that is available to be 
claimed. If this is the first year for which you are entitled to the 
credit, enter the amount that you are entitled to claim. If this is a 
carryforward from a previous year, enter the amount that you are 
carrying forward into this year.

Column F. Enter the amount of the credit that you are claiming 
during this year. Please note that if you are claiming a credit listed 
on multiple lines for a taxable year (e.g., a research expense 
credit from two different pass-through entities), list the amount 
claimed against each line separately. Do not claim more than the 
amount listed in Column E.

Column G. Enter the amount in Column E minus the amount in 
Column F. If the credit is eligible to be carried forward, this is the 
amount available for carryforward. Complete this column even if 
the credit cannot be carried forward.

                                           *24100000000*
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