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Indiana Free Printable  for 2023 Indiana Indiana Disability Retirement Deduction

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Indiana Disability Retirement Deduction
Form IT-2440

Indiana Disability Retirement Deduction Schedule IT-2440 Attach to Form IT-40 or Form IT-40PNR State Form 46003 (R15 / 9-21) Your Social Security Number Your first name Initial Spouse’s Social Security Number Last name If filing a joint return, spouse’s first name Initial Last name ►Enter the date you and/or your spouse retired. Yourself MM DD ►Enter the employer’s name below or give payer’s name, if other than employer. Spouse YYYY MM DD Your Employer’s or Payer’s Name YYYY ►Your Daytime Telephone Number Note 2021 Enclosure Sequence No. 15 Spouse’s Employer’s or Payer’s Name • To claim this deduction, you must complete lines 1 through 6 and enclose this schedule with your Indiana return. • Joint return filers use lines 1A and 3A for you and/or lines 1B and 3B for your spouse’s information. Column A: Yours Column B: Spouse’s 1. Enter total disability payments received during the year_______ 1A .00 1B .00 2. Add lines 1A and 1B______________________________________________________________ 2 .00 3. Excess of disability payments over $100 per week (see line 3 instructions, Table A and the Worksheet)__________ 3A .00 3B .00 4. Excess of federal adjusted gross income over $15,000 (over $7,500 if married filing separately - see instructions)________________________________ 4 .00 5. Add lines 3A, 3B, and 4___________________________________________________________ 5 .00 6. Line 2 minus line 5 (if less than zero, enter zero). This is your disability retirement deduction. Enter here and on Form IT-40, Schedule 2, under line 11, or on Form IT-40PNR, Schedule C, under line 11____________________________________________________________________ 6 .00 Physician’s Statement of Permanent and Total Disability Completed statement must be signed and dated by the physician Name of Disabled Individual First Name Date you Retired Initial Last Name M M Physician Information First Name Address (Street Address, City, State Initial Last Name and Zip Code) ► I certify that the taxpayer named above is permanently and totally disabled (see instructions). Physician’s Signature Date ____________________________________________________________________________________ *24100000000* 24100000000 D D YYYY Line-by-Line Instructions Do You Qualify for the Deduction? You may qualify for the deduction if you meet both of the following requirements: • you retired on disability before December 31 of the tax year for which you are claiming the deduction; and • you were permanently and totally disabled when you retired. Table A - How to figure your weekly pay: If you were paid: Figure your weekly pay by: Every 2 weeks.............. Divide your gross pay by 2 Twice a month.............. Multiply your gross pay by 24 and divide the result by 52 Once a month............... Multiply your gross pay by 12 and divide the result by 52 If you meet these requirements, you may be eligible to subtract up to $5,200 a year of your disability payments from your gross income. The amount you subtract is limited to the amount of disability pay you actually received or $100 a week, whichever is less, and may have to be reduced by part of your federal adjusted gross income. Note: If you did not receive disability income for the whole year, use the actual amount of weeks/months. Your spouse may also be eligible to subtract up to $5,200 of disability payments if you file a joint return and your spouse meets all the above requirements. Example: Jim received disability income of $130 a week for six weeks. He should complete the worksheet below, entering the $130 amount on line a. Note: In no case may the total deduction be more than $10,400 on a joint return. Worksheet - How to figure the excess over $100 for full weeks: General Instructions Enter your name(s), Social Security number(s) and, if applicable, the date you retired. On a joint return, if both spouses qualify for the disability retirement deduction, two Physician’s Statements must be attached. Use only one Schedule IT-2440 to calculate the deduction. Any other way............... Divide your gross yearly pay by 52 a. Weekly disability pay received.......... a ___________ b. Maximum weekly deduction............. b 100 c. Subtract line b from line a (If line b is larger than line a, enter 0)............. c ___________ d. Number of full weeks for which you received disability pay...................... d ___________ e. Multiply the amount on line c by line d. Enter here and on line 3A or 3B on the front of this schedule............. e ___________ Line 1 - Enter the amount received during the taxable year through an accident and health plan for personal injuries or sickness. Use line 1A for yourself and line 1B for your spouse. Line 4 - The deduction is further reduced by the excess of the federal adjusted gross income (AGI) over $15,000 ($7,500 if married filing separately). Line 3 - The amount you can deduct is limited to the disability income you received each week or $100 per week, whichever is less. a. Federal AGI (from IT-40 line 1 or from IT-40PNR Schedule A, line 36A)...... a ___________ b. Income limit (see above).................. b - c. Subtract b from a (if b is larger than a, enter 0). Enter here and on line 4 on the front of this schedule.... c ___________ If you did not receive your disability pay each week, you will have to figure your weekly pay (see Table A). Instructions for Physician’s Statement A person is permanently and totally disabled when: • He or she cannot engage in any substantial gainful activity because of a physical or mental condition; and • A physician determines that the disability (a) has lasted or can be expected to last continuously for at least a year, or (b) can be expected to result in death. *24100000000* 24100000000
Extracted from PDF file 2021-indiana-form-it-2440.pdf, last modified April 2020

More about the Indiana Form IT-2440 Individual Income Tax

We last updated the Indiana Disability Retirement Deduction in January 2022, and the latest form we have available is for tax year 2021. This means that we don't yet have the updated form for the current tax year. Please check this page regularly, as we will post the updated form as soon as it is released by the Indiana Department of Revenue. You can print other Indiana tax forms here.


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Other Indiana Individual Income Tax Forms:

TaxFormFinder has an additional 69 Indiana income tax forms that you may need, plus all federal income tax forms.

Form Code Form Name
Form ES-40 Estimated Tax Payment Voucher
Form SC-40 Unified Tax Credit for the Elderly
Schedule C Deductions (Nonresident)
Form IT-65 Partnership Return Forms and Schedules
Form CT-40PNR County Tax Schedule for Part-Year and Full-Year Nonresidents

Download all IN tax forms View all 70 Indiana Income Tax Forms


Form Sources:

Indiana usually releases forms for the current tax year between January and April. We last updated Indiana Form IT-2440 from the Department of Revenue in January 2022.

Show Sources >

About the Individual Income Tax

The IRS and most states collect a personal income tax, which is paid throughout the year via tax withholding or estimated income tax payments.

Most taxpayers are required to file a yearly income tax return in April to both the Internal Revenue Service and their state's revenue department, which will result in either a tax refund of excess withheld income or a tax payment if the withholding does not cover the taxpayer's entire liability. Every taxpayer's situation is different - please consult a CPA or licensed tax preparer to ensure that you are filing the correct tax forms!

Historical Past-Year Versions of Indiana Form IT-2440

We have a total of eleven past-year versions of Form IT-2440 in the TaxFormFinder archives, including for the previous tax year. Download past year versions of this tax form as PDFs here:


2018 Form IT-2440

Schedule IT-2440 (09-12).indd

2017 Form IT-2440

Schedule IT-2440 (09-12).indd

2016 Form IT-2440

Schedule IT-2440 (09-12).indd

2015 Form IT-2440

Schedule IT-2440 (09-12).indd

Indiana Disability Retirement Deduction 2014 Form IT-2440

Schedule IT-2440 (09-12).indd

Indiana Disability Retirement Deduction 2013 Form IT-2440

Schedule IT-2440 (09-12).indd

2012 Form IT-2440

Schedule IT-2440 (09-12).indd

2011 Form IT-2440

Schedule IT-2440 (09-11).indd


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