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NP-20 |
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Indiana Department of Revenue |
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State Form 51062 |
Indiana Nonprofit Organization's Annual Report |
(R12 / 8-21) |
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For the Calendar Year or Fiscal Year |
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Beginning |
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and Ending |
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Place “X” in box if: Change of Address |
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Amended Report |
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Final Report: |
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Indicate Date Closed______
Due on the 15th day of the 5th month following the end of the tax year.
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NO FEE REQUIRED |
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Name of Organization |
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Telephone Number |
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Address |
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County |
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Indiana Taxpayer Identification Number |
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City |
State |
ZIP Code |
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Federal Employer Identification Number |
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Printed Name of Person to Contact |
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Contact’s Telephone Number |
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If you are filing a federal return, attach a completed copy of Form 990, 990EZ, or 990PF.
Note: If your organization has unrelated business income of more than $1,000 as defined under Section 513 of the
Internal Revenue Code, you must also file Form IT-20NP.
Current Information
1.Indicate number of years your organization has been in continuous existance: _______
2.Have any changes not previously reported to the Department been made in your governing instruments, (e.g.) articles of incorporation, bylaws, or other instruments of importance? If yes, attach a detailed description of changes.
3.Attach a schedule, listing the names, titles and addresses of your current officers.
4.Briefly describe the purpose or mission of your organization below.
Email Address:
I declare under the penalties of perjury that I have examined this return, including all attachments, and to the best of my knowledge and belief, it is true, complete, and correct.
Signature of Officer or Trustee |
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Date |
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Name of Person(s) to Contact |
Daytime Telephone Number |
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*25421111594*