Fillable Form 19000106: 2019 Ohio IT 1040 Individual Income (State of Ohio)

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Form 19000106: 2019 Ohio IT 1040 Individual Income (State of Ohio)

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The Form 19000106: 2019 Ohio IT 1040 Individual Income (State of Ohio) form is 21 pages long and contains:

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  • 45 check-boxes
  • 446 other fields

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2019 Ohio IT 1040
Individual Income Tax Return
Use only black ink/UPPERCASE letters.
Sequence No. 1
If deceased
check box
Single, head of household or qualifying widow(er)
Married ling jointly
Married ling separately
StateCity
ZIP code
Ohio county (rst four letters)
Do not staple or paper clip.
1. Federal adjusted gross income (from the federal 1040, line 8b). Include page 1 and
2 of your federal return if the amount is zero or negative. Place a "-" in the box at the right
if the amount is less than zero................................................................................................. .. 1.
2a. Additions – Ohio Schedule A, line 10 (INCLUDE SCHEDULE) .....................................................2a.
2b. Deductions – Ohio Schedule A, line 38 (INCLUDE SCHEDULE)..................................................2b.
3. Ohio adjusted gross income (line 1 plus line 2a minus line 2b). Place a "-" in the box at
the right if the amount is less than zero................................................................................... ..3.
4. Exemption amount (if claiming dependent(s), INCLUDE SCHEDULE J) ........................................4.
Number of exemptions claimed:
5. Ohio income tax base (line 3 minus line 4; if less than zero, enter zero) .........................................5.
6. Taxable business income – Ohio Schedule IT BUS, line 13 (INCLUDE SCHEDULE) .................... 6.
7. Line 5 minus line 6 (if less than zero, enter zero) ............................................................................7.
Filing Status – Check one (as reported on federal income tax return)
Check here if this is an amended return. Include the Ohio IT RE (do NOT include a copy of the previously led return).
Address line 1 (number and street) or P.O. Box
Primary taxpayer's SSN (required)
Spouse’s SSN (if ling jointly)

Enter school district # for
this return (see instructions).

SD#
Foreign country (if the mailing address is outside the U.S.) Foreign postal code
First name Last nameM.I.
Spouse's rst name (only if married ling jointly) Last nameM.I.
MM-DD-YY Code
Residency Status – Check only one for primary
Check only one for spouse (if married ling jointly)
Full-year
resident
Part-year
resident
Nonresident
Indicate state

Full-year
resident
Part-year
resident
Nonresident
Indicate state

Address line 2 (apartment number, suite number, etc.)
Check here if you led the federal extension form 4868.
Check here if someone else is able to claim you (or your spouse if
joint return) as a dependent.
Do not staple or paper clip.
Ohio Nonresident Statement – See instructions for required criteria
Primary meets the ve criteria for irrebuttable presumption as nonresident.
Spouse meets the ve criteria for irrebuttable presumption as nonresident.
Check here if claiming a Net Operating Loss (NOL) carryback. Include Ohio Schedule IT NOL.
If deceased
check box
Rev. 10/19. IT 1040 – page 1 of 2
Spouse’s SSN
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19000106
Clear Form
Sequence No. 2
2019 Ohio IT 1040
Individual Income Tax Return
SSN
Rev. 10/19. IT 1040 – page 2 of 2
If line 20 is MORE THAN line 13, skip to line 24. OTHERWISE, continue to line 21.
Preparer's printed name Phone number
Primary signature Phone number
Spouse’s signature
Date (MM/DD/YY)
Sign Here (required): I have read this return. Under penalties of perjury, I declare that, to the best of my knowledge
and belief, the return and all enclosures are true, correct and complete.
If your refund is $1.00 or less, no refund will be issued.
If you owe $1.00 or less, no payment is necessary.
NO Payment Included – Mail to:
Ohio Department of Taxation
P.O. Box 2679
Columbus, OH 43270-2679
Payment Included – Mail to:
Ohio Department of Taxation
P.O. Box 2057
Columbus, OH 43270-2057
Check here to authorize your preparer to discuss this return with the Department
7a. Amount from line 7 on page 1 ........................................................................................................ 7a.
8a. Nonbusiness income tax liability on line 7a (see instructions for tax tables)...............................................8a.
8b. Business income tax liability – Ohio Schedule IT BUS, line 14 (INCLUDE SCHEDULE) ..........................8b.
8c. Income tax liability before credits (line 8a plus line 8b) ..............................................................................8c.
9. Ohio nonrefundable credits – Ohio Schedule of Credits, line 34 (INCLUDE SCHEDULE) ..........................9.
10. Tax liability after nonrefundable credits (line 8c minus line 9; if less than zero, enter zero)........................10.
11. Interest penalty on underpayment of estimated tax (include Ohio IT/SD 2210)..........................................11.
12. Use tax due on Internet, mail order or other out-of-state purchases (see instructions).
Check here to certify that no use tax is due .................................................................................... ....12.
13. Total Ohio tax liability before withholding or estimated payments (add lines 10, 11 and 12) ...................13.
14. Ohio income tax withheld (include copies of W-2, box 17; W-2G, box 15; 1099-R, box 12). .................14.
15. Estimated and extension payments (from Ohio IT 1040ES and IT 40P), and credit carryforward
from last year's return .................................................................................................................................15.
16. Refundable credits – Ohio Schedule of Credits, line 41 (INCLUDE SCHEDULE) .....................................16.
17. Amended return only – amount previously paid with original and/or amended return .............................17.
18. Total Ohio tax payments (add lines 14, 15, 16 and 17) ............................................................................ 18.
19. Amended return only – overpayment previously requested on original and/or amended return .............. 19.
20. Line 18 minus line 19. Place a "-" in the box at the right if the amount is less than zero ........................... ....20.
21. Tax liability (line 13 minus line 20). If line 20 is negative, ignore the "-" and add line 20 to line 13 ............. 21.
22. Interest and penalty due on late ling or late payment of tax (see instructions) ..............................................................22.
23. TOTAL AMOUNT DUE (line 21 plus line 22). Include Ohio IT 40P (if original return) or IT 40XP
(if amended return) and make check payable to “Ohio Treasurer of State” ....... AMOUNT DUE23.
24. Overpayment (line 20 minus line 13) ..........................................................................................................24.
25. Original return only – amount of line 24 to be credited toward 2020 income tax liability ............................25.
26. Original return only – amount of line 24 to be donated:
a. State nature preserves b. Breast/Cervical Cancer c. Wishes for Sick Children
Total ....26g.
d. Wildlife species e. Military injury relief f. Ohio History Fund
27. REFUND (line 24 minus lines 25 and 26g) ................................................................. YOUR REFUND27.
Preparer's TIN (PTIN)
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19000206
P
2019 Ohio Schedule A
Income Adjustments – Additions and Deductions
Use only black ink/UPPERCASE letters.
Do not staple or paper clip.
Sequence No. 3
Primary taxpayer’s SSN
Additions
(add income items only to the extent not included on Ohio IT 1040, line 1)
1. Non-Ohio state or local government interest and dividends ....................................................................... 1.
2. CertainOhiopass-throughentityandnancialinstitutionstaxespaid ....................................................... 2.
3. Ohio529planfundsusedfornon-qualiedexpensesandreimbursementofcollegeexpenses
previously deducted ................................................................................................................................... 3.
4. LossesfromsaleordispositionofOhiopublicobligations ......................................................................... 4.
5. Nonmedical withdrawals from a medical savings account ......................................................................... 5.
6. ReimbursementofexpensespreviouslydeductedonanOhioincometaxreturn ..................................... 6.
Federal
7. InternalRevenueCode168(k)and179depreciationexpenseaddback ................................................... 7.
8. Federalinterestanddividendssubjecttostatetaxation ............................................................................ 8.
9. Federal conformity additions ...................................................................................................................... 9.
10. Total additions (add lines 1 through 9 ONLY). Enter here and on Ohio IT 1040, line 2a ..............10.
Deductions
(deduct income items only to the extent included on Ohio IT 1040, line 1)
11. Business income deduction – Ohio Schedule IT BUS, line 11 ................................................................. 11.
12. EmployeecompensationearnedinOhiobyresidentsofneighboringstates ............................................. 12.
13. State or municipal income tax overpayments shown on the federal 1040, Schedule 1, line 1 ................. 13.
14. TaxableSocialSecuritybenets ............................................................................................................... 14.
15. Certainrailroadretirementbenets .......................................................................................................... 15.
16. InterestincomefromOhiopublicobligationsandpurchaseobligations;gainsfromthe
dispositionofOhiopublicobligations;orincomefromatransferagreement ........................................... 16.
17. AmountscontributedtoanOhiocounty'sindividualdevelopmentaccountprogram ............................... 17.
18. AmountscontributedtoSTABLEaccount:Ohio'sABLEplan .................................................................. 18.
19. IncomeearnedinOhiobyaqualifyingout-of-statebusinessoremployeefordisaster
work conducted during a disaster response period .................................................................................. 19.
Federal
20. Federal interest and dividends exempt from state taxation ...................................................................... 20.
21. Deductionofprioryear168(k)and179depreciationaddbacks ............................................................... 21.
22. Refundorreimbursementsfromthefederal1040,Schedule1,line8forfederal
itemized deductions claimed on a prior year return .................................................................................. 22.
Do not staple or paper clip.
Rev. 10/19. Schedule A – page 1 of 2
19000306
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Sequence No. 4
2019 Ohio Schedule A
Income Adjustments – Additions and Deductions
Primary taxpayer’s SSN
23. Repayment of income reported in a prior year ......................................................................................... 23.
24. Wageexpensenotdeductedbasedonthefederalworkopportunitytaxcredit ....................................... 24.
25.
Federal conformity deductions ................................................................................................................... 25.
Uniformed Services
26. MilitarypayreceivedbyOhioresidentswhilestationedoutsideOhio ....................................................... 26.
27. Compensationearnedbynonresidentmilitaryservicemembersandtheircivilianspouses ...................... 27.
28. Uniformed services retirement income ..................................................................................................... 28.
29. Militaryinjuryrelieffund ....................................................................................................................................... 29.
30. CertainOhioNationalGuardreimbursementsandbenets ..................................................................... 30.
Education
31. AmountscontributedtoOhioCollegeAdvantage:Ohio’s529Plan .......................................................... 31.
32. Pell/OhioCollegeOpportunitytaxablegrantamountsusedtopayroomandboard ............................... 32.
Medical
33. Disabilitybenets ..................................................................................................................................... 33.
34.Survivorbenets ....................................................................................................................................... 34.
35. Unreimbursedmedicalandhealthcareexpenses(seeinstructionsforworksheet;include a copy) ..... 35.
36. Medicalsavingsaccountcontributions/earnings(seeinstructionsforworksheet;include a copy) ........ 36.
37. Qualiedorgandonorexpenses .............................................................................................................. 37.
38. Total deductions(addlines11through37ONLY).EnterhereandonOhioIT1040,line2b ...............38.
Rev. 10/19. Schedule A – page 2 of 2
19000406
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2019 Ohio Schedule IT BUS
Business Income
Use only black ink/UPPERCASE letters.
Sequence No. 5
Do not staple or paper clip.
Part 1 – Business Income From IRS Schedules
Note: Do not include amounts listed on the IRS schedules below that are nonbusiness income.
See R.C. 5747.01(C). If the amount on a line is negative, place a “-“ in the box provided.
1. Schedule B – Interest and Ordinary Dividends ...........................................................................................1.
2.ScheduleC–ProtorLossFromBusiness(SoleProprietorship).................................................. ....2.
3.ScheduleD–CapitalGainsandLosses ......................................................................................... ....3.
4.ScheduleE–SupplementalIncomeandLoss................................................................................ ....4.
5. Guaranteed payments or compensation from a pass-through entity to a 20% or greater direct
or indirect owner .........................................................................................................................................5.
6.ScheduleF–ProtorLossFromFarming ..................................................................................... ....6.
7. Other business income or loss not reported above (i.e. form 4797 amounts)
................................. ....7.
8. Total business income (add lines 1 through 7) ................................................................................ ....8.
Part 2 – Business Income Deduction
9. Enter the lesser of line 8 above or Ohio IT 1040, line 1. If less than zero, enter zero;
stop here and do not complete Part 3 ........................................................................................................9.
10. Enter$250,000iflingstatusissingleormarriedlingjointly;OR
Enter$125,000iflingstatusismarriedlingseparately .........................................................................10.
11. Enter the lesser of line 9 or line 10. Enter here and on Ohio Schedule A, line 11 ...........................................11.
Part 3 – Taxable Business Income
Note: If Ohio IT 1040, line 5 equals zero, do not complete Part 3.
12.Line9minusline11 ...................................................................................................................................12.
13. Taxable business income (enter the lesser of line 12 above or Ohio IT 1040, line 5). Enter here and
on Ohio IT 1040, line 6 ..............................................................................................................................13.
14. Business income tax liability – multiply line 13 by 3% (.03). Enter here and on Ohio IT 1040, line 8b .........14.
Primary taxpayer’s SSN
Enterallbusinessincomethatyou(andyourspouse,iflingjointly)receivedduringthetaxyear,fromallsources,onthisschedule.Enteronlythoseamounts
thatareincludedinyourfederaladjustedgrossincome.Only one IT BUS should be used for each return led. See R.C. 5747.01(B).
Do not staple or paper clip.
Rev. 10/19. Schedule IT BUS – page 1 of 2
19260106
Do not write in this area; for department use only.
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Part 4 – Business Sources
Listallsourcesofbusinessincome.Ifyouarelingajointreturnandyouarelistingabusinessownedbyyourspouse,checkthe“Spouse’sownership”
box.Ifyouandyourspousebothhaveownershipinabusiness,listthebusinesstwicetoreporteachofyourownershippercentagesseparately.List
anyOhiosourcesofbusinessincomerst.Ifnecessary,completeadditionalcopiesofthispageandincludewithyourincometaxreturn.
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15.
Business nameSpouse’s ownershipFEIN/SSN Ownership percentage
Business nameSpouse’s ownershipFEIN/SSN Ownership percentage
Business nameSpouse’s ownershipFEIN/SSN Ownership percentage
Business nameSpouse’s ownershipFEIN/SSN Ownership percentage
Business nameSpouse’s ownershipFEIN/SSN Ownership percentage
Business nameSpouse’s ownershipFEIN/SSN Ownership percentage
Business nameSpouse’s ownershipFEIN/SSN Ownership percentage
Business nameSpouse’s ownershipFEIN/SSN Ownership percentage
Business nameSpouse’s ownershipFEIN/SSN Ownership percentage
Business nameSpouse’s ownershipFEIN/SSN Ownership percentage
Business nameSpouse’s ownership
FEIN/SSN Ownership percentage
Business nameSpouse’s ownershipFEIN/SSN Ownership percentage
Business nameSpouse’s ownership
FEIN/SSN Ownership percentage
Business nameSpouse’s ownership
FEIN/SSN Ownership percentage
2019 Ohio Schedule IT BUS
Business Income
Sequence No. 6
Primary taxpayer’s SSN
Rev. 10/19. Schedule IT BUS – page 2 of 2
Business nameSpouse’s ownership
FEIN/SSN Ownership percentage
19260206
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Sequence No. 7
2019 Ohio Schedule of Credits
Use only black ink/UPPERCASE letters.
Do not staple or paper clip.
Rev. 10/19. Schedule of Credits – page 1 of 2
Do not staple or paper clip.
Nonrefundable Credits
1. Tax liability before credits (from Ohio IT 1040, line 8c) .............................................................................. 1.
2. Retirement income credit (see instructions for table; include 1099-R forms) ............................................. 2.
3. Lump sum retirement credit (see instructions for worksheet; include a copy) ....................................... 3.
4. Senior citizen credit (must be 65 or older to claim this credit) ................................................................. 4.
5. Lump sum distribution credit (see instructions for worksheet; include a copy) ...................................... 5.
6. Child care & dependent care credit (see instructions for worksheet; include a copy)......................... ... 6.
7. Displaced worker training credit (see instructions for all required documentation; include copies) ....... 7.
8. CampaigncontributioncreditforOhiostatewideoceorGeneralAssembly ..............................................8.
9. Income-based exemption credit ($20 times the number of exemptions) ................................................. 9.
10. Total (add lines 2 through 9) .................................................................................................................. 10.
11. Tax less credits (line 1 minus line 10; if less than zero, enter zero) ....................................................... 11.
12. Jointlingcredit(seeinstructionsfortable).%timestheamountonline11.......................................... 12.
13. Earned income credit ............................................................................................................................. 13.
14. Ohio adoption credit ............................................................................................................................... 14.
15. Nonrefundable job retention credit (include a copy of the credit certicate) ..................................... 15.
16. Credit for eligible new employees in an enterprise zone (include a copy of the credit certicate) ... 16.
17. Credit for purchases of grape production property ................................................................................ 17.
18. InvestOhio credit (include a copy of the credit certicate) ................................................................ 18.
19. Opportunity zone investment credit (include a copy of the credit certicate) .................................... 19.
20. Technology investment credit carryforward (include a copy of the credit certicate) ........................ 20.
21. Enterprise zone day care & training credits (include a copy of the credit certicate) ....................... 21.
22. Research & development credit (include a copy of the credit certicate) ......................................... 22.
23. Nonrefundable Ohio historic preservation credit (include a copy of the credit certicate) ................ 23.
24. Total (add lines 12 through 23) .............................................................................................................. 24.
25. Tax less additional credits (line 11 minus line 24; if less than zero, enter zero) ..................................... 25.
Primary taxpayer’s SSN
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19280106
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2019 Ohio Schedule of Credits
Sequence No. 8
Rev. 10/19. Schedule of Credits – page 2 of 2
Date of nonresidency to State of residency
26.
Nonresident Portion of Ohio adjusted gross income -
Ohio IT NRC Section I, line 18 (include a copy)
............ 26.
27. Enter the Ohio adjusted gross income (Ohio IT 1040,
line 3) ....................................................................................27.
28. Divide line 26 by line 27 and enter the result here (four digits; do not round).
Multiply this factor by the amount on line 25 to calculate your nonresident credit ................................... 28.
Resident Credit
29. Enter the portion of Ohio adjusted gross income (Ohio
IT 1040, line 3) subjected to tax by other states or the
District of Columbia while you were an Ohio resident .... 29.
30. Enter the Ohio adjusted gross income (Ohio IT 1040,
line 3) .............................................................................30.
31. Divide line 29 by line 30 and enter the result here (four digits; do not round).
Multiply this factor by the amount on line 25 and enter
the result here ................................................................31.
32. Enter the 2019 income tax, less all credits other than
withholding and estimated tax payments and overpayment
carryforwards from previous years, paid to other states or
the District of Columbia .................................................. 32.
33. Enter the lesser of line 31 or line 32. This is your Ohio resident tax credit. Enter the two-letter
state abbreviation in the boxes below for each state in which income was subject to tax ..................... 33.
34. Total nonrefundable credits (add lines 10, 24, 28 and 33; enter here and on Ohio IT 1040, line 9) .. 34.
Refundable Credits
35. Refundable Ohio historic preservation credit (include a copy of the credit certicate) ..................... 35.
36. Refundable job creation credit & job retention credit (include a copy of the credit certicate) ..................36.
37. Pass-through entity credit (include a copy of the Ohio IT K-1s) ......................................................... 37.
38. Motion picture & Broadway theatrical production credit (include a copy of the credit certicate) ..... 38.
39. Financial Institutions Tax (FIT) credit (include a copy of the Ohio IT K-1s) ........................................ 39.
40. Venture capital credit (include a copy of the credit certicate) ......................................................... 40.
41. Total refundable credits (add lines 35 through 40; enter here and on Ohio IT 1040, line 16) ............. 41.
Nonresident Credit
Primary taxpayer’s SSN
.
.
.
0 0
.
0 0
.
0 0
.
0 0
.
0 0
.
0 0
.
0 0
.
0 0
.
0 0
.
0 0
.
0 0
.
0 0
.
0 0
.
0 0
.
0 0
.
0 0
19280206
Dependent's date of birth (MM-DD-YYYY – required)
Do not list the primary ler and/or spouse (if ling jointly) as dependents on this schedule. Use this schedule to claim dependents. If you have more
than 15 dependents, complete additional copies of this schedule and include them with your income tax return. Abbreviate the “Dependent’s relationship to
you” if there are not enough boxes to spell it out completely.
1.
2.
3.
4.
5.
6.
7.
Primary taxpayer's SSN (required)
Dependent’s SSN (required)
Dependent’s rst name (required) Dependent's last name (required)M.I.
Dependent’s relationship to you (required)
Dependent's date of birth (MM-DD-YYYY – required)
Dependent's last name (required)
Dependent’s SSN (required)
Dependent’s rst name (required) M.I.
Dependent’s relationship to you (required)
Dependent's date of birth (MM-DD-YYYY – required)Dependent’s SSN (required)
Dependent’s rst name (required) Dependent's last name (required)M.I.
Dependent’s relationship to you (required)
Dependent's date of birth (MM-DD-YYYY – required)
Dependent's last name (required)
Dependent’s SSN (required)
Dependent’s rst name (required) M.I.
Dependent’s relationship to you (required)
Dependent's date of birth (MM-DD-YYYY – required)
Dependent's last name (required)
Dependent’s SSN (required)
Dependent’s rst name (required) M.I.
Dependent’s relationship to you (required)
Dependent's date of birth (MM-DD-YYYY – required)Dependent’s SSN (required)
Dependent’s rst name (required) Dependent's last name (required)M.I.
Dependent’s relationship to you (required)
Dependent's date of birth (MM-DD-YYYY – required)
Dependent's last name (required)
Dependent’s SSN (required)
Dependent’s rst name (required) M.I.
Dependent’s relationship to you (required)
Tax Year
Do not staple or paper clip.
2 0 1 9
Rev. 10/19. Schedule J – page 1 of 2
Ohio Schedule J
Dependents Claimed on the Ohio IT 1040 Return
Use only black ink/UPPERCASE letters.
Sequence No. 9
Do not staple or paper clip.
19230106
Do not write in this area; for department use only.
8.
9.
10.
11.
12.
13.
14.
15.
Dependent's date of birth (MM-DD-YYYY – required)Dependent’s SSN (required)
Dependent’s rst name (required) Dependent's last name (required)M.I.
Dependent’s relationship to you (required)
Dependent's date of birth (MM-DD-YYYY – required)
Dependent's last name (required)
Dependent’s SSN (required)
Dependent’s rst name (required) M.I.
Dependent’s relationship to you (required)
Dependent's date of birth (MM-DD-YYYY – required)
Dependent’s SSN (required)
Dependent’s rst name (required) Dependent's last name (required)M.I.
Dependent’s relationship to you (required)
Dependent's date of birth (MM-DD-YYYY – required)
Dependent's last name (required)
Dependent’s SSN (required)
Dependent’s rst name (required) M.I.
Dependent’s relationship to you (required)
Dependent's date of birth (MM-DD-YYYY – required)
Dependent's last name (required)
Dependent’s SSN (required)
Dependent’s rst name (required) M.I.
Dependent’s relationship to you (required)
Dependent's date of birth (MM-DD-YYYY – required)
Dependent’s SSN (required)
Dependent’s rst name (required) Dependent's last name (required)M.I.
Dependent’s relationship to you (required)
Dependent's date of birth (MM-DD-YYYY – required)
Dependent's last name (required)
Dependent’s SSN (required)
Dependent’s rst name (required) M.I.
Dependent’s relationship to you (required)
Dependent's date of birth (MM-DD-YYYY – required)
Dependent's last name (required)
Dependent’s SSN (required)
Dependent’s rst name (required) M.I.
Dependent’s relationship to you (required)
Primary taxpayer's SSN (required)
Tax Year
2 0 1 9
Rev. 10/19. Schedule J – page 2 of 2
Sequence No. 10
Ohio Schedule J
Dependents Claimed on the Ohio IT 1040 Return
19230206
Ohio IT RE
Reason and Explanation of Corrections
Note: For amended individual return only
Complete the Ohio IT 1040 (checking the amended return box) and include this form with documentation to support any adjustments to
the line items on the return.
IT RE
Rev. 10/19
Federal Privacy Act Notice
Because we require you to provide us with a Social Security number, the Federal Privacy Act of 1974 requires us to inform you that
providing us your Social Security number is mandatory. Ohio Revised Code sections 5703.05, 5703.057 and 5747.08 authorize us to
request this information. We need your Social Security number in order to administer this tax.
Note: Include any worksheets and/or documentation necessary to support your changes. See the ling tips on the next page as well as
the Ohio Individual and School District income tax instructions.
Detailed explanation of adjusted items (include additional sheet[s] if necessary):
E-mail address Telephone number
Net operating loss carryback (IMPORTANT: You must complete
and include Ohio Schedule IT NOL, available at tax.ohio.gov,
and check the box on the front of the Ohio IT 1040 indicating
that you are amending for a NOL.)
SSN of primary ler
Federal adjusted gross income decreased*
Filing status changed*
Exemptions increased (include Schedule J)*
19270106
Tax Year
* If you checked one of the boxes above, do not le your Ohio amended return until the IRS has accepted the changes on your federal
amended return. To avoid delays you must include a copy of your federal account transcript OR a copy of your federal amended income
tax return with a copy of the federal acceptance letter or refund check.
Federal adjusted gross income increased
Exemptions decreased (include Schedule J
)
Residency status changed
Ohio Schedule A, additions to income
Ohio Schedule A, deductions from income
Ohio Schedule of Credits, nonrefundable credit(s) increased
Ohio Schedule of Credits, nonrefundable credit(s) decreased
Ohio Schedule of Credits, nonresident credit increased
Ohio Schedule of Credits, nonresident credit decreased
Ohio Schedule of Credits, resident credit increased
Ohio Schedule of Credits, resident credit decreased
Ohio Schedule of Credits, refundable credit(s) increased
Ohio Schedule of Credits, refundable credit(s) decreased
Ohio withholding increased
(include W-2, W-2G, and/or 1099 forms)
Ohio withholding decreased
(include W-2, W-2G, and/or 1099 forms)
Other (describe the reason below)
Reason(s):
2019
IT RE
Rev. 10/19
If your amended IT 1040 results in tax due, you should always include an IT 40XP payment voucher with your payment. Do not use the
IT 40P payment voucher.
Amended IT 1040 Filing Tips
When amending due to changes to my federal return, should I le my amended Ohio return(s) at the same time I le my
amended federal return with the IRS?
Refund: You should wait to le your amended Ohio IT 1040 and/or SD 100 until the IRS has approved the changes to your
amended federal return. When ling your amended returns, you must include:
Option #1
• A copy of your federal amended return (1040X), AND
• A copy of the IRS acceptance letter -or- refund check.
Option #2
• A copy of your updated IRS account transcript reecting
the changes to your federal return.
Tax Due: To reduce the amount of interest you will owe, you should le your amended Ohio IT 1040 and pay any tax due as soon
as possible.
What documentation should I include when amending to show a change in my Ohio residency status?
Submit any and all relevant information you believe supports your change in residency status from one state to another. Provide
as many relevant documents as possible. Relevant documents include, but are not limited to, the following: driver's license or
state IDs, property records, voter registration, resident state tax returns, and vehicle registrations.
When should I NOT le an amended return?
Some common mistakes may not require an amended return. Instead, the Department of Taxation will either make the corrections
or contact you to request documentation. For example, the following mistakes generally do not require an amended return:
• Math errors;
• Missing return pages, schedules, or worksheets;
• Unclaimed withholding;**
• Missing credit certcate granted by the Ohio Development
*Generally, unclaimed estimated and/or extension payments will automatically be added to your original return when filed.
**If you have unclaimed withholding, please submit a detailed explanation along with legible copies of all income statements
(W-2s and 1099s) showing the Ohio withholding amounts instead of filing an amended return.
For additional information, you can go to tax.ohio.gov for FAQs (located under the "Income - Amended Returns" category).
• Demographic errors (such as name, address or SSN
corrections); Services Agency.
• Unclaimed estimated and/or extension payments;*
What documentation should I include when amending to show a change to Ohio Schedule A, deductions from income?
You should always include supporting documentation to substantiate your changes specic to the deduction. Some common
deductions and related documentation include, but are not limited to, the following:
Business income – Ohio Schedule IT BUS, page 1 and 2 of your federal return, the federal schedule(s) showing your business
income, federal K-1(s), wage and income statement(s), along with any other supporting documentation. Include a short statement
explaining your position on the amounts claimed as business income, along with all relevant facts and law used in making that
determination.
Disability/survivorship benets – A copy of your wages and income statements (such as 1099’s), page 1 and 2 of your federal
return, your disability/survivorship plan, and, if you are deducting disability benets, you must also provide a letter from your
employer from when your disability was approved, your social security disability award letter, and your age at the time of disability.
Unreimbursed medical and health care expenses – A copy of Ohio's medical expense worksheet, federal schedule A, and
proof of payments (cancelled checks, bank statements, credit card statements, etc.).
Ohio 529 Plan Contributions – Proof of payments (cancelled checks, bank statements, credit card statements, etc.) and proof of
an Ohio 529 account (by providing the plan year-end statement). If you are not the account holder, include a list of the benecia-
ries and contribution dates/amounts.
What documentation should I include when amending to show a change to the nonresident or resident credit?
Nonresident credit: A copy of form IT NRC and all wage and income statements (W-2, 1099, K-1, etc.).
Resident credit: A copy of all other state returns and proof of taxes paid to other states (cancelled checks, transcripts).
First name M.I. Last name
Spouse’s rst name (only if joint ling) M.I. Last name
Address
City, State, ZIP code
$
0
.
0
2019 Ohio IT 40P
Include the voucher below with your payment for your ORIGINAL 2019 Ohio income tax return.
Important
• Make payment payable to: Ohio Treasurer of State
• Include the tax year and the last four digits of your SSN on the “Memo” line of your
payment.
• Do not send cash.
• Do not use this voucher to make a payment for an amended return. Use Ohio IT 40XP.
• Do not use this voucher to make a payment for a school district income tax return.
Use Ohio SD 40P for an original school district income tax return. Use Ohio SD 40XP
for an amended school district income tax return.
Electronic Payment Options
You can eliminate writing a paper check by using any of our electronic payment options.
Electronic Check Credit Card Debit Card
For more information, go to our website at tax.ohio.gov.
Federal Privacy Act Notice
Because we require you to provide us with a Social Security number, the Federal Privacy Act of 1974 requires us to inform you that providing
us with your Social Security number is mandatory. Ohio Revised Code sections 5703.05, 5703.057 and 5747.08 authorize us to request this
information. We need your Social Security number in order to administer this tax.
Cut on the dotted lines. Use only black ink.
ORIGINAL PAYMENT
2019
Taxpayer’s SSN
Spouse’s SSN
(only if joint ling)
Amount of
Payment
Taxpayer’s
last name
Use UPPERCASE letters
to print the rst three letters of
Spouse’s last name
(only if joint ling)
Taxable Year
OHIO IT 40P
Original Income Tax Payment Voucher
Rev. 10/19
Do NOT fold check or voucher.
Do NOT staple or paper clip.
Do NOT send cash.
Make payment payable to: Ohio Treasurer of State
Sending with return - Mail to: Ohio Department of Taxation,
P.O. Box 2057, Columbus, OH 43270-2057
Sending without return - Mail to: Ohio Department of Taxation,
P.O. Box 182131, Columbus, OH 43218-2131
0
0
000000000
0
0
9
X
Print blank form
This form requires Adobe Acrobat Reader to function
properly, available at https://get.adobe.com/reader/ .
0
0
0
0
0
0
0
0
5
1
9
000000000
000000000
000000000
X
X
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X
0
2
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$
First name M.I. Last name
Spouse’s rst name (only if joint ling) M.I. Last name
Address
City, State, ZIP code
2019 Ohio IT 40XP
Include the voucher below with your payment for your AMENDED 2019 Ohio income tax return.
Important
• Make payment payable to: Ohio Treasurer of State
• Include the tax year and the last four digits of your SSN on the “Memo” line of your
payment.
• Do not send cash.
• Do not use this voucher to make a payment for an original return. Use Ohio IT 40P.
• Do not use this voucher to make a payment for a school district income tax return.
Use Ohio SD 40XP for an amended school district income tax return. Use Ohio SD 40P
for an original school district income tax return.
Electronic Payment Options
You can eliminate writing a paper check by using any of our electronic payment options.
Electronic Check Credit Card Debit Card
For more information, go to our website at tax.ohio.gov.
Cut on the dotted lines. Use only black ink.
AMENDED PAYMENT
Federal Privacy Act Notice
Because we require you to provide us with a Social Security number, the Federal Privacy Act of 1974 requires us to inform you that providing
us with your Social Security number is mandatory. Ohio Revised Code sections 5703.05, 5703.057 and 5747.08 authorize us to request this
information. We need your Social Security number in order to administer this tax.
0
.
0
2019
Taxpayer’s SSN
Spouse’s SSN
(only if joint ling)
Amount of
Payment
Taxpayer’s
last name
Use UPPERCASE letters
to print the rst three letters of
Spouse’s last name
(only if joint ling)
Taxable Year
Amended Income Tax Payment Voucher
Rev. 10/19
OHIO IT 40XP
Do NOT fold check or voucher.
Do NOT staple or paper clip.
Do NOT send cash.
Make payment payable to: Ohio Treasurer of State
Sending with return - Mail to: Ohio Department of Taxation,
P.O. Box 2057, Columbus, OH 43270-2057
Sending without return - Mail to: Ohio Department of Taxation,
P.O. Box 182131, Columbus, OH 43218-2131
0
0
000000000
0
0
9
X
Print blank form
This form requires Adobe Acrobat Reader to function
properly, available at https://get.adobe.com/reader/ .
0
0
0
0
0
0
0
0
5
1
9
000000000
000000000
000000000
X
X
X
X
2
4
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Form 19000106: 2019 Ohio IT 1040 Individual Income (State of Ohio)

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Completed 17 December 2020

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