2021 Ohio IT 1040 hio Department of Taxation Use only ...
2021 Ohio IT 1040
Do not staple or paper clip.
hio
Department of
Taxation
Individual Income Tax Return
AMENDED RETURN - Check here and include Ohio IT RE.
Primary taxpayer's SSN (required)
21000102
Use only black ink/UPPERCASE letters.
?If deceased
Sequence No. 1
NOL CARRYBACK - Check here and include Schedule IT NOL.
Spouse¡¯s SSN (if filing jointly)
First name
M.I.
Spouse's first name (if filing jointly)
M.I. Last name
?If deceased
School district #
Last name
Address line 1 (number and street) or P.O. Box
Address line 2 (apartment number, suite number, etc.)
State
Foreign country (if the mailing address is outside the U.S.)
Foreign postal code
Residency Status ¨C Check only one for primary
Resident
Part-year
resident
Check only one for spouse (if filing jointly)
Part-year
Resident
resident
Nonresident ?
?
Indicate state
Ohio county (first four letters)
Filing Status ¨C Check one (as reported on federal income tax return)
Single, head of household or qualifying widow(er)
Married filing jointly
Nonresident ?
?
Indicate state
Ohio Nonresident Statement ¨C See instructions for required criteria
Do not staple or paper clip.
ZIP code
City
Spouse¡¯s SSN
Married filing separately
Primary meets the five criteria for irrebuttable presumption as nonresident.
Federal extension filers - check here.
Spouse meets the five criteria for irrebuttable presumption as nonresident.
If someone can claim you (or your spouse if filing jointly) as a
dependent, check here.
1. Federal adjusted gross income (federal 1040 or 1040-SR, line 11). Place a "-" in the box
if negative.................................................................................................................................
..1.
.0
0
2a. Additions ¨C Ohio Schedule of Adjustments, line 10 (include schedule)........................................ 2a.
.0
0
2b. Deductions ¨C Ohio Schedule of Adjustments, line 39 (include schedule)..................................... 2b.
.0
0
.0
0
.0
0
5. Ohio income tax base (line 3 minus line 4; if negative, enter zero).................................................. 5.
.0
0
6. Taxable business income ¨C Ohio Schedule IT BUS, line 13 (include schedule)............................. 6.
.0
0
7. Taxable nonbusiness income (line 5 minus line 6; if negative, enter zero)....................................... 7.
.0
0
3. Ohio adjusted gross income (line 1 plus line 2a minus line 2b). Place a "-" in the box
if negative................................................................................................................................
..3.
4. Exemption amount (include Schedule of Dependents if applicable)............................................. 4.
Number of exemptions including you and your spouse/dependents, if applicable:
Do not write in this area; for department use only.
MM-DD-YY
Code
IT 1040 ¨C page 1 of 2
2021 Ohio IT 1040
Individual Income Tax Return
SSN
21000202
Sequence No. 2
7a. Amount from line 7 on page 1......................................................................................................... 7a.
.0
0
8a. Nonbusiness income tax liability on line 7a (see instructions for tax tables)...............................................8a.
.0
0
8b. Business income tax liability ¨C Ohio Schedule IT BUS, line 14 (include schedule)...................................8b.
.0
0
8c. Income tax liability before credits (line 8a plus line 8b)...............................................................................8c.
.0
0
9. Ohio nonrefundable credits ¨C Ohio Schedule of Credits, line 38 (include schedule)...................................9.
.0
0
10. Tax liability after nonrefundable credits (line 8c minus line 9; if negative, enter zero).................................10.
.0
0
11. Interest penalty on underpayment of estimated tax (include Ohio IT/SD 2210).........................................11.
.0
0
12. Unpaid use tax (see instructions).................................................................................................................12.
.0
0
13. Total Ohio tax liability before withholding or estimated payments (add lines 10, 11 and 12)....................13.
.0
0
14. Ohio income tax withheld ¨C Schedule of Ohio Withholding, part A, line 1 (include schedule and
income statements)...................................................................................................................................14.
.0
0
15. Estimated and extension payments (from Ohio IT 1040ES and IT 40P), and credit carryforward
from last year's return..................................................................................................................................15.
.0
0
16. Refundable credits ¨C Ohio Schedule of Credits, line 44 (include schedule)..............................................16.
.0
0
17. Amended return only ¨C amount previously paid with original and/or amended return..............................17.
.0
0
18. Total Ohio tax payments (add lines 14, 15, 16 and 17).............................................................................18.
.0
0
19. Amended return only ¨C overpayment previously requested on original and/or amended return...............19.
.0
0
....20.
.0
0
21. Tax due (line 13 minus line 20). If line 20 is negative, ignore the "-" and add line 20 to line 13..................21.
.0
0
22. Interest due on late payment of tax (see instructions)...............................................................................................22.
.0
0
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 DUE?.
23.
.0
0
24. Overpayment (line 20 minus line 13)...........................................................................................................24.
.0
0
.0
0
Total..... 26g.
.0
0
27. REFUND (line 24 minus lines 25 and 26g)..................................................................YOUR REFUND?27.
.0
0
20. Line 18 minus line 19. Place a "-" in the box if negative.........................................................................
If line 20 is MORE THAN line 13, skip to line 24. OTHERWISE, continue to line 21.
25. Original return only ¨C portion of line 24 carried forward to next year¡¯s tax liability......................................25.
26. Original return only ¨C portion of line 24 you wish to donate:
a. Military Injury Relief
b. Ohio History Fund
c. Nature Preserves/Scenic Rivers
.0
0
.0
0
d. Breast/Cervical Cancer
.0
0
.0
0
e. Wishes for Sick Children
.0
0
.0
0
f. Wildlife Species
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.
?
?
Primary signature
Phone number
Spouse¡¯s signature
Date
Check here to authorize your preparer to discuss this return with the Department.
Preparer's printed name
Phone number
Preparer's TIN (PTIN)
P
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 ¨C Mail to:
Ohio Department of Taxation
P.O. Box 2679
Columbus, OH 43270-2679
Payment Included ¨C Mail to:
Ohio Department of Taxation
P.O. Box 2057
Columbus, OH 43270-2057
IT 1040 ¨C page 2 of 2
2021 Ohio Schedule
of Adjustments
21000302
Use only black ink/UPPERCASE letters.
Primary taxpayer¡¯s SSN
Sequence No. 3
Additions
.
(Only add the following amounts if they are not included on Ohio IT 1040, line 1)
1. Non-Ohio state or local government interest and dividends........................................................................ 1.
.0
0
2. Ohio pass-through entity taxes excluded from federal adjusted gross income........................................... 2.
.0
0
3. Ohio 529 plan funds used for non-qualified expenses................................................................................ 3.
.0
0
4. Losses from sale or disposition of Ohio public obligations.......................................................................... 4.
.0
0
5. Nonmedical withdrawals from a medical savings account.......................................................................... 5.
.0
0
6. Reimbursement of expenses previously deducted on an Ohio income tax return...................................... 6.
.0
0
7. Internal Revenue Code 168(k) and 179 depreciation expense addback.................................................... 7.
.0
0
8. Exempt federal interest and dividends subject to state taxation................................................................. 8.
.0
0
9. Federal conformity additions....................................................................................................................... 9.
.0
0
.0
0
11. Business income deduction ¨C Ohio Schedule IT BUS, line 11.................................................................. 11.
.0
0
12. Employee compensation earned in Ohio by residents of neighboring states.............................................. 12.
.0
0
13. Taxable refunds, credits, or offsets of state and local income taxes (federal 1040, Schedule 1, line 1)... 13.
.0
0
14. Taxable Social Security benefits (federal 1040 and 1040-SR, line 6b)..................................................... 14.
.0
0
15. Certain railroad benefits............................................................................................................................ 15.
.0
0
.0
0
17. Amounts contributed to an Ohio county's individual development account program................................ 17.
.0
0
18. Amounts contributed to a STABLE account: Ohio's ABLE plan................................................................ 18.
.0
0
.0
0
20. Federal interest and dividends exempt from state taxation....................................................................... 20.
.0
0
21. Deduction of prior year 168(k) and 179 depreciation addbacks................................................................ 21.
.0
0
.0
0
Federal
10. Total additions (add lines 1 through 9 ONLY). Enter here and on Ohio IT 1040, line 2a...............10.
Deductions
(Only deduct the following amounts if they are included on Ohio IT 1040, line 1)
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.
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
22. Refund or reimbursements from the federal 1040, Schedule 1, line 8z for federal
itemized deductions claimed on a prior year return................................................................................... 22.
Schedule of Adjustments ¨C page 1 of 2
2021 Ohio Schedule
of Adjustments
21000402
Primary taxpayer¡¯s SSN
Sequence No. 4
23. Repayment of income reported in a prior year.......................................................................................... 23.
.0
0
24. Wage expense not deducted based on the federal work opportunity tax credit........................................ 24.
.0
0
25. Federal conformity deductions.................................................................................................................... 25.
.0
0
26. Military pay received by Ohio residents while stationed outside Ohio........................................................ 26.
.0
0
27. Compensation earned by nonresident military servicemembers and their civilian spouses....................... 27.
.0
0
28. Uniformed services retirement income...................................................................................................... 28.
.0
0
29. Military injury relief fund grants and veteran¡¯s disability severance payments................................................... 29.
.0
0
30. Certain Ohio National Guard reimbursements and benefits...................................................................... 30.
.0
0
31. Amounts contributed to Ohio CollegeAdvantage: Ohio¡¯s 529 Plan........................................................... 31.
.0
0
32. Pell/Ohio College Opportunity taxable grant amounts used to pay room and board................................ 32.
.0
0
33. Ohio educator expenses in excess of federal deduction........................................................................... 33.
.0
0
34. Disability benefits...................................................................................................................................... 34.
.0
0
35. Survivor benefits........................................................................................................................................ 35.
.0
0
36. Unreimbursed medical and health care expenses (see instructions for worksheet; include a copy)...... 36.
.0
0
37. Medical savings account contributions/earnings (see instructions for worksheet; include a copy)......... 37.
.0
0
38. Qualified organ donor expenses............................................................................................................... 38.
.0
0
39. Total deductions (add lines 11 through 38 ONLY). Enter here and on Ohio IT 1040, line 2b................39.
.0
0
Uniformed Services
Education
Medical
Schedule of Adjustments ¨C page 2 of 2
2021 Ohio Schedule IT BUS
Business Income
Use only black ink/UPPERCASE letters.
Primary taxpayer¡¯s SSN
21260102
Sequence No. 5
Enter all business income that you (and your spouse, if filing jointly) received during the tax year 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 filed. See R.C. 5747.01(B).
Part 1 ¨C 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 ¨C Interest and Ordinary Dividends............................................................................................1.
.0
0
2. Schedule C ¨C Profit or Loss From Business (Sole Proprietorship)..................................................
.....2.
.0
0
3. Schedule D ¨C Capital Gains and Losses..........................................................................................
.....3.
.0
0
4. Schedule E ¨C Supplemental Income and Loss................................................................................
.....4.
.0
0
or indirect owner..........................................................................................................................................5.
.0
0
5. Guaranteed payments or compensation from a pass-through entity to a 20% or greater direct
6. Schedule F ¨C Profit or Loss From Farming......................................................................................
.....6.
.0
0
7. Other business income or loss not reported above (e.g. form 4797 amounts)................................
.....7.
.0
0
8. Total business income (add lines 1 through 7).................................................................................
.....8.
.0
0
9. Enter the lesser of line 8 above or Ohio IT 1040, line 1. If negative, enter zero;
stop here and do not complete Part 3.........................................................................................................9.
.0
0
.0
0
.0
0
.0
0
.0
0
.0
0
Part 2 ¨C Business Income Deduction
10. Enter $250,000 if filing status is single or married filing jointly; OR
Enter $125,000 if filing status is married filing separately..........................................................................10.
11. Enter the lesser of line 9 or line 10. Enter here and on Ohio Schedule of Adjustments, line 11....................... 11.
Part 3 ¨C Taxable Business Income
Note: If Ohio IT 1040, line 5 is 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 ¨C multiply line 13 by 3% (.03). Enter here and on Ohio IT 1040, line 8b..........14.
Do not write in this area; for department use only.
Schedule IT BUS ¨C page 1 of 2
................
................
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