Electronic Payment Available                                                                               2016 Ohio SD 40P
You can eliminate writing a paper check by using any of 
our electronic payment methods. Go to our Web site at 
tax.ohio.gov for all electronic payment options.

           Federal Privacy Act Notice
Because we require you to provide us with a Social Se-
curity number, the        Federal Privacy Act of 1974 requires 
us to inform you that providing us with your Social Secu-
rity 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.

                      Rev. 6/16                                   DO NOT STAPLE OR 
SD 40P                                                            OTHERWISE ATTACH                                  Do NOT fold check or voucher.
School District Income Tax Payment Voucher                        YOUR PAYMENT TO 
                                                                       THIS VOUCHER.      2016SP                     Use UPPERCASE letters
                                                                  DO NOT SEND CASH.
                                                                                                                     to print the fi rst three letters of
First name                                 M.I.  Last name                                School district           Taxpayer’s          Spouse’s last name
                                                                                          number                    last name           (only if joint fi ling)
Spouse’s fi rst name (only if joint fi ling) M.I.   Last name

Address                                                                                            Your SSN

                                                                                          Spouse’s SSN
City, state, ZIP code                                                                              (if joint fi ling)

                                                                                          Amount of
If you are sending this voucher and paper check or money order (payable to School 
District Income Tax) with or separately from your school district income tax return, mail Payment         $           ,            ,           0        0
to: School District Income Tax, P.O. Box 182389, Columbus, OH  43218-2389. Write 
the last four digits of the taxpayer’s SSN on the check or money order.

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