Electronic Payment Available                                                                                  2016 Ohio IT 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. 

OHIO IT 40P                                Rev. 6/16 
                                                                                                   Taxable Year      Do NOT fold check or voucher. 
Income Tax Payment Voucher                                          OTHERWISEDO NOT STAPLEATTACHOR 
                                                                    YOUR PAYMENT TO  
                                                                    THIS VOUCHER.                                         Use UPPERCASE letters
                                                                    DO NOT SEND CASH.              2016                   to print the fi rst three letters of 
First name                                     M.I.     Last name                                                        Taxpayer’s          Spouse’s last name 
                                                                                                                         last name           (only if joint filing) 
Spouse’s fi  rst name (only if joint filing)     M.I.     Last name 

                                                                                                            Your SSN 
Address 
                                                                                                   Spouse’s SSN
                                                                                                   (only if joint filing) 
City, state, ZIP code 

If you are sending this voucher and paper check or money order (payable to Ohio Treasurer 
                                                                                                   Amount of
of State) with your income tax return, mail to the address shown on page 2 of Ohio IT 1040.                                                                0 0
If you are sending ONLY this voucher and paper check or money order separately from the            Payment      $          ,             ,         .
return, then mail this voucher and payment to Ohio Department of Taxation, P.O. Box 182131, 
Columbus, OH 43218-2131. 
                                                                    402 
                                                                                                                             1111111 111111111111111 II