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






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