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
1.1•• 1••11 •••1.1•••111••1••••11.11••11 •••••1.1 •• 11.1      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 
                                                                                                                      I         I 
                                                                                                       Your SSN 
Address 
                                                                                                                    I 
                                                                                              Spouse’s SSN
                                                                                              (only if joint filing) 
City, state, ZIP code                                                                                               I 

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               i                             .          i 
return, then mail this voucher and payment to Ohio Department of Taxation, P.O. Box 182131, 
Columbus, OH 43218-2131.                                                                               .. 
                                                               402 
*  
                                                                                                                            1111111 11111111111111111