Rev. 11/3/17

Scan Specifications for the 

    2017 Ohio SD 100

       Important Note

   The following document (2017 Ohio SD 100) contains grids for place-
   ment of information on this specific tax form. To accurately print, do not 
   reduce the size, rotate or center this document. Doing so jeopardizes 
   the integrity of the grid. When printing from Adobe Reader, select 
   “None” for “Page Scaling,” which is under “Page Handling.”

   The 2017 Ohio SD 100 test samples must be completed and sub-
   mitted for approval no later than Dec. 22, 2017. 

       Ohio Department of Taxation

                            4485 Northland Ridge Blvd.

                            Columbus, OH 43229

                            tax.ohio.gov

Grid layout 

with notations

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85
2
3
4                                Do not staple or paper clip. 
5                                            The date the return was generated 
6                                            by the taxpayer (MM DD YY).               2017 Ohio SD 100 
                                                     Rev. 9/17
7                                                                 School District Income Tax Return                                                                                           17020110
8                               88 88 88                File a separate Ohio SD 100 for each taxing school district in which you lived during the taxable year.
9
10                              X   Check here if this is an amended return. Include the Ohio SD RE (doNOT includePlacementa copyof theof1Dthebarpreviouslycode andfiledtax yearreturn).is   critical. 
11                              X   Check here if this a Net Operating Loss (NOL) carryback. Include Ohio Schedule IT NOL. Make sure to follow the grid positions for layout. Do 
12                                                                                                                                 not forget to get your bar code(s) assignments for 
13                              Taxpayer’s SSN (required)               If deceased                       Spouse’s SSNevery(if filingform,jointly)version and page.If deceased            Enter school district # for 
14                                                                                                                                                                                            this return (see instructions).
                                888 88 8888                                      X                          888 88 8888                                                   X
15                                                                             check box                                                                          check box                   SD#                8888
16                              First name                                                           M.I.          Last name
17                              JOHNXXXXXXXXXXX                                                      Q             PUBL I CXXXXXXXXXXXXXX 
18
19                              Spouse's first name (only if married filing jointly)                 M.I.          Last name
20                              JANEXXXXXXXXXXX                                                      Q             PUBL I CXXXXXXXXXXXXXX 
21
22                              Address line 1 (number and street) or P.O. Box
23                              8888  CHERRY    LANEXXXXXXXXXXXXXXXXXXX
24
25                              Address line 2 (apartment number, suite number, etc.)
26
                                APT  88 XXXXXXXXXXXXXXXXXXXXXXXXXXXX
27
28                              City                                                                                          State     ZIP code                          Ohio county (first four letters)
29                              CITYXXXXXXXXXXXXXXXX                                                                          OH        88888                             PICK
30
31                              Foreign country (if the mailing address is outside the U.S.)                                  Foreign postal code
32                              JAPANXXXXXXXXXXXXXXX                                                                          8888888
33
34                                                                        Check applicable box                                   Check applicable box for spouse (only if married filing jointly)
                                 School District Residency –
35
36                                   Full-year          Part-year resident           Full-year nonresident                              Full-year                 Part-year resident                     Full-year nonresident 
37                              X                   X   of SD# above             X                                                 X    resident            X     of SD# above                X          of SD# above
                                     resident                                        of SD# above
                                Enter date                                                                                         Enter date 
38                              of nonresidency         88 88 88               to    88 88 88                                      of nonresidency                88 88 88                    to         88 88 88
39
40                              Filing Status – Check one (must match the Ohio IT 1040):                                           Tax Type – Check one (for an explanation, see instructions)
41                              X    Single, head of household or qualifying widow(er)                                             The school district for whichDo notthisplacereturnspacesis beingbetweenfiled is a(n):
42                                                                                                                                 X    Traditional tax base school district.whole dollar numbers. There  You must start with Schedule A, 
43                                   Married filing jointly                                                                             line 19 on page 2 of this return.is only a space between dollar 
                                X                                                                                                                                 amounts and cents fields.
44                                                                                                                                 X    Earned income tax base school district. You must start with Schedule 
45                                   Married filing separately                                                                          B, line 24 on page 2 of this return.
                                X
46
47                              1.School district taxable income:Traditional tax base:Enter on this line the amount you show on line 23.
                                                                Earned income tax base: Enter on this line the amount you show on line 27 ....1.
48 Do not staple or paper clip.                                                                                                                                                                888888888 00
                                2.  School district tax rate    .8888          times line 1 (rates found in the instructions) ......................................2.                          88888888 00
49
                                3.  Senior citizen credit (you must be 65 or older to claim this credit; limit $50 per return) ...............................3.                                                    88 00
50
                                4.  School district income tax liability (line 2 minus line 3; if less than -0-, enter -0-) ..........................................4.                                  888888 00
51                                                                             2D barcode required. Delete this 
52                              5.  Interest penalty on underpayment of estimatedbox withtax.textIncludeand replaceOhioitIT/SDwith 2210 and the appropriate 
                                  worksheet if you annualize .............................................................................................................................5.              888888 00
53                                                                             the 2D barcode.
                                6.  Total school district income tax liability before withholding or estimated payments (line 4 plus line 5)....6.                                                        888888 00
54
55
56
57                                                                                                                                                                                           Target marks or registration marks 
58                                           Software vendors: Place 2D barcode in this location                                                                                             must measure 6 mm X 6 mm. The 
                                                                                                                                                                                             four target marks or registration 
59                                           Do not place a box around the 2D barcode. The box                                                                                               marks on every page must follow 
                                                                                                                                                                           /                 /
60                                                      is only here for placement purposes.                                                                                                 grid layout.
61                                                                                                                                                                        Postmark date                         Code
62
63
                                                                                                                                        2017 Ohio SD 100 – page 1 of 2
64
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1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85
2
3
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5
6                                                                       2017 Ohio SD 100 
                             Rev. 9/17
7                                                 School District Income Tax Return                                                                                               17020210
8
9    SSN       888 88 8888                                       SD#    8888
10
11
   6a. Amount from line 6 on page 1 ........................................................................................................................... 6a.                    888888 00 
12
13  7. School district income tax withheld School district number on W-2(s), W-2G(s) and/or 1099-R(s) must 
         agree with the school district number on this return). Include W-2(s), W-2G(s) and 1099-R(s) with the return...........7.                                                     888888 00 
14
    8. Estimated (2017 Ohio SD 100ES) and extensionNEW!(2017ForOhiostaticSDtext40P)use Arialpaymentsfont (blackandink)creditand 
15                                                                   try to match size. For data entry fields (shown in 
       carryforward from previous year return.............................................................................................................    8.                       888888 00 
16                                                                   red for identification purposes only), use Arial font 
    9. Amended return only – amount previously paid with original and/or amended return ...................................  9.                                                        888888 00 
17                                                                   (black ink). All the data entry fields must follow 
                                                                     grid layout. Never hard code a negative sign, and 
18                                                                   do not include the negative sign with the amounts. 
    10. Total school district income tax payments (add lines 7, 8 and 9) ................................................................ 10.                                          888888 00 
19                                                                   This is now a separate field.
20
   11.  Amended return only – overpayment previously requested on original and/or amended return .................... 11.                                                              888888 00 
21
22                                                                                                                                                                             -
   12. Line 10 minus line 11 ........................................................................................................................................ 12.              888888 00 
23
24               If line 12 is MORE THAN line 6a, go to line 16. OTHERWISE, continue to line 13.
25
   13. Tax liability (line 6a minus line 12) If line 12 is negative, ignore the “-” and add line 12 to line 6a .................... 13.
26                                                                                                                                                                                  8888888 00 
    14. Interest and penalty due on late filing or late payment of tax (see instructions) ....................................................... 14.                               8888888 00 
27
    15. 
28      TOTAL AMOUNT DUE         NEW!(line 13Theseplusfieldsline 14).mayIncludepossiblyOhiobe a negativeSD 40P (ifvalue.original return) or Ohio SD 40XP 
       (if amended return) and make check payable to “School District Income Tax” .......AMOUNT DUE                                                        15.                   88888888 00 
29                              Include a “-“ sign here if this line has a negative value.
     
30 16. Overpayment (line 12 minus line 6a) .............................................................................................................  16.                       8888888 00 
31  
    
32 17. Original return only– amount of line 16 to be credited toward 2018 school district income tax liability ................ 17.                                                 8888888 00 
33
34  18. REFUND (line 16 minus line 17) ..........................................................................................YOUR REFUND              18.                      8888888 00 
35
   Schedule A – Traditional Tax Base School District Amounts (see instructions)
36  
    Complete this schedule only if filing a traditional tax base school district return.
37 19. Ohio income tax base (Ohio IT 1040, line 3 minus Ohio IT 1040, line 4).  ..................................................... 19.                                      -  888888888 00 
38 20. Business income deduction add-back (see instructions) ...............................................................................  20.                                      888888 00 
39  21. Total traditional tax base school district income (line 19 plus line 20) ............................................................ 21.                              -  888888888 00 
40  
41  22. The amount from line 21, if any, that you earned while not a resident of the school district whose 
       number you entered on this return ................................................................................................................. 22.                    888888888 00 
42
43 23.  School district taxable income (line 21 minus line 22; if less than zero, enter zero). Enter here and on 
       line 1 of this return .......................................................................................................................................... 23.       888888888 00 
44  Schedule B – Earned Income Tax Base School District Amounts (see instructions)
45
   Complete this schedule only if filing an earned income tax base school district return.
46 24. Wages and other compensation you earned while you were a resident of the school district whose 
47     number you entered on this return (see instructions) .....................................................................................  24.                            888888888 00 
48 25. Net earnings from self-employment to the extent included in Ohio adjusted gross income ...........................  25.                                                 - -888888888 00 
49                                                                                                                                                                             - -
    26. Miscellaneous federal adjustments (see instructions) ....................................................................................  26.                                 888888 00 
50
51  27. School district taxable income (add lines 24, 25 and 26; if less than zero, enter zero). Enter here and on line 1 of this return888888888...... 27.                                       00 
52
53  Sign Here (required): I have read this return. Under penalties of perjury, I declare that, to the best of my knowledge                                If your refund is $1.00 or less, no refund will be issued. 
54  and belief, the return and all enclosures are true, correct and complete.                                                                                           If you owe $1.00 or less, no payment is necessary.
55 Your signature  Date (MM/DD/YY)                                                                                                                                         NO Payment Included  –Mail to:
56                                                                                                                                                                          School District Income Tax
   Spouse’s signature                                                                                 Phone number                                                               P.O. Box 182197
57                                                                                                                                                                          Columbus, OH 43218-2197
58      X   Check here to authorize your preparer to discuss this return with Taxation.                                                                                     Payment Included  –Mail to:
59  Preparer's printed name                                                                                                                                                 School District Income Tax
                                                                                                                                                                                  P.O. Box 182389
60  Phone number                                                        Preparer's TIN (PTIN)                  PXXXXXXXX                                                    Columbus, OH 43218-2389
61
62
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64                                                                                                                               2017 Ohio SD 100 – page 2 of 2
65
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Grid layout

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85
2
3
4                                Do not staple or paper clip. 
5
6                                                                                      2017 Ohio SD 100 
                                                    Rev. 9/17
7                                                                School District Income Tax Return                                                                                           17020110
8                               88 88 88              File a separate Ohio SD 100 for each taxing school district in which you lived during the taxable year.
9
10                              X   Check here if this is an amended return. Include the Ohio SD RE (do NOT include a copy of the previously filed return). 
11                              X   Check here if this a Net Operating Loss (NOL) carryback. Include Ohio Schedule IT NOL. 
12
13                              Taxpayer’s SSN (required)               If deceased                  Spouse’s SSN (if filing jointly)  If deceased                                       Enter school district # for 
14                                                                                                                                                                                           this return (see instructions).
                                888 88 8888                                      X                     888 88 8888                         X
15                                                                             check box                                                   check box                                         SD#   8888
16                              First name                                                        M.I. Last name
17                              JOHNXXXXXXXXXXX                                                   Q      PUBL I CXXXXXXXXXXXXXX 
18
19                              Spouse's first name (only if married filing jointly)              M.I. Last name
20                              JANEXXXXXXXXXXX                                                   Q      PUBL I CXXXXXXXXXXXXXX 
21
22                              Address line 1 (number and street) or P.O. Box
23                              8888  CHERRY    LANEXXXXXXXXXXXXXXXXXXX
24
25                              Address line 2 (apartment number, suite number, etc.)
26
                                APT  88 XXXXXXXXXXXXXXXXXXXXXXXXXXXX
27
28                              City                                                                             State      ZIP code       Ohio county (first four letters)
29                              CITYXXXXXXXXXXXXXXXX                                                             OH         88888          PICK
30
31                              Foreign country (if the mailing address is outside the U.S.)                     Foreign postal code
32                              JAPANXXXXXXXXXXXXXXX                                                             8888888
33
34                                                                        Check applicable box                           Check applicable box for spouse (only if married filing jointly)
                                 School District Residency –
35
36                                   Full-year        Part-year resident             Full-year nonresident                  Full-year      Part-year resident                                    Full-year nonresident 
37                              X                   X of SD# above               X                                  X       resident    X  of SD# above                                       X  of SD# above
                                     resident                                        of SD# above
                                Enter date                                                                             Enter date 
38                              of nonresidency       88 88 88                 to    88 88 88                          of nonresidency     88 88 88                                          to 88 88 88
39
40                              Filing Status – Check one (must match the Ohio IT 1040):                               Tax Type – Check one (for an explanation, see instructions)

41                              X    Single, head of household or qualifying widow(er)                                 The school district for which this return is being filed is a(n):
42                                                                                                                     X    Traditional tax base school district. You must start with Schedule A, 
43                                   Married filing jointly                                                                 line 19 on page 2 of this return.
                                X
44                                                                                                                     X    Earned income tax base school district. You must start with Schedule 
45                                   Married filing separately                                                              B, line 24 on page 2 of this return.
                                X
46
47                              1.School district taxable income:Traditional tax base:Enter on this line the amount you show on line 23.
                                                                Earned income tax base: Enter on this line the amount you show on line 27 ....1.
48 Do not staple or paper clip.                                                                                                                                                                888888888 00
                                2.  School district tax rate    .8888          times line 1 (rates found in the instructions) ......................................2.                          88888888 00
49
                                3.  Senior citizen credit (you must be 65 or older to claim this credit; limit $50 per return) ...............................3.                                         88 00
50
                                4.  School district income tax liability (line 2 minus line 3; if less than -0-, enter -0-) ..........................................4.                          888888 00
51
52                              5.  Interest penalty on underpayment of estimated tax. Include Ohio IT/SD 2210 and the appropriate 
                                  worksheet if you annualize .............................................................................................................................5.      888888 00
53
                                6.  Total school district income tax liability before withholding or estimated payments (line 4 plus line 5)....6.                                                888888 00
54
55
56
57
58                                         Software vendors: Place 2D barcode in this location
59                                         Do not place a box around the 2D barcode. The box
                                                                                                                                                                        /                    /
60                                                    is only here for placement purposes.
61                                                                                                                                         Postmark date                                             Code
62
63
                                                                                                                         2017 Ohio SD 100 – page 1 of 2
64
65
66

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85
2
3
4
5
6                                                            2017 Ohio SD 100 
                             Rev. 9/17
7                                              School District Income Tax Return                                                                                                 17020210
8
9    SSN       888 88 8888                           SD#     8888
10
11
   6a. Amount from line 6 on page 1 ........................................................................................................................... 6a.                    888888 00 
12
13  7. School district income tax withheld School district number on W-2(s), W-2G(s) and/or 1099-R(s) must 
         agree with the school district number on this return). Include W-2(s), W-2G(s) and 1099-R(s) with the return...........7.                                                     888888 00 
14
    8. Estimated (2017 Ohio SD 100ES) and extension (2017 Ohio SD 40P) payments and credit
15
       carryforward from previous year return.............................................................................................................    8.                       888888 00 
16
    9.  Amended return only – amount previously paid with original and/or amended return ...................................  9.                                                       888888 00 
17
18
    10. Total school district income tax payments (add lines 7, 8 and 9) ................................................................ 10.                                          888888 00 
19
20
   11.  Amended return only – overpayment previously requested on original and/or amended return .................... 11.                                                              888888 00 
21
22                                                                                                                                                                             -
   12. Line 10 minus line 11 ........................................................................................................................................ 12.              888888 00 
23
24               If line 12 is MORE THAN line 6a, go to line 16. OTHERWISE, continue to line 13.
25
   13. Tax liability (line 6a minus line 12) If line 12 is negative, ignore the “-” and add line 12 to line 6a .................... 13.
26                                                                                                                                                                                  8888888 00 
    14. Interest and penalty due on late filing or late payment of tax (see instructions) ....................................................... 14.                               8888888 00 
27
    15. 
28      TOTAL AMOUNT DUE (line 13 plus line 14). Include Ohio SD 40P (if original return) or Ohio SD 40XP 
       (if amended return) and make check payable to “School District Income Tax” .......AMOUNT DUE                                           15.                               88888888 00 
29
     
30 16. Overpayment (line 12 minus line 6a) .............................................................................................................  16.                       8888888 00 
31  
    
32 17.  Original return only– amount of line 16 to be credited toward 2018 school district income tax liability ................ 17.                                                8888888 00 
33
34  18. REFUND (line 16 minus line 17) ..........................................................................................YOUR REFUND 18.                                   8888888 00 
35
   Schedule A – Traditional Tax Base School District Amounts (see instructions)
36  
    Complete this schedule only if filing a traditional tax base school district return.
37 19. Ohio income tax base (Ohio IT 1040, line 3 minus Ohio IT 1040, line 4).  ..................................................... 19.                                      - 888888888 00 
38 20. Business income deduction add-back (see instructions) ...............................................................................  20.                                      888888 00 
39  21. Total traditional tax base school district income (line 19 plus line 20) ............................................................ 21.                              - 888888888 00 
40  
41  22. The amount from line 21, if any, that you earned while not a resident of the school district whose 
       number you entered on this return ................................................................................................................. 22.                   888888888 00 
42
43 23.  School district taxable income (line 21 minus line 22; if less than zero, enter zero). Enter here and on 
       line 1 of this return .......................................................................................................................................... 23.      888888888 00 
44  Schedule B – Earned Income Tax Base School District Amounts (see instructions)
45
   Complete this schedule only if filing an earned income tax base school district return.
46 24. Wages and other compensation you earned while you were a resident of the school district whose 
47     number you entered on this return (see instructions) .....................................................................................  24.                           888888888 00 
48 25. Net earnings from self-employment to the extent included in Ohio adjusted gross income ...........................  25.                                                 - 888888888 00 
49                                                                                                                                                                             -
    26. Miscellaneous federal adjustments (see instructions) ....................................................................................  26.                                 888888 00 
50
51  27. School district taxable income (add lines 24, 25 and 26; if less than zero, enter zero). Enter here and on line 1 of this return888888888...... 27.                                       00 
52
53  Sign Here (required): I have read this return. Under penalties of perjury, I declare that, to the best of my knowledge                                If your refund is $1.00 or less, no refund will be issued. 
54  and belief, the return and all enclosures are true, correct and complete.                                                                                           If you owe $1.00 or less, no payment is necessary.
55 Your signature  Date (MM/DD/YY)                                                                                                                                         NO Payment Included  –Mail to:
56                                                                                                                                                                          School District Income Tax
   Spouse’s signature                                                          Phone number                                                                                     P.O. Box 182197
57                                                                                                                                                                          Columbus, OH 43218-2197
58      X   Check here to authorize your preparer to discuss this return with Taxation.                                                                                     Payment Included  –Mail to:
59  Preparer's printed name                                                                                                                                                 School District Income Tax
                                                                                                                                                                                 P.O. Box 182389
60  Phone number                                        Preparer's TIN (PTIN)    PXXXXXXXX                                                                                  Columbus, OH 43218-2389
61
62
63
64                                                                                           2017 Ohio SD 100 – page 2 of 2
65
66

Layout 

without grid

   Do not staple or paper clip. 
                                                       2017 Ohio SD 100 
                    Rev. 9/17
                                 School District Income Tax Return                                                                                           17020110
88 88 88                 File a separate Ohio SD 100 for each taxing school district in which you lived during the taxable year.

X   Check here if this is an amended return. Include the Ohio SD RE (do NOT include a copy of the previously filed return). 
X   Check here if this a Net Operating Loss (NOL) carryback. Include Ohio Schedule IT NOL. 
Taxpayer’s SSN (required)              If deceased                   Spouse’s SSN (if filing jointly)  If deceased                                       Enter school district # for 
                                                                                                                                                             this return (see instructions).
888 88 8888                                      X                     888 88 8888                         X
                                               check box                                                   check box                                         SD#   8888
First name                                                        M.I. Last name
JOHNXXXXXXXXXXX                                                   Q      PUBL I CXXXXXXXXXXXXXX 

Spouse's first name (only if married filing jointly)              M.I. Last name
JANEXXXXXXXXXXX                                                   Q      PUBL I CXXXXXXXXXXXXXX 

Address line 1 (number and street) or P.O. Box
8888  CHERRY    LANEXXXXXXXXXXXXXXXXXXX
Address line 2 (apartment number, suite number, etc.)
APT  88 XXXXXXXXXXXXXXXXXXXXXXXXXXXX
City                                                                             State      ZIP code       Ohio county (first four letters)
CITYXXXXXXXXXXXXXXXX                                                             OH         88888          PICK
Foreign country (if the mailing address is outside the U.S.)                     Foreign postal code
JAPANXXXXXXXXXXXXXXX                                                             8888888

 School District Residency – Check applicable box                                        Check applicable box for spouse (only if married filing jointly)
     Full-year        Part-year resident             Full-year nonresident                  Full-year      Part-year resident                                    Full-year nonresident 
X    resident       X of SD# above               X   of SD# above                   X       resident    X  of SD# above                                        X of SD# above
Enter date                                                                             Enter date 
of nonresidency       88 88 88                 to    88 88 88                          of nonresidency     88 88 88                                          to  88 88 88
Filing Status – Check one (must match the Ohio IT 1040):                               Tax Type – Check one (for an explanation, see instructions)

X    Single, head of household or qualifying widow(er)                                 The school district for which this return is being filed is a(n):
                                                                                       X    Traditional tax base school district. You must start with Schedule A, 
     Married filing jointly                                                                 line 19 on page 2 of this return.
X
                                                                                       X    Earned income tax base school district. You must start with Schedule 
     Married filing separately                                                              B, line 24 on page 2 of this return.
X
1.School district taxable income:Traditional tax base:Enter on this line the amount you show on line 23.
Do   not staple or paper clip.  Earned income tax base: Enter on this line the amount you show on line 27 ....1.                                               888888888 00
2.  School district tax rate    .8888          times line 1 (rates found in the instructions) ......................................2.                           88888888 00
3.  Senior citizen credit (you must be 65 or older to claim this credit; limit $50 per return) ...............................3.                                         88 00
4.  School district income tax liability (line 2 minus line 3; if less than -0-, enter -0-) ..........................................4.                          888888 00
5.  Interest penalty on underpayment of estimated tax. Include Ohio IT/SD 2210 and the appropriate 
  worksheet if you annualize .............................................................................................................................5.      888888 00
6.  Total school district income tax liability before withholding or estimated payments (line 4 plus line 5)....6.                                                888888 00

           Software vendors: Place 2D barcode in this location
           Do not place a box around the 2D barcode. The box
                         is only here for placement purposes.                                                                           /                    /
                                                                                                           Postmark date                                             Code

                                                                                         2017 Ohio SD 100 – page 1 of 2

                                                          2017 Ohio SD 100 
                            Rev. 9/17
                                              School District Income Tax Return                                                                                               17020210

  SSN       888 88 8888                               SD# 8888

6a. Amount from line 6 on page 1 ........................................................................................................................... 6a.                    888888 00 
 7. School district income tax withheld School district number on W-2(s), W-2G(s) and/or 1099-R(s) must 
      agree with the school district number on this return). Include W-2(s), W-2G(s) and 1099-R(s) with the return...........7.                                                     888888 00 
 8. Estimated (2017 Ohio SD 100ES) and extension (2017 Ohio SD 40P) payments and credit
    carryforward from previous year return.............................................................................................................    8.                       888888 00 
 9.  Amended return only – amount previously paid with original and/or amended return ...................................  9.                                                       888888 00 

 10. Total school district income tax payments (add lines 7, 8 and 9) ................................................................ 10.                                          888888 00 

11.  Amended return only – overpayment previously requested on original and/or amended return .................... 11.                                                              888888 00 

12. Line 10 minus line 11 ........................................................................................................................................ 12.      -       888888 00 
              If line 12 is MORE THAN line 6a, go to line 16. OTHERWISE, continue to line 13.
13.  Tax liability (line 6a minus line 12) If line 12 is negative, ignore the “-” and add line 12 to line 6a .................... 13.                                            8888888 00 
 14. Interest and penalty due on late filing or late payment of tax (see instructions) ....................................................... 14.                               8888888 00 
 15. TOTAL AMOUNT DUE (line 13 plus line 14). Include Ohio SD 40P (if original return) or Ohio SD 40XP 
    (if amended return) and make check payable to “School District Income Tax” .......AMOUNT DUE                                           15.                               88888888 00 
  
 16. Overpayment (line 12 minus line 6a) .............................................................................................................  16.                      8888888 00 
 
 17. Original return only– amount of line 16 to be credited toward 2018 school district income tax liability ................ 17.                                                8888888 00 

 18. REFUND (line 16 minus line 17) ..........................................................................................YOUR REFUND 18.                                   8888888 00 
Schedule    A – Traditional Tax Base School District Amounts (see instructions)
 Complete this schedule only if filing a traditional tax base school district return.
19. Ohio income tax base (Ohio IT 1040, line 3 minus Ohio IT 1040, line 4).  ..................................................... 19.                                      - 888888888 00 
20. Business income deduction add-back (see instructions) ...............................................................................  20.                                      888888 00 
 21. Total traditional tax base school district income (line 19 plus line 20) ............................................................ 21.                              - 888888888 00 
 
 22. The amount from line 21, if any, that you earned while not a resident of the school district whose 
    number you entered on this return ................................................................................................................. 22.                   888888888 00 
23.  School district taxable income (line 21 minus line 22; if less than zero, enter zero). Enter here and on 
    line 1 of this return .......................................................................................................................................... 23.      888888888 00 
 Schedule B – Earned Income Tax Base School District Amounts (see instructions)
Complete this schedule only if filing an earned income tax base school district return.
24. Wages and other compensation you earned while you were a resident of the school district whose 
    number you entered on this return (see instructions) .....................................................................................  24.                           888888888 00 
25. Net earnings from self-employment to the extent included in Ohio adjusted gross income ...........................  25.                                                 - 888888888 00 
 26. Miscellaneous federal adjustments (see instructions) ....................................................................................  26.                         -       888888 00 

 27. School district taxable income (add lines 24, 25 and 26; if less than zero, enter zero). Enter here and on line 1 of this return888888888...... 27.                                       00 
 Sign Here (required): I have read this return. Under penalties of perjury, I declare that, to the best of my knowledge                                 If your refund is $1.00 or less, no refund will be issued. 
 and belief, the return and all enclosures are true, correct and complete.                                                                                           If you owe $1.00 or less, no payment is necessary.
Your signature  Date (MM/DD/YY)                                                                                                                                         NO Payment Included  –Mail to:
                                                                                                                                                                         School District Income Tax
Spouse’s signature                                                            Phone number                                                                                   P.O. Box 182197
                                                                                                                                                                         Columbus, OH 43218-2197
     X   Check here to authorize your preparer to discuss this return with Taxation.                                                                                     Payment Included  –Mail to:
 Preparer's printed name                                                                                                                                                 School District Income Tax
                                                                                                                                                                              P.O. Box 182389
 Phone number                                            Preparer's TIN (PTIN)    PXXXXXXXX                                                                              Columbus, OH 43218-2389

                                                                                               2017 Ohio SD 100 – page 2 of 2

Ohio SD RE
Note: This form is not captured, but is required for 

submissions of any amended test scenarios. The last 

two-digits of the barcode for this form is the same as 

what you were assigned for the other scanned forms.

                                                                                                 Tax Year              SD RE
                                                                                                                       Rev. 9/17

                                                           17290110

                                                      Ohio SD RE
                           Reason and Explanation of Corrections
                                Note: For amended school district return only
                          Complete the Ohio SD 100 (checking the amended return box) and include this 
                       form with documentation to support any adjustments to the line items on the return. 
Taxpayer's SSN (required) 

First name                                            M.I. Last name

Reason(s):
  Net operating loss carryback (IMPORTANT: Be sure to complete        Ohio IT 1040, Schedule A, additions to income
  and include Ohio Schedule IT NOL, Net Operating Loss Carryback,     Ohio IT 1040, Schedule A, deductions from income
  [available at tax.ohio.gov] and check the box on the front of the 
  Ohio SD 100 indicating that you are amending for a NOL.)            Senior citizen credit claimed
  Federal adjusted gross income increased                             Ohio IT/SD 2210 interest penalty amount increased
  Federal adjusted gross income decreased*                            Ohio IT/SD 2210 interest penalty amount decreased
  Change in amount of earned income (earned income tax base           School district withholding increased
  filers)                                                             School district withholding decreased
  Filing status changed*                                              Estimated and/or Ohio SD 40P amount or previous year 
  Residency status changed                                            carryforward overpayment increased
                                                                      Estimated and/or Ohio SD 40P amount or previous year 
  Exemptions increased(traditionaltaxbasefilers)*                     carryforward overpayment decreased
  Exemptions decreased(traditionaltaxbasefilers)
                                                                      Amount paidwithoriginalfilingdidnotequalamountreported
                                                                      aspaidwiththeoriginalfiling

*To avoid delays you must include a copy of your federal account transcript OR a copy of your federal amended income tax return with a 
copy of the federal acceptance letter or refund check.
Detailed explanation of adjusted items (include additional sheet[s] if necessary):

E-mail address                                                        Telephone number

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

General information 

regarding this form

         General Information (2017 SD 100):

1) Dimensions: 
  
  Target or Registration Marks - 6 mm X 6 mm. Follow grid layout for positioning.

   1D barcode (2 of 5 interleaved) - .375”H x 1.5”W. Follow grid layout for positioning. Center the barcode  
  number directly under the barcode.

  2D barcode (PDF 417) - See 2D instructions and schema. Follow grid layout for positioning. There is one 
  2D barcode for the SD 100.

2) 1D barcode - The last two numbers of the 1D barcode represent the vendor number. Use the same vendor 
number as you did for last year’s return. If you have a question about your barcode assignment, e-mail the Forms 
Unit at Forms@tax.state.oh.us. The first six numbers are constant for this form (170201XX - 170202XX). 

  17 = tax year
  02 = SD 100 
  01-02 = page number 
  XX = vendor number (assigned to you by the Ohio Dept. of Taxation, Forms Unit)

   NOTE: The vendor number also serves as the first two digits of the SSN in the test scenarios.

3) New! Use Arial font for the static text on the form. The static text for all target marks and header information
(target marks, logo, title and 1D barcode) must match grid.

4) Use monospaced Arial or similar monospaced san serif font for the variable data fields on the form.

5) Follow the grid layout for the variable data fields shown in red. Ensure that the tax year, target or reg-
istration marks, “For Department Use Only” area and the 1D and 2D barcodes follow grid layout.

6) Do not use commas, hyphens or decimals in the variable data fields except where shown in specs.

7)  All monetary fields must always show “00” in the cents field even though there may not be a value for that line.

8) The possible negative fields for this return are lines 12, 19, 21, 25 and 26. Do not hard-code negative signs.

9) Provide guidance to customers regarding duplex printing that instructs them to print pages 1 and 2 together. 
Taxpayers have filed returns with pages 2 and 3 duplexed or a worksheet or software receipt on the back of a 
page of the return. This slows the processing of the tax return.

10) New! Generate the following message for customers: “Do not enclose other documentation unless it is 
specified on the tax return or instructions.” Taxpayers often submit worksheets and receipts from the vendor 
product, which slows the processing of tax returns. Any other documents generated from the software must in-
clude a 1D barcode identifying it as additional information.  The preferred placement is centered on the top edge 
of the page within the print area, however placement at any location on the page will be accepted.  Always use 
the following 1D barcode (2 of 5 interleaved).

11) When the SD 100 is filed as an amended return, please include the SD RE (Reason of Explanation and Correc-
tions), and if necessary, the IT NOL. Make sure that any barcodes on these returns represent your vendor number 
assignment. For example, if your last two digits of your 1D barcode are “05”, make sure that these are “05” also.

12) New! For all balance due returns, generate the proper payment voucher.  For an original return use the Ohio 
SD 40P and for an amended return use the Ohio SD 40XP.

13) IMPORTANT NOTE: Add this statement to your software programs. It should print out with the taxpayer’s 
return. “Do not hand write in any corrections on the printed paper return. Hand writing in corrections will 
result in capturing incorrect data and delaying the processing of this income tax return. Make any cor-
rections to this income tax return within [the software program name], then print and mail.”

14) See the 2D barcode instructions for submission details.

Additional Instructions 

for the 2D barcode and 

regarding submissions, 

testing and notifications 

for the 2017 Ohio SD 100

              Important Note

It is required that vendors program the Ohio SD 100 to include 2D barcodes.

                     2017 Ohio SD 100 

       School District Income Tax Return Bundle 

                    2D Barcode Instructions 
 
 General Information 
 • The Ohio SD 100 must be enabled for 2D barcode decoding 
 • A form enabled for 2D barcode should not allow users or practitioners the option to turn 
   off/on the 2D barcode function 
 • The minimum error correction code level is 4 
 • Products must not print a 2D barcode prior to being approved in Ohio 
 
 2D Barcode Size and Placement on the Form 
 • 2D barcode must be placed on each page of form in the designated area indicated in the 
   grid layout 
 • The maximum size of the 2D barcode is 3.5 inches wide by 1 inch in height and must fit 
   within the designated space in the grid layout 
 • 2D barcode must not be bigger than the allocated area 
 
 2D Barcode Layout 
 • Each field in the barcode is delimited by a single carriage return 
   o    <CR> equals single carriage return character 
   o    This separates each piece of data so it may be identified and processed. 
 • Data included in the 2D barcode can be broken down into three general sections 
 
 Header 
   Header Version Number 
        • Static for all barcodes, value is T1 
   Developer Code 
        • A four-digit vendor code identifying the software developer whose application 
          produced the barcode 
   Jurisdiction 
        • Static for all barcodes, value is OH 
   Description 
        • A four-digit form identifier, specific to each form 
   Spec Version 
        • A one-digit specification version control number starting with the number zero 
        • This number identifies the version of the specifications used to produce the form 
          barcode 
   Form Version 
        • A one-digit form version control number starting with the number one (1) 
        • This number will only be incremented when there are changes made that would 
          affect the content of the barcode 
   Date Generated 
        • Included on page 1 only 
        • Indicates date return was generated from the product 
 
 Form Specific Data – Please see encoding schemas for form specific data 
   •    All fields on form are required and must be included in the 2D barcode 
   •    Fields with values are represented by the data followed by a carriage return 

   •     Fields with no values are represented by a carriage return only; this results in two 
         adjacent carriage returns 
   •     Note that the data format within the 2D barcode for the Weight, Ratio and Weighted 
         Ratio differs from the print version. Do not include the decimal point in the 2D data. 
 
 Trailer 
   •     The last field in the barcode data stream is the trailer 
   •     The trailer is used to indicate the end of data has been reached 
   •     A static string of *EOD* is used as the trailer value 
 
 Examples of 2D Barcode data streams 
   Header Version Number           T1<CR> 
   Developer Code                  1111<CR> 
   Jurisdiction                    OH<CR> 
   Description                     1702<CR> 
   Spec Version                    0<CR> 
   Form Version                    1<CR> 
   Date Generated                  011517<CR> 
   Line Item Specific Data         IN<CR> 
   Line Item Specific Data         IT40<CR> 
   Line Item Specific Data         0<CR> 
   Trailer                         *EOD* <CR> 
 
 Submission Process 
 • The deadline for submitting Ohio SD 100 test packets is December 22, 2017 
 • Test packets may be submitted by email to  Forms@tax.state.oh.us 
 • The email subject line must include the vendor number, product name, tax year and form 
   number in that order e.g. 12_ABCTax_ 17_SD100 
 • Submissions must include 
   •     Ohio form STF- Approval Request for Scannable Tax Forms 
   •     One (1) full field sample in a PDF format 
   •    Seventeen (17) test scenarios for the Ohio SD 100 bundle provided by the Ohio 
         Department of Taxation. These test scenarios can include the following return, 
         documents and vouchers: Ohio SD 100, SD RE, SD 40P, SD 40XP and others  
         depending on the scenario. Send only the forms that each scenario requires.                       
         Note: Make sure to send in the correct payment voucher if a scenario requires it. 
         • Each test scenario must be in a separate PDF using the following naming 
           convention: vendor number, product name, tax year, form number, test number 
           e.g.12_ABCTax_17_SD100_Test 1 
 • An emailed confirmation is sent to the vendor indicating the packet was received 
 • Submissions found to be missing any of the items above are rejected 
 
 Testing Process 
 • Testing of Ohio SD 100 packets commences on December 8, 2017 
 • Test packets are reviewed in two (2) content areas- printed forms and 2D barcode data 
 • A submission is approved in its entirety once all sample documents pass in both areas 
 
 Printed forms 
         • Vendor full field matches template provided in the specifications 
         • All fields are present, are formatted properly and align with grid layout 
         • Test scenarios contain values specified by Ohio Department of Taxation 
         • Place zeroes in the numeric fields (except ZIP code) that either do not pertain to 
           the taxpayer(s) or value is zero or less and cannot be a negative value 
 

 2D Barcode Data 
            •  Barcodes read as valid 
            •  All test scenarios can be decoded 
            •  2D barcode data matches data on printed forms 
            •  Place zeroes in the numeric fields (except ZIP code) that either do not pertain to 
               the taxpayer(s) or value is zero or less and cannot be a negative value 
             
Additional instructions 
   • The static text for all target marks and header information (target marks, logo, title and 1D 
     barcode) must match grid. 
   • For all balance due returns, generate the proper payment voucher. For an original school 
     district return, use the Ohio SD 40P and for an amended school district return, use the Ohio 
     SD 40XP. 
   • Any other documentation generated from the software must include a 1D barcode identifying 
     it as an additional information. The preferred placement is centered on the top edge of the 
     page within the print area, however placement at any location on the page will be accepted. 
     Always use the following 1D barcode (2 of 5 interleaved): 

 Notifications 
 •  Communications from the Ohio Department of Taxation regarding submissions are sent 
     from  Forms@tax.state.oh.us  to the vendor email address(es) on file for the product 
   • Vendor contact information is compiled from STF- Approval Request for Scannable Tax 
     Forms but may also be submitted by email to the address above. 
 •  If unapproved forms are released in software packages, vendors must include a visual 
     indicator signifying the return cannot be filed. 
 •  If unapproved forms are released in software packages, vendors must ensure that 
     taxpayers cannot print returns containing 2D barcodes. 
 •  An emailed confirmation is sent to the vendor indicating the packet was approved, at 
     which point the product is authorized to print with a 2D barcode. 
 •  An emailed confirmation is sent to the vendor for packets that are rejected 
     •     Feedback is provided regarding the errors found 
          •   Resubmit packets must include all test scenarios and the full field return 
     •     After the third submission of test materials, the department cannot guarantee 
            timeliness of the review 
 •  If a tax form changes before January 1, 2018 vendors will be notified and required to 
     submit revised test packets.