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.

                                           Rev. 6/16
OHIO IT 40P                                                                                 Taxable Year          Do NOT fold check or voucher.
Income Tax Payment Voucher                                    DO NOT STAPLE OR 
                                                              OTHERWISE ATTACH 
                                                              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 fi ling)
Spouse’s fi rst name (only if joint fi ling) M.I.     Last name

                                                                                                     Your SSN
Address
                                                                                            Spouse’s SSN
                                                                                            (only if joint fi ling)
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.
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