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                                                                 Rev. 8/19/16

Scan Speciﬁ cations for the 

2016 Ohio IT 1140

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       Ohio Department of Taxation

                        4485 Northland Ridge Blvd.

                        Columbus, OH 43229

                        tax.ohio.gov

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with notations

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4                                                  Do not use staples. Use only black ink and UPPERCASE letters. 
5                   New! The date the return was gen-
                                                           2016 Ohio IT 1140 
6                   erated by the taxpayer (MM DD YY).
7                             Rev. 7/16                  Pass-Through Entity and 
                                                                                                                                                                                                 16170110
8  88 88 88
9                                                     Trust Withholding Tax Return
                                                                       Placement of the tax year and 1D barcode is critical. 
10                                                                     Make sure to follow the grid positions for layout. Do                                                                     For taxable year beginning in
11                            XCheck here if amended returnnot forgetX               Checkto get yourherebarcode(s)if ﬁ nal returnassignments for                                                88/2016
12 FEIN                                                                every form, version and page.
13 88 8888888                                         Entity Type:     X  S corporation                                                                                         X Partnership
14                                                    (check only one) X  Limited liability company                                                                             X Trust
15 Name of pass-through entity
16 JOHNXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
17
18 Address (if address change, check box)     X
19 8888 CHERRY   LANEXXXXXXXXXXXXXXXXXXX
20 City                                                                                           State           ZIP code
21                                                                                                OH              88888                                                                      New! Do not place spaces be-
   CITYXXXXXXXXXXXXXXXX
22                                                                                                                                                                                           tween whole dollar numbers. There 
23 Number of investors           Apportionment ratio, page 3, line 8          Schedule B, line 1 – total of columns A and B                                                                  is only a space between dollar 
                                                                                                                                                                                             amounts and cents ﬁ elds.
24 888888                        8 . 888888                                                                   888888888 00
25
26
27 Schedule A – Reconciliation Tax and Payments
28                                                                                                       Column (I) – Withholding Tax                                                            Column (II) – Entity Tax
     1. Tax for each column (from Schedule B, line 11, columns A and B or from Schedule 
29      D, line 5)                                                                                                                                                            888888888 00       888888888 00
               ........................................................................................................................1.
30
     2. Interest penalty on underpayment of estimated tax if the sum of columns A and 
31      B on line 9 on page 3 exceeds $10,000 (include OhioFor staticIT/SDtext2210)use.............................2.Arial font (black ink) and888888888try to                               00  888888888 00
32  2a. Add lines 1 and 2.........................................................................................................2a.match size. For data entry ﬁ elds (shown in888888888red 00  888888888 00
33                                                       for identiﬁ cation purposes only), use Arial font 
     3. Ohio IT 1140ES and IT 1140P payments the entity or trust made and/or 2015 (black ink). All the data entry ﬁ elds must follow 
34   ...................................................3.overpayment credited to 2016 (see Note 1 on pagegrid6)layout. When a  ﬁ eld  reﬂ ects a negative888888888 00                           888888888 00
35                                                       amount, make sure there is no space between 
36 3a. Payments transferred from Ohio IT 4708ES and IT 4708P (include schedule if the amount and the negative sign. Never hard 
        required; see instructions) and other payments previouslycode a negativemade forsign.this taxable 
37      year .............................................................................................................................3a.                                 888888888 00
38
    3b. Payments transferred to Ohio IT 4708 and refunds, if any, previously claimed for 
39   ...........................................................................................................3b.this taxable year                                          888888888 00
40
41                                                                                                                                                                            888888888 00       888888888 00
      3c. Net payments (sum of lines 3 and 3a minus line 3b) not less than zero .....................3c.
42
43   4. For each column, subtract line 3c from line 2a ...............................................................4.                                                      888888888 00       888888888 00
44
    5. If  the sum of line 4, columns (I) and (II) is an overpayment, enter that sum here
45      ..............................................................................................................................................................OVERPAYMENT5.             888888888 00
46
47   6.  Amount of line 5 to be CREDITED to year 2017    .................................................................................CREDIT TO 20176.                                      888888888 00
48
49    7.  Amount of line 5 to be REFUNDED (line 5 minus line 6) ......................................................................YOUR REFUND7.                                             888888888 00
50
51                                                                                                                                                                                               888888888 00
      8.  If the sum of line 4, columns (I) and (II) is a balance due or zero, enter here the amount due ............................................8.
52
                                                                                                                                                                                                 888888888 00
53    9. Interest and penalty due on late-paid tax and/or late-ﬁ led return, if any     .................................................................................9.
54
   10. Total amount due (sum of  lines 8 and 9). Make check payable to Ohio Treasurer of State. Include 
55     Ohio IT 1140P and place FEIN on check................................................................................... TOTAL AMOUNT DUE10.                                             888888888 00
56         Target marks or registration marks If your refund is $1.00 or less, no refund will be issued. If you owe $1.00 or less, no payment is necessary.
57         must measure 6 mm X 6 mm.  The 
58         four target marks or registration 
           marks on every page must follow                                                                    New! 2D barcode required. Delete 
59         grid layout.                                                                                       this box and replace it with the 2D 
60                                                                                                            barcode.
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                                                           2016 Ohio IT 1140 
6
7                  Rev. 7/16                          Pass-Through Entity and 
                                                                                                                                                           16170210
8
9  FEIN                                       Trust Withholding Tax Return
10 88 8888888
11
12 Sign Here (required): I declare under penalties of perjury that this report, including any ac-
13 companying schedules and statements, has been examined by me and to the best of my knowledge                                Do not staple or otherwise attach. 
   and belief is a true, correct and complete return and report.
14                                                                                                                             Place any supporting documents, including 
15                                                                                                                             K-1’s, after the last page of this return.
16 Pass-through entity ofﬁ cer or agent (print name)  
17                                                                                                                                                         Mail to: 
18 Title of ofﬁ cer or agent (print name)             Phone number
                                                                                                                               Ohio Dept. of Taxation
19 Signature of pass-through ofﬁ cer or agent         Date                                                                                    P.O. Box 181140
20
                                                                                                                               Columbus, OH 43218-1140
21 Preparer’s name (print name)                       Phone number
22                                                                                                                             Instructions for this form are on our 
23 Preparer’s e-mail address                          PTIN                                                                                    Web site at tax.ohio.gov. 
24 Do you authorize your preparer to contact us regarding this return?  Yes        X No                               X  
25
26 Schedule B – Qualifying Pass-Through Entities – Tax Due
27 Use this schedule to calculate the adjusted qualifying amounts and tax due for all qualifying investors in qualifying pass-through entities. Include federal K-1s 
   and a listing of pass-through credits of participating investors. See “Special Notes” in the instructions, which are available on our Web site at tax.ohio.gov. 
28
                                                                                                                           (A)                                      (B)
29
                                                                                     Qualifying Investors Who Are                                          Qualifying Investors Other 
30                                                                                                                    Nonresident Individuals Than Nonresident Individuals
31
32   1.  Sum of all qualifying investors’ distributive shares of income, gain, 
    expenses and losses............................................................................... 1.                888888888 00                       888888888 00
33
34      X X        X
    2a.  Add        2/3,    5/6 or       6/6 (check applicable box) of the qualify-
35  ing investors’ distributive shares of Internal Revenue Code (I.R.C.) 
36  sections 168(k) and 179 depreciation expense and miscellaneous 
37  federal income tax adjustments, if any. Include a separate schedule 
    showing calculations............................................................................. 2a.                888888888 00                       888888888 00
38
39  2b.  Subtract qualifying investors’ distributive shares of other statutory 
40  adjustments and miscellaneous federal income tax adjustments, if 
    any  ........................................................................................................ 2b.    888888888 00                       888888888 00
41
42   3.  Qualifying investors’ distributive shares of adjusted qualifying amount: 
    Sum of lines 1 and 2a minus line 2b ......................................................... 3.                     888888888 00                       888888888 00
43
44
     4.  Add all qualifying investors’ distributive shares of expenses and 
45  losses incurred in connection with all direct and indirect transactions 
46  between the qualifying pass-through entity and its related members, 
    including certain investors’ family members (see Note 2 on page 6). 
47  However, do not add expenses or losses incurred in connection with 
48  sales of inventory to the extent that the cost of the inventory and the 
49  loss incurred were calculated in accordance with I.R.C. sections 
    263A and 482 (see Note 3 on page 6)..................................................... 4.                          888888888 00                       888888888 00
50
51
52   5. If the qualifying pass-through entity is either a partnership or a 
    limited liability company treated as a partnership, add all qualifying 
53  investors’ distributive shares of guaranteed payments that the quali-
54  fying pass-through entity made to any qualifying investor directly or 
    indirectly owning at least 20% of the qualifying pass-through entity ......... 5.                                    888888888 00                       888888888 00
55
56
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58                                                                                                                     New! 2D barcode required. Delete 
                                                                                                                               For Department Use Only
59                                                                                                                     this box and replace it with the 2D 
                                                                                                                       barcode.
60                                                                                                                                            /            /
61                                                                                                                                            Postmark date         Code
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                                                           2016 Ohio IT 1140 
6
                          Rev. 7/16
7                                                     Pass-Through Entity and                                                                        16170310
8  FEIN
9                                                     Trust Withholding Tax Return
   88 8888888
10
11
   Schedule B – Qualifying Pass-Through Entities – Tax Due...cont.
12
13                                                                                                                     (A)                                   (B)
14   6.  If the qualifying pass-through entity is an S corporation, add all                                   Qualifying Investors Who Are      Qualifying Investors Other 
15     qualifying investors’ distributive shares of compensation that the                                     Nonresident Individuals        Than Nonresident Individuals
       qualifying pass-through entity S corporation made to any qualifying 
16     investor directly or indirectly owning at least 20% of the qualifying 
       pass-through entity. Reciprocity agreements do not apply. (See 
17     Note 3 on page 6.) ................................................................................ 6.    888888888 00                                888888888 00
18
19   7. Qualifying investors’ adjusted distributive shares. Sum of lines 
       3, 4, 5 and 6, but not less than -0- ....................................................... 7.           888888888 00                                888888888 00
20
21   8.  Apportionment ratio from Schedule C, line 4, below............................ 8.                               8.888888                                                8.888888
22  
23   9. Qualifying investors’ adjusted qualifying amount: Line 7 times 
       line 8. Complete the remainder of this worksheet only if the sum 
24     of columns A and B on line 9 exceeds $1,000 .....................................9.                       888888888 00                                888888888 00
25  10.  Tax rate (see Note 4 on page 6)                                                                                   X .05                                                 X .085
                                        ........................................................ 10.
26
27 11.  Tax due: Line 9 times line 10. Round tax to the nearest dollar. Enter 
       the column A amount on page 1, line 1, column I; enter the column 
28     B amount on page 1, line 1, column II.................................................. 11.               888888888 00                                888888888 00
29
30 Schedule C – Qualifying Pass-Through Entities – Apportionment Worksheet
31 Use this schedule to calculate the apportionment ratio for a qualifying pass-through entity that is not a ﬁ nancial institution as deﬁ ned in Ohio Revised Code 
32 section (R.C.) 5725.01. If the pass-through entity is a ﬁ nancial institution, refer to the instructions. Note: All ratios are to be carried to six decimal places.
33  1.  Property                                           Within Ohio                                                                       Total Everywhere
34     a) Owned (average cost)                        88888888888 00                                                                  88888888888New! Weight is now a00variable data 
35                                                         WithinThisOhioﬁ eld requires a leading zero,                                    ﬁ eldTotaland mustEverywhereinclude a leading 
36     b) Rented (annual rental X 8)                  88888888888 00e.g. .000026 should be displayed                                  88888888888 00zero. See schema for accepted 
37                                                         Within Ohioas 0.000026.                                                         characters.Total Everywhere

38     c) Total (lines 1a and 1b)                     88888888888 00                                                    ÷             88888888888 00
39
40                                                                                                               Ratio       Weight                          Weighted Ratio
41                                                         =                                                               x                    =            8. 888888
                                                                                                              8. 888888      8.88
42                                                         Within Ohio                                                                       Total Everywhere
43  2.  Payroll                                       88888888888 00                                                    ÷             88888888888 00
44                                                                                                               Ratio       WeightThis ﬁ eld requires a leading zero, Weighted Ratio
                                                                                                                                           e.g. .000026 should be displayed 
45                                                         =                                                  8. 888888    x 8.88as 0.000026.=               8. 888888
46                                                         Within Ohio                                                                       Total Everywhere
47  3.  Sales                                         88888888888 00                                                    ÷             88888888888 00
48                                                                                                               Ratio       Weight                          Weighted Ratio
    
49                                                         =                                                  8. 888888      8.88                            8. 888888
50                                                                                                                         x                    =
51                                                                                                                                                           Weighted Ratio
52   4.  Total weighted apportionment ratio (add lines 1c, 2 and 3). Enter ratio here and on line 8, above (both columns).                                   8. 888888
53
   Note: If the denominator of any factor is zero, the weight given to the other factors must be proportionately increased so that the total weight given to the 
54 combined number of factors used is 100%, i.e., if no property/payroll, use 25% and 75%; if no sales, use 50% property/payroll; if only one factor, use 100%.
55
56
57
58                                                                                                               New! 2D barcode required. Delete 
59                                                                                                               this box and replace it with the 2D 
60                                                                                                               barcode.
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                                                                2016 Ohio IT 1140 
6
7                          Rev. 7/16               Pass-Through Entity and 
                                                                                                                                                                        16170410
8  FEIN
9                                                Trust Withholding Tax Return
   88 8888888
10
11
   Schedule D – Trusts – Tax Due
12
   Use this schedule to calculate the adjusted qualifying amounts and withholding tax due for nonresident individuals who are beneﬁ ciaries of trusts that 
13 made distributions of either income or gain attributable to the trust’s ownership of or disposition of either tangible personal property located in Ohio or real 
14 property located in Ohio.
15
16   1.  Sum of all distributions to nonresident individuals of income or gain attributable to the trust’s 
17     ownership of or disposition of either tangible personal property located in Ohio or real property 
       located in Ohio ........................................................................................................................................ 1.      888888888 00
18  
19 2a. Add  X2/3, X 5/6 or X6/6 (check applicable box) of I.R.C. section 168(k) depreciation 
20     expense and miscellaneous federal income tax adjustments attributed to nonresident individu-
       als who are beneﬁ ciaries of trusts. Include a separate schedule showing calculations  ...................... 2a.                                                888888888 00
21  
    2b.  Other statutory adjustments and miscellaneous federal income tax adjustments attributed to 
22     nonresident individuals who are beneﬁ ciaries of trusts ......................................................................... 2b.                            888888888 00
23  
     3.  Adjusted qualifying amount: sum of lines 1 and 2a minus line 2b. Complete the remainder of 
24     the worksheet only if line 3 exceeds $1,000 ........................................................................................... 3.                       888888888 00
25
26  4.  Tax rate ................................................................................................................................................... 4.         X .05
27  
28     5. Tax due: Line 3 times line 4. Round tax to the nearest dollar. Enter here and on page 1, line 1, 
       column I................................................................................................................................................... 5.   888888888 00
29                                                                  Value is the numeric equivalent 
30                                                                  of the percent of ownership and 
31 Schedule E – Investor Information                                must include the leading zero, e.g. 
       Check the box if this year’s investor information either (i) includes45.62%names= 0.4562that were not listed on last year’s return or (ii) excludes names that were listed on 
32 X   last year’s return. Provide investor information for  all(resident and nonresident) investors in the pass-through entity or trust. List investors by highest to lowest 
33     ownership percentage. Use an additional sheet, if necessary. See Note 5 on page 6 for the amount of pass-through entity tax credits.
34 SSN                                    FEIN                                      Percent of ownership               Amount of PTE tax credit
35 888 88  8888                           88 8888888                                8.8888                             888888888 00
36
37 First name/entity                                             M.I. Last name
38 JOHNXXXXXXXXXXX                                               Q        PUBL I CXXXXXXXXXXXXXX
39 Address
40 8888 CHERRY              LANEXXXXXXXXXXXXXXXXXXX
41 City                                                                                        State         ZIP code
42 CITYXXXXXXXXXXXXXXXX                                                                        OH            88888
43
44
45 SSN                                    FEIN                                      Percent of ownership               Amount of PTE tax credit
46 888 88  8888                           88 8888888                                8.8888                             888888888 00
47
48 First name/entity                                             M.I. Last name
49 JOHNXXXXXXXXXXX                                               Q        PUBL I CXXXXXXXXXXXXXX
50 Address
51 8888 CHERRY              LANEXXXXXXXXXXXXXXXXXXX
52 City                                                                                        State         ZIP code
53 CITYXXXXXXXXXXXXXXXX                                                                        OH            88888
54
55
56
57
58                                                                                                       New! 2D barcode required. Delete 
59                                                                                                       this box and replace it with the 2D 
60                                                                                                       barcode.
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6                                             2016 Ohio IT 1140 
7                    Rev. 7/16                Pass-Through Entity and 
                                                                                                                      16170510
8  FEIN
9                                      Trust Withholding Tax Return
   88 8888888
10
11
   Schedule E – Investor Information...cont.
12
   Provide investor information for all (resident and nonresident) investors in the pass-through entity or trust. List investors by highest to lowest ownership percent-
13 age. Use an additional sheet, if necessary. See Note 5 on page 6 for the amount of pass-through entity tax credits.
14 SSN                                 FEIN         Percent of ownership      Amount of PTE tax credit
15 888 88  8888                        88 8888888   8.8888                    888888888 00
16
17 First name/entity                              M.I. Last name
18 JOHNXXXXXXXXXXX                                Q PUBL I CXXXXXXXXXXXXXX
19 Address
20 8888 CHERRY       LANEXXXXXXXXXXXXXXXXXXX
21 City                                                         State ZIP code
22 CITYXXXXXXXXXXXXXXXX                                         OH    88888
23
24
25 SSN                                 FEIN         Percent of ownership      Amount of PTE tax credit
26 888 88  8888                        88 8888888   8.8888                    888888888 00
27
28 First name/entity                              M.I. Last name
29 JOHNXXXXXXXXXXX                                Q PUBL I CXXXXXXXXXXXXXX
30 Address
31 8888 CHERRY       LANEXXXXXXXXXXXXXXXXXXX
32 City                                                         State ZIP code
33 CITYXXXXXXXXXXXXXXXX                                         OH    88888
34
35
36 SSN                                 FEIN         Percent of ownership      Amount of PTE tax credit
37 888 88  8888                        88 8888888   8.8888                    888888888 00
38
39 First name/entity                              M.I. Last name
40 JOHNXXXXXXXXXXX                                Q PUBL I CXXXXXXXXXXXXXX
41 Address
42 8888 CHERRY       LANEXXXXXXXXXXXXXXXXXXX
43 City                                                         State ZIP code
44 CITYXXXXXXXXXXXXXXXX                                         OH    88888
45
46
47 SSN                                 FEIN         Percent of ownership      Amount of PTE tax credit
48 888 88  8888                        88 8888888   8.8888                    888888888 00
49
50 First name/entity                              M.I. Last name
51 JOHNXXXXXXXXXXX                                Q PUBL I CXXXXXXXXXXXXXX
52 Address
53 8888 CHERRY       LANEXXXXXXXXXXXXXXXXXXX
54 City                                                         State ZIP code
55 CITYXXXXXXXXXXXXXXXX                                         OH    88888
56
57
58                                                                    New! 2D barcode required. Delete 
59                                                                    this box and replace it with the 2D 
60                                                                    barcode.
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4                                                  Do not use staples. Use only black ink and UPPERCASE letters. 
5
                                                         2016 Ohio IT 1140 
6
7                             Rev. 7/16                  Pass-Through Entity and 
                                                                                                                                                                                 16170110
8  88 88 88
9                                                     Trust Withholding Tax Return
10                                                                                                                                                                               For taxable year beginning in
11                            X Check here if amended return             X  Check here if ﬁ nal return                                                                           88/2016
12 FEIN
13 88 8888888                                         Entity Type:     X S corporation                                                        X Partnership
14                                                    (check only one) X Limited liability company                                            X Trust
15 Name of pass-through entity
16 JOHNXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
17
18 Address (if address change, check box)     X
19 8888 CHERRY   LANEXXXXXXXXXXXXXXXXXXX
20 City                                                                              State ZIP code
   CITYXXXXXXXXXXXXXXXX
21                                                                                   OH    88888
22
23 Number of investors           Apportionment ratio, page 3, line 8     Schedule B, line 1 – total of columns A and B
24 888888                        8 . 888888                                                888888888 00
25
26
27 Schedule A – Reconciliation Tax and Payments
28                                                                                       Column (I) – Withholding Tax                                                             Column (II) – Entity Tax
     1. Tax for each column (from Schedule B, line 11, columns A and B or from Schedule 
29      D, line 5)                                                                                                                            888888888 00                           888888888 00
               ........................................................................................................................1.
30
     2. Interest penalty on underpayment of estimated tax if the sum of columns A and 
31      B on line 9 on page 3 exceeds $10,000 (include Ohio IT/SD 2210) .............................2.                                       888888888 00                           888888888 00
32  2a. Add lines 1 and 2.........................................................................................................2a.         888888888 00                           888888888 00
33
     3. Ohio IT 1140ES and IT 1140P payments the entity or trust made and/or 2015 
34   ...................................................3.overpayment credited to 2016 (see Note 1 on page 6)                                 888888888 00                           888888888 00
35  
36 3a. Payments transferred from Ohio IT 4708ES and IT 4708P (include schedule if 
        required; see instructions) and other payments previously made for this taxable 
37      year .............................................................................................................................3a. 888888888 00
38
    3b. Payments transferred to Ohio IT 4708 and refunds, if any, previously claimed for 
39   ...........................................................................................................3b.this taxable year          888888888 00
40
41                                                                                                                                            888888888 00                           888888888 00
      3c. Net payments (sum of lines 3 and 3a minus line 3b) not less than zero .....................3c.
42
43   4. For each column, subtract line 3c from line 2a ...............................................................4.                      888888888 00                           888888888 00
44
    5. If  the sum of line 4, columns (I) and (II) is an overpayment, enter that sum here
45      ..............................................................................................................................................................OVERPAYMENT5. 888888888 00
46
47   6.  Amount of line 5 to be CREDITED to year 2017    .................................................................................CREDIT TO 20176.                          888888888 00
48
49    7.  Amount of line 5 to be REFUNDED (line 5 minus line 6) ......................................................................YOUR REFUND7.                                 888888888 00
50
51                                                                                                                                                                                   888888888 00
      8.  If the sum of line 4, columns (I) and (II) is a balance due or zero, enter here the amount due ............................................8.
52
                                                                                                                                                                                     888888888 00
53    9. Interest and penalty due on late-paid tax and/or late-ﬁ led return, if any.................................................................................9.
54
   10. Total amount due (sum of  lines 8 and 9). Make check payable to Ohio Treasurer of State. Include 
55     Ohio IT 1140P and place FEIN on check................................................................................... TOTAL AMOUNT DUE10.                                 888888888 00
56                    If your refund is $1.00 or less, no refund will be issued. If you owe $1.00 or less, no payment is necessary.
57
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                                                           2016 Ohio IT 1140 
6
7                  Rev. 7/16                          Pass-Through Entity and 
                                                                                                                                                16170210
8
9  FEIN                                       Trust Withholding Tax Return
10 88 8888888
11
12 Sign Here (required): I declare under penalties of perjury that this report, including any ac-
13 companying schedules and statements, has been examined by me and to the best of my knowledge                              Do not staple or otherwise attach. 
   and belief is a true, correct and complete return and report.
14                                                                                                                           Place any supporting documents, including 
15                                                                                                                           K-1’s, after the last page of this return.
16 Pass-through entity ofﬁ cer or agent (print name)  
17                                                                                                                                              Mail to: 
18 Title of ofﬁ cer or agent (print name)             Phone number
                                                                                                                             Ohio Dept. of Taxation
19 Signature of pass-through ofﬁ cer or agent         Date                                                                                    P.O. Box 181140
20
                                                                                                                             Columbus, OH 43218-1140
21 Preparer’s name (print name)                       Phone number
22                                                                                                                           Instructions for this form are on our 
23 Preparer’s e-mail address                          PTIN                                                                                    Web site at tax.ohio.gov. 
24 Do you authorize your preparer to contact us regarding this return?  Yes        X No                               X  
25
26 Schedule B – Qualifying Pass-Through Entities – Tax Due
27 Use this schedule to calculate the adjusted qualifying amounts and tax due for all qualifying investors in qualifying pass-through entities. Include federal K-1s 
   and a listing of pass-through credits of participating investors. See “Special Notes” in the instructions, which are available on our Web site at tax.ohio.gov. 
28
                                                                                                                         (A)                                (B)
29
                                                                                     Qualifying Investors Who Are                               Qualifying Investors Other 
30                                                                                                                    Nonresident Individuals Than Nonresident Individuals
31
32   1.  Sum of all qualifying investors’ distributive shares of income, gain, 
    expenses and losses............................................................................... 1.                888888888 00                     888888888 00
33
34      X X        X
    2a.  Add        2/3,    5/6 or       6/6 (check applicable box) of the qualify-
35  ing investors’ distributive shares of Internal Revenue Code (I.R.C.) 
36  sections 168(k) and 179 depreciation expense and miscellaneous 
37  federal income tax adjustments, if any. Include a separate schedule 
    showing calculations............................................................................. 2a.                888888888 00                     888888888 00
38
39  2b.  Subtract qualifying investors’ distributive shares of other statutory 
40  adjustments and miscellaneous federal income tax adjustments, if 
    any  ........................................................................................................ 2b.    888888888 00                     888888888 00
41
42   3.  Qualifying investors’ distributive shares of adjusted qualifying amount: 
    Sum of lines 1 and 2a minus line 2b ......................................................... 3.                     888888888 00                     888888888 00
43
44
     4.  Add all qualifying investors’ distributive shares of expenses and 
45  losses incurred in connection with all direct and indirect transactions 
46  between the qualifying pass-through entity and its related members, 
    including certain investors’ family members (see Note 2 on page 6). 
47  However, do not add expenses or losses incurred in connection with 
48  sales of inventory to the extent that the cost of the inventory and the 
49  loss incurred were calculated in accordance with I.R.C. sections 
    263A and 482 (see Note 3 on page 6)..................................................... 4.                          888888888 00                     888888888 00
50
51
52   5. If the qualifying pass-through entity is either a partnership or a 
    limited liability company treated as a partnership, add all qualifying 
53  investors’ distributive shares of guaranteed payments that the quali-
54  fying pass-through entity made to any qualifying investor directly or 
    indirectly owning at least 20% of the qualifying pass-through entity ......... 5.                                    888888888 00                     888888888 00
55
56
57
58
                                                                                                                             For Department Use Only
59
60                                                                                                                                            / /
61                                                                                                                                            Postmark date Code
62
63
                                                                                                                             2016 IT 1140 – pg. 2 of 5
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4
5
                                                           2016 Ohio IT 1140 
6
                       Rev. 7/16
7                                                     Pass-Through Entity and                                                             16170310
8  FEIN
9                                                     Trust Withholding Tax Return
   88 8888888
10
11
   Schedule B – Qualifying Pass-Through Entities – Tax Due...cont.
12
13                                                                                                               (A)                      (B)
14   6.  If the qualifying pass-through entity is an S corporation, add all                                Qualifying Investors Who Are Qualifying Investors Other 
15  qualifying investors’ distributive shares of compensation that the                                     Nonresident Individuals      Than Nonresident Individuals
    qualifying pass-through entity S corporation made to any qualifying 
16  investor directly or indirectly owning at least 20% of the qualifying 
    pass-through entity. Reciprocity agreements do not apply. (See 
17  Note 3 on page 6.) ................................................................................ 6. 888888888 00                   888888888 00
18
19   7. Qualifying investors’ adjusted distributive shares. Sum of lines 
    3, 4, 5 and 6, but not less than -0- ....................................................... 7.        888888888 00                   888888888 00
20
21   8.  Apportionment ratio from Schedule C, line 4, below............................ 8.                           8.888888                           8.888888
22  
23   9. Qualifying investors’ adjusted qualifying amount: Line 7 times 
    line 8. Complete the remainder of this worksheet only if the sum 
24  of columns A and B on line 9 exceeds $1,000 .....................................9.                    888888888 00                   888888888 00
25  10.  Tax rate (see Note 4 on page 6)                                                                               X .05                            X .085
                                        ........................................................ 10.
26
27 11.  Tax due: Line 9 times line 10. Round tax to the nearest dollar. Enter 
    the column A amount on page 1, line 1, column I; enter the column 
28  B amount on page 1, line 1, column II.................................................. 11.            888888888 00                   888888888 00
29
30 Schedule C – Qualifying Pass-Through Entities – Apportionment Worksheet
31 Use this schedule to calculate the apportionment ratio for a qualifying pass-through entity that is not a ﬁ nancial institution as deﬁ ned in Ohio Revised Code 
32 section (R.C.) 5725.01. If the pass-through entity is a ﬁ nancial institution, refer to the instructions. Note: All ratios are to be carried to six decimal places.
33  1.  Property                                           Within Ohio                                                                  Total Everywhere
34     a) Owned (average cost)                        88888888888 00                                                               88888888888 00
35                                                         Within Ohio                                                                  Total Everywhere
36     b) Rented (annual rental X 8)                  88888888888 00                                                               88888888888 00
37                                                         Within Ohio                                                                  Total Everywhere
38     c) Total (lines 1a and 1b)                     88888888888 00                                                 ÷             88888888888 00
39
40                                                                                                         Ratio         Weight           Weighted Ratio
41                                                         =                                                           x                = 8. 888888
                                                                                                           8. 888888     8.88
42                                                         Within Ohio                                                                  Total Everywhere
43  2.  Payroll                                       88888888888 00                                                 ÷             88888888888 00
44                                                                                                         Ratio         Weight           Weighted Ratio
    
45                                                         =                                               8. 888888   x 8.88           = 8. 888888
46                                                         Within Ohio                                                                  Total Everywhere
47  3.  Sales                                         88888888888 00                                                 ÷             88888888888 00
48                                                                                                         Ratio         Weight           Weighted Ratio
    
49                                                         =                                               8. 888888     8.88             8. 888888
50                                                                                                                     x                =
51                                                                                                                                        Weighted Ratio
52   4.  Total weighted apportionment ratio (add lines 1c, 2 and 3). Enter ratio here and on line 8, above (both columns).                8. 888888
53
   Note: If the denominator of any factor is zero, the weight given to the other factors must be proportionately increased so that the total weight given to the 
54 combined number of factors used is 100%, i.e., if no property/payroll, use 25% and 75%; if no sales, use 50% property/payroll; if only one factor, use 100%.
55
56
57
58
59
60
61
62
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                                                                2016 Ohio IT 1140 
6
7                          Rev. 7/16               Pass-Through Entity and 
                                                                                                                                                                        16170410
8  FEIN
9                                                Trust Withholding Tax Return
   88 8888888
10
11
   Schedule D – Trusts – Tax Due
12
   Use this schedule to calculate the adjusted qualifying amounts and withholding tax due for nonresident individuals who are beneﬁ ciaries of trusts that 
13 made distributions of either income or gain attributable to the trust’s ownership of or disposition of either tangible personal property located in Ohio or real 
14 property located in Ohio.
15
16   1.  Sum of all distributions to nonresident individuals of income or gain attributable to the trust’s 
17     ownership of or disposition of either tangible personal property located in Ohio or real property 
       located in Ohio ........................................................................................................................................ 1.      888888888 00
18  
19 2a. Add  X2/3, X 5/6 or X6/6 (check applicable box) of I.R.C. section 168(k) depreciation 
20     expense and miscellaneous federal income tax adjustments attributed to nonresident individu-
       als who are beneﬁ ciaries of trusts. Include a separate schedule showing calculations  ...................... 2a.                                                888888888 00
21  
    2b.  Other statutory adjustments and miscellaneous federal income tax adjustments attributed to 
22     nonresident individuals who are beneﬁ ciaries of trusts ......................................................................... 2b.                            888888888 00
23  
     3.  Adjusted qualifying amount: sum of lines 1 and 2a minus line 2b. Complete the remainder of 
24     the worksheet only if line 3 exceeds $1,000 ........................................................................................... 3.                       888888888 00
25
26  4.  Tax rate ................................................................................................................................................... 4.         X .05
27  
28     5. Tax due: Line 3 times line 4. Round tax to the nearest dollar. Enter here and on page 1, line 1, 
       column I................................................................................................................................................... 5.   888888888 00
29
30
31 Schedule E – Investor Information
       Check the box if this year’s investor information either (i) includes names that were not listed on last year’s return or (ii) excludes names that were listed on 
32 X   last year’s return. Provide investor information for  all(resident and nonresident) investors in the pass-through entity or trust. List investors by highest to lowest 
33     ownership percentage. Use an additional sheet, if necessary. See Note 5 on page 6 for the amount of pass-through entity tax credits.
34 SSN                                    FEIN                                     Percent of ownership     Amount of PTE tax credit
35 888 88  8888                           88 8888888                               8.8888                   888888888 00
36
37 First name/entity                                             M.I. Last name
38 JOHNXXXXXXXXXXX                                               Q        PUBL I CXXXXXXXXXXXXXX
39 Address
40 8888 CHERRY              LANEXXXXXXXXXXXXXXXXXXX
41 City                                                                            State     ZIP code
42 CITYXXXXXXXXXXXXXXXX                                                            OH        88888
43
44
45 SSN                                    FEIN                                     Percent of ownership     Amount of PTE tax credit
46 888 88  8888                           88 8888888                               8.8888                   888888888 00
47
48 First name/entity                                             M.I. Last name
49 JOHNXXXXXXXXXXX                                               Q        PUBL I CXXXXXXXXXXXXXX
50 Address
51 8888 CHERRY              LANEXXXXXXXXXXXXXXXXXXX
52 City                                                                            State     ZIP code
53 CITYXXXXXXXXXXXXXXXX                                                            OH        88888
54
55
56
57
58
59
60
61
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6                                             2016 Ohio IT 1140 
7                    Rev. 7/16                Pass-Through Entity and 
                                                                                                                      16170510
8  FEIN
9                                      Trust Withholding Tax Return
   88 8888888
10
11
   Schedule E – Investor Information...cont.
12
   Provide investor information for all (resident and nonresident) investors in the pass-through entity or trust. List investors by highest to lowest ownership percent-
13 age. Use an additional sheet, if necessary. See Note 5 on page 6 for the amount of pass-through entity tax credits.
14 SSN                                 FEIN         Percent of ownership      Amount of PTE tax credit
15 888 88  8888                        88 8888888   8.8888                    888888888 00
16
17 First name/entity                              M.I. Last name
18 JOHNXXXXXXXXXXX                                Q PUBL I CXXXXXXXXXXXXXX
19 Address
20 8888 CHERRY       LANEXXXXXXXXXXXXXXXXXXX
21 City                                                         State ZIP code
22 CITYXXXXXXXXXXXXXXXX                                         OH    88888
23
24
25 SSN                                 FEIN         Percent of ownership      Amount of PTE tax credit
26 888 88  8888                        88 8888888   8.8888                    888888888 00
27
28 First name/entity                              M.I. Last name
29 JOHNXXXXXXXXXXX                                Q PUBL I CXXXXXXXXXXXXXX
30 Address
31 8888 CHERRY       LANEXXXXXXXXXXXXXXXXXXX
32 City                                                         State ZIP code
33 CITYXXXXXXXXXXXXXXXX                                         OH    88888
34
35
36 SSN                                 FEIN         Percent of ownership      Amount of PTE tax credit
37 888 88  8888                        88 8888888   8.8888                    888888888 00
38
39 First name/entity                              M.I. Last name
40 JOHNXXXXXXXXXXX                                Q PUBL I CXXXXXXXXXXXXXX
41 Address
42 8888 CHERRY       LANEXXXXXXXXXXXXXXXXXXX
43 City                                                         State ZIP code
44 CITYXXXXXXXXXXXXXXXX                                         OH    88888
45
46
47 SSN                                 FEIN         Percent of ownership      Amount of PTE tax credit
48 888 88  8888                        88 8888888   8.8888                    888888888 00
49
50 First name/entity                              M.I. Last name
51 JOHNXXXXXXXXXXX                                Q PUBL I CXXXXXXXXXXXXXX
52 Address
53 8888 CHERRY       LANEXXXXXXXXXXXXXXXXXXX
54 City                                                         State ZIP code
55 CITYXXXXXXXXXXXXXXXX                                         OH    88888
56
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                                                                         2016 IT 1140 – pg. 5 of 5
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 Layout 

without grid

- 15 -

                                                Do not use staples. Use only black ink and UPPERCASE letters. 

                                                                2016 Ohio IT 1140 
                           Rev. 7/16                    Pass-Through Entity and 
                                                                                                                                                                               16170110
88 88 88
                                                   Trust Withholding Tax Return
                                                                                                                                                                               For taxable year beginning in
                              X Check here if amended return             X Check here if ﬁ nal return                                                                          88/2016
FEIN
88 8888888                                            Entity Type:     X S corporation                                                      X Partnership
                                                      (check only one) X Limited liability company                                          X Trust
Name of pass-through entity
JOHNXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX

Address (if address change, check box)     X
8888 CHERRY   LANEXXXXXXXXXXXXXXXXXXX
City                                                                               State    ZIP code
CITYXXXXXXXXXXXXXXXX                                                               OH       88888
Number of investors            Apportionment ratio, page 3, line 8       Schedule B, line 1 – total of columns A and B
888888                        8 . 888888                                                    888888888 00

Schedule A – Reconciliation Tax and Payments
                                                                                        Column (I) – Withholding Tax                                                            Column (II) – Entity Tax
  1. Tax for each column (from Schedule B, line 11, columns A and B or from Schedule 
      D, line 5) ........................................................................................................................1. 888888888 00                           888888888 00
  2. Interest penalty on underpayment of estimated tax if the sum of columns A and 
      B on line 9 on page 3 exceeds $10,000 (include Ohio IT/SD 2210) .............................2.                                       888888888 00                           888888888 00
 2a. Add lines 1 and 2.........................................................................................................2a.          888888888 00                           888888888 00
  3. Ohio IT 1140ES and IT 1140P payments the entity or trust made and/or 2015 
  ...................................................3.overpayment credited to 2016 (see Note 1 on page 6)                                  888888888 00                           888888888 00
 
3a. Payments transferred from Ohio IT 4708ES and IT 4708P (include schedule if 
      required; see instructions) and other payments previously made for this taxable 
      year .............................................................................................................................3a. 888888888 00
 3b. Payments transferred to Ohio IT 4708 and refunds, if any, previously claimed for 
  ...........................................................................................................3b.this taxable year           888888888 00

   3c. Net payments (sum of lines 3 and 3a minus line 3b) not less than zero .....................3c.                                       888888888 00                           888888888 00

  4. For each column, subtract line 3c from line 2a ...............................................................4.                       888888888 00                           888888888 00
 5. If  the sum of line 4, columns (I) and (II) is an overpayment, enter that sum here
      ..............................................................................................................................................................OVERPAYMENT5. 888888888 00

  6.  Amount of line 5 to be CREDITED to year 2017      .................................................................................CREDIT TO 20176.                         888888888 00

   7.  Amount of line 5 to be REFUNDED (line 5 minus line 6) ......................................................................YOUR REFUND7.                                  888888888 00

   8.   If the sum of line 4, columns (I) and (II) is a balance due or zero, enter here the amount due ............................................8.                              888888888 00

                                                                                                                                                                                   888888888 00
   9. Interest and penalty due on late-paid tax and/or late-ﬁ led return, if any.................................................................................9.
10. Total amount due (sum of  lines 8 and 9). Make check payable to Ohio Treasurer of State. Include 
    Ohio IT 1140P and place FEIN on check................................................................................... TOTAL AMOUNT DUE10.                                  888888888 00
                      If your refund is $1.00 or less, no refund will be issued. If you owe $1.00 or less, no payment is necessary.

                                                                                                                                              2016 IT 1140 – pg. 1 of 5

- 16 -

2016 Ohio IT 1140
Rev. 7/16 Pass-Through Entity and
16170210
FEIN Trust Withholding Tax Return
88 8888888

Sign Here (required): I declare under penalties of perjury that this report, including any ac-
companying schedules and statements, has been examined by me and to the best of my knowledge Do not staple or otherwise attach.
and belief is a true, correct and complete return and report.
Place any supporting documents, including
K-1’s, after the last page of this return.
Pass-through entity ofﬁ cer or agent (print name)
Mail to:
Title of ofﬁ cer or agent (print name) Phone number
Ohio Dept. of Taxation
Signature of pass-through ofﬁ cer or agent Date P.O. Box 181140
Columbus, OH 43218-1140
Preparer’s name (print name) Phone number
Instructions for this form are on our
Preparer’s e-mail address PTIN Web site at tax.ohio.gov.
Do you authorize your preparer to contact us regarding this return? Yes X No X
Schedule B – Qualifying Pass-Through Entities – Tax Due
Use this schedule to calculate the adjusted qualifying amounts and tax due for all qualifying investors in qualifying pass-through entities. Include federal K-1s
and a listing of pass-through credits of participating investors. See “Special Notes” in the instructions, which are available on our Web site at tax.ohio.gov.
(A) (B)
Qualifying Investors Who Are Qualifying Investors Other
Nonresident Individuals Than Nonresident Individuals
1. Sum of all qualifying investors’ distributive shares of income, gain,
expenses and losses............................................................................... 1. 888888888 00 888888888 00

2a. Add X 2/3, X 5/6 or X6/6 (check applicable box) of the qualify-
ing investors’ distributive shares of Internal Revenue Code (I.R.C.)
sections 168(k) and 179 depreciation expense and miscellaneous
federal income tax adjustments, if any. Include a separate schedule
showing calculations............................................................................. 2a. 888888888 00 888888888 00

2b. Subtract qualifying investors’ distributive shares of other statutory
adjustments and miscellaneous federal income tax adjustments, if
any ........................................................................................................ 2b. 888888888 00 888888888 00
3. Qualifying investors’ distributive shares of adjusted qualifying amount:
Sum of lines 1 and 2a minus line 2b ......................................................... 3. 888888888 00 888888888 00

4. Add all qualifying investors’ distributive shares of expenses and
losses incurred in connection with all direct and indirect transactions
between the qualifying pass-through entity and its related members,
including certain investors’ family members (see Note 2 on page 6).
However, do not add expenses or losses incurred in connection with
sales of inventory to the extent that the cost of the inventory and the
loss incurred were calculated in accordance with I.R.C. sections
263A and 482 (see Note 3 on page 6)..................................................... 4. 888888888 00 888888888 00

5. If the qualifying pass-through entity is either a partnership or a
limited liability company treated as a partnership, add all qualifying
investors’ distributive shares of guaranteed payments that the quali-
fying pass-through entity made to any qualifying investor directly or
indirectly owning at least 20% of the qualifying pass-through entity ......... 5. 888888888 00 888888888 00

For Department Use Only

/ /
Postmark date Code

2016 IT 1140 – pg. 2 of 5

- 17 -

                                                        2016 Ohio IT 1140 
                    Rev. 7/16
                                                   Pass-Through Entity and                                                             16170310
FEIN
                                                   Trust Withholding Tax Return
88 8888888

Schedule B – Qualifying Pass-Through Entities – Tax Due...cont.
                                                                                                              (A)                      (B)
  6.  If the qualifying pass-through entity is an S corporation, add all                                Qualifying Investors Who Are Qualifying Investors Other 
 qualifying investors’ distributive shares of compensation that the                                     Nonresident Individuals      Than Nonresident Individuals
 qualifying pass-through entity S corporation made to any qualifying 
 investor directly or indirectly owning at least 20% of the qualifying 
 pass-through entity. Reciprocity agreements do not apply. (See 
 Note 3 on page 6.) ................................................................................ 6. 888888888 00                   888888888 00
  7. Qualifying investors’ adjusted distributive shares. Sum of lines 
 3, 4, 5 and 6, but not less than -0- ....................................................... 7.        888888888 00                   888888888 00

  8.  Apportionment ratio from Schedule C, line 4, below............................ 8.                           8.888888                           8.888888
 
  9. Qualifying investors’ adjusted qualifying amount: Line 7 times 
 line 8. Complete the remainder of this worksheet only if the sum 
 of columns A and B on line 9 exceeds $1,000 .....................................9.                    888888888 00                   888888888 00
 10.  Tax rate (see Note 4 on page 6) ........................................................ 10.                  X .05                            X .085
11.  Tax due: Line 9 times line 10. Round tax to the nearest dollar. Enter 
 the column A amount on page 1, line 1, column I; enter the column 
 B amount on page 1, line 1, column II.................................................. 11.            888888888 00                   888888888 00
Schedule C – Qualifying Pass-Through Entities – Apportionment Worksheet
Use this schedule to calculate the apportionment ratio for a qualifying pass-through entity that is not a ﬁ nancial institution as deﬁ ned in Ohio Revised Code 
section (R.C.) 5725.01. If the pass-through entity is a ﬁ nancial institution, refer to the instructions. Note: All ratios are to be carried to six decimal places.
 1.  Property                                           Within Ohio                                                                  Total Everywhere
    a) Owned (average cost)                        88888888888 00                                                               88888888888 00
                                                        Within Ohio                                                                  Total Everywhere
    b) Rented (annual rental X 8)                  88888888888 00                                                               88888888888 00
                                                        Within Ohio                                                                  Total Everywhere
    c) Total (lines 1a and 1b)                     88888888888 00                                                 ÷             88888888888 00

                                                                                                        Ratio         Weight           Weighted Ratio
                                                        =                                                           x                = 8. 888888
                                                                                                        8. 888888     8.88
                                                        Within Ohio                                                                  Total Everywhere
 2.  Payroll                                       88888888888 00                                                 ÷             88888888888 00
                                                                                                        Ratio         Weight           Weighted Ratio
 
                                                        =                                               8. 888888   x 8.88           = 8. 888888
                                                        Within Ohio                                                                  Total Everywhere
 3.  Sales                                         88888888888 00                                                 ÷             88888888888 00
                                                                                                        Ratio         Weight           Weighted Ratio
 
                                                        =                                               8. 888888     8.88             8. 888888
                                                                                                                    x                =
                                                                                                                                       Weighted Ratio
  4.  Total weighted apportionment ratio (add lines 1c, 2 and 3). Enter ratio here and on line 8, above (both columns).                8. 888888
Note: If the denominator of any factor is zero, the weight given to the other factors must be proportionately increased so that the total weight given to the 
combined number of factors used is 100%, i.e., if no property/payroll, use 25% and 75%; if no sales, use 50% property/payroll; if only one factor, use 100%.

                                                                                                                    2016 IT 1140 – pg. 3 of 5

- 18 -

2016 Ohio IT 1140
Rev. 7/16 Pass-Through Entity and
16170410
FEIN
Trust Withholding Tax Return
88 8888888

Schedule D – Trusts – Tax Due
Use this schedule to calculate the adjusted qualifying amounts and withholding tax due for nonresident individuals who are beneﬁ ciaries of trusts that
made distributions of either income or gain attributable to the trust’s ownership of or disposition of either tangible personal property located in Ohio or real
property located in Ohio.
1. Sum of all distributions to nonresident individuals of income or gain attributable to the trust’s
ownership of or disposition of either tangible personal property located in Ohio or real property
located in Ohio ........................................................................................................................................ 1. 888888888 00

2a. Add X2/3, X 5/6 or X6/6 (check applicable box) of I.R.C. section 168(k) depreciation
expense and miscellaneous federal income tax adjustments attributed to nonresident individu-
als who are beneﬁ ciaries of trusts. Include a separate schedule showing calculations ...................... 2a. 888888888 00

2b. Other statutory adjustments and miscellaneous federal income tax adjustments attributed to
nonresident individuals who are beneﬁ ciaries of trusts ......................................................................... 2b. 888888888 00

3. Adjusted qualifying amount: sum of lines 1 and 2a minus line 2b. Complete the remainder of
the worksheet only if line 3 exceeds $1,000 ........................................................................................... 3. 888888888 00

4. Tax rate ................................................................................................................................................... 4. X .05

5. Tax due: Line 3 times line 4. Round tax to the nearest dollar. Enter here and on page 1, line 1,
column I................................................................................................................................................... 5. 888888888 00

Schedule E – Investor Information
Check the box if this year’s investor information either (i) includes names that were not listed on last year’s return or (ii) excludes names that were listed on
X last year’s return. Provide investor information for all(resident and nonresident) investors in the pass-through entity or trust. List investors by highest to lowest
ownership percentage. Use an additional sheet, if necessary. See Note 5 on page 6 for the amount of pass-through entity tax credits.
SSN FEIN Percent of ownership Amount of PTE tax credit
888 88 8888 88 8888888 8.8888 888888888 00

First name/entity M.I. Last name
JOHNXXXXXXXXXXX Q PUBL I CXXXXXXXXXXXXXX
Address
8888 CHERRY LANEXXXXXXXXXXXXXXXXXXX
City State ZIP code
CITYXXXXXXXXXXXXXXXX OH 88888

SSN FEIN Percent of ownership Amount of PTE tax credit
888 88 8888 88 8888888 8.8888 888888888 00

First name/entity M.I. Last name
JOHNXXXXXXXXXXX Q PUBL I CXXXXXXXXXXXXXX
Address
8888 CHERRY LANEXXXXXXXXXXXXXXXXXXX
City State ZIP code
CITYXXXXXXXXXXXXXXXX OH 88888

2016 IT 1140 – pg. 4 of 5

- 19 -

                                           2016 Ohio IT 1140 
                  Rev. 7/16                Pass-Through Entity and 
                                                                                                                   16170510
FEIN
                                    Trust Withholding Tax Return
88 8888888

Schedule E – Investor Information...cont.
Provide investor information for all (resident and nonresident) investors in the pass-through entity or trust. List investors by highest to lowest ownership percent-
age. Use an additional sheet, if necessary. See Note 5 on page 6 for the amount of pass-through entity tax credits.
SSN                                 FEIN         Percent of ownership      Amount of PTE tax credit
888 88  8888                        88 8888888   8.8888                    888888888 00

First name/entity                              M.I. Last name
JOHNXXXXXXXXXXX                                Q PUBL I CXXXXXXXXXXXXXX
Address
8888 CHERRY       LANEXXXXXXXXXXXXXXXXXXX
City                                                         State ZIP code
CITYXXXXXXXXXXXXXXXX                                         OH    88888

SSN                                 FEIN         Percent of ownership      Amount of PTE tax credit
888 88  8888                        88 8888888   8.8888                    888888888 00

First name/entity                              M.I. Last name
JOHNXXXXXXXXXXX                                Q PUBL I CXXXXXXXXXXXXXX
Address
8888 CHERRY       LANEXXXXXXXXXXXXXXXXXXX
City                                                         State ZIP code
CITYXXXXXXXXXXXXXXXX                                         OH    88888

SSN                                 FEIN         Percent of ownership      Amount of PTE tax credit
888 88  8888                        88 8888888   8.8888                    888888888 00

First name/entity                              M.I. Last name
JOHNXXXXXXXXXXX                                Q PUBL I CXXXXXXXXXXXXXX
Address
8888 CHERRY       LANEXXXXXXXXXXXXXXXXXXX
City                                                         State ZIP code
CITYXXXXXXXXXXXXXXXX                                         OH    88888

SSN                                 FEIN         Percent of ownership      Amount of PTE tax credit
888 88  8888                        88 8888888   8.8888                    888888888 00

First name/entity                              M.I. Last name
JOHNXXXXXXXXXXX                                Q PUBL I CXXXXXXXXXXXXXX
Address
8888 CHERRY       LANEXXXXXXXXXXXXXXXXXXX
City                                                         State ZIP code
CITYXXXXXXXXXXXXXXXX                                         OH    88888

                                                                      2016 IT 1140 – pg. 5 of 5

- 20 -

General information 

regarding this form

- 21 -

            General Information (2016 IT 1140):
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 on each page of the IT 1140.

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 ﬁ rst six numbers are constant for this form (161701XX - 161705XX). 

  16 = tax year
  17 = IT 1140 
  01-05 = page number 
  XX = vendor number (assigned to you by the Ohio Dept. of Taxation, Forms Unit).

  NOTE: The vendor number also serves as the ﬁ rst two digits of the SSN and FEIN ﬁ elds in the test 
  scenarios.

3) Use Arial font for the static text on the form.

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

5) Follow the grid layout for the variable data ﬁ elds 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 ﬁ elds except where shown in specs.

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

8) You must include a leading zero on ratio ﬁ elds. For example, if the ratio is .000026, it should display as 0.000026.

9) When a variable data ﬁ eld reﬂ ects a negative amount, make sure there is no space between the negative sign 
and the amount (for example: -888888888 00). The possible negative ﬁ elds for this return are lines Schedule A, 
line 4; Schedule B, line 1, 3 and 4; and Schedule D, line 1 and 3. Do not hard-code negative signs.

10) Provide guidance to customers regarding duplex printing that instructs them to print pages 1 and 2 together 
and pages 3 and 4 together. Taxpayers have ﬁ led 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.

11) Generate the following message for customers: “Do not enclose other documentation unless it is speciﬁ ed 
on the tax return or instructions.” Taxpayers often submit worksheets and receipts from the vendor product, 
which slows the processing of tax returns.

12) 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.”

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

PDF file checksum: 1692022277

(Plugin #1/9.12/13.0)