Taxable year beginning in 
                                                                                                                                                                             Schedule J 
                                                                                                                                                                             Rev. 11/14 
                                                                                      2014 
Primary SS#                                                    
                                                            Schedule J
            Dependents Claimed on the Ohio IT 1040EZ or IT 1040 Return
Use UPPERCASE letters. 
Use this dependent schedule to claim dependents on your Ohio form IT 1040EZ or IT 1040. If you have more than 14 dependents, copy page 2 of this sched-
ule and include all completed pages with your income tax return. Do not list on this schedule the primary and/or spouse reported on the income tax return. 
1.  Dependent’s Social Security no. (required) Dependent's date of birth (MM/DD/YYYY) 

Dependent’s fi rst name                               M.I.      Last name 

2.  Dependent’s Social Security no. (required) Dependent's date of birth (MM/DD/YYYY) 

Dependent’s fi rst name                               M.I.      Last name 

3.  Dependent’s Social Security no. (required) Dependent's date of birth (MM/DD/YYYY) 

Dependent’s fi rst name                               M.I.      Last name 

4.  Dependent’s Social Security no. (required) Dependent's date of birth (MM/DD/YYYY) 

Dependent’s fi rst name                               M.I.      Last name 

5.  Dependent’s Social Security no. (required) Dependent's date of birth (MM/DD/YYYY) 

Dependent’s fi rst name                               M.I.      Last name 

6.  Dependent’s Social Security no. (required) Dependent's date of birth (MM/DD/YYYY) 

Dependent’s fi rst name                               M.I.      Last name 

                       Do not staple or otherwise attach. Place your  W-2(s), check  
                       (payable to Ohio Treasurer of State), Ohio form IT 40P and any  
                       other supporting documents or statements after the last page of  
                       your return. Include forms W-2G and 1099-R if tax was withheld.  

                                                     Go paperless. It’s FREE!
                                               Visit tax.ohio.gov to try Ohio I-File.
                       MostMost taxpayerstaxpayers whowho fi le their returns electronically and request                                                    file their returns electronically and request 
                       direct deposit will receive their refunds in 10-15 business days. direct deposit will receive their refunds in 10-15 business days. 
                       Paper returns will take approximately 30 days to process.Paper returns will take approximately 30 days to process. 

2014 Schedule J                                                                             2014 Schedule J 
                                                               - 1 -

                                                                                      Taxable year beginning in 
                                                                                                                Schedule J 
                                                                                                                Rev. 11/14 
                                                                                      2014 
Primary SS#                                         

                                               Schedule J
            Dependents Claimed on the Ohio IT 1040EZ or IT 1040 Return
Use UPPERCASE letters. 
Use this dependent schedule to claim dependents on your Ohio form IT 1040EZ or IT 1040. If you have more than 14 dependents, copy page 2 of this sched-
ule and include all completed pages with your income tax return. Do not list on this schedule the primary and/or spouse reported on the income tax return. 
7.  Dependent’s Social Security no. (required) Dependent's date of birth (MM/DD/YYYY) 

Dependent’s fi rst name                         M.I. Last name 

8.  Dependent’s Social Security no. (required) Dependent's date of birth (MM/DD/YYYY) 

Dependent’s fi rst name                         M.I. Last name 

9.  Dependent’s Social Security no. (required) Dependent's date of birth (MM/DD/YYYY) 

Dependent’s fi rst name                         M.I. Last name 

10. Dependent’s Social Security no. (required) Dependent's date of birth (MM/DD/YYYY) 

Dependent’s fi rst name                         M.I. Last name 

11. Dependent’s Social Security no. (required) Dependent's date of birth (MM/DD/YYYY) 

Dependent’s fi rst name                         M.I. Last name 

12. Dependent’s Social Security no. (required) Dependent's date of birth (MM/DD/YYYY) 

Dependent’s fi rst name                         M.I. Last name 

13. Dependent’s Social Security no. (required) Dependent's date of birth (MM/DD/YYYY) 

Dependent’s fi rst name                         M.I. Last name 

14. Dependent’s Social Security no. (required) Dependent's date of birth (MM/DD/YYYY) 

Dependent’s fi rst name                         M.I. Last name 

2014 Schedule J                                                                       2014 Schedule J
                                                    - 2 -